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Physical Recovery After Transfemoral Amputation Using Press-Fit Percutaneous Osseointegrated Prosthesis.

Jesse C Christensen¹, Jacob Smith¹, Benjamin J Darter²

¹Veterans Affairs Salt Lake City Health Care System, Department of Physical Medicine and Rehabilitation, 500 So, Foothill Dr., Salt Lake City, UT, USA, 84148.

Archives of Physical Medicine and Rehabilitation

|March 28, 2026

Summary

Press-fit percutaneous osseointegrated prosthesis (POP) improves gait economy and mobility within 12 months post-implantation. Early gains in gait economy and CHAMP scores suggest faster recovery compared to other physiological measures.

Keywords:

amputation metabolic economy physical activity physical function press-fit percutaneous osseointegrated prosthesis

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Area of Science:

Orthopedics and Rehabilitation Engineering
Biomedical Engineering
Prosthetics and Orthotics

Background:

Press-fit percutaneous osseointegrated prosthesis (POP) offers an alternative to traditional socket suspension for transfemoral amputees.
Limited research exists on the physical recovery trajectory following POP implantation.
Understanding recovery patterns is crucial for patient and clinician expectations.

Purpose of the Study:

To evaluate the physical recovery of patients after transfemoral amputation and POP implantation.
To assess changes in gait economy, gait speed, exertional heart rate, CHAMP scores, and daily step counts over 12 months.
To establish a baseline for expected recovery outcomes post-POP.

Main Methods:

Prospective longitudinal cohort study conducted at an academic hospital.
Ten participants with unilateral transfemoral amputation underwent POP surgery.
Outcome measures included gait economy, gait speed, exertional heart rate, CHAMP, and daily step counts.

Main Results:

Significant improvements in gait economy were observed at 3, 6, and 12 months post-POP (p<0.01).
CHAMP scores significantly increased at 6 and 12 months (p<0.01), with earlier gains noted.
Gait speed, exertional heart rate, and daily step counts showed significant improvements at 12 months (p<0.05).

Conclusions:

POP implantation leads to significant physical recovery over 12 months, particularly in gait economy and mobility.
Gait economy and CHAMP scores demonstrate earlier improvements, guiding expectations for initial recovery phases.
These findings aid in setting patient expectations and identifying individuals who may need targeted interventions.