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Changes in hip muscles after above-knee amputation

S M Jaegers1, J H Arendzen, H J de Jongh

  • 1Department of Anatomy and Embryology, University of Groningen, The Netherlands.

Clinical Orthopaedics and Related Research
|October 1, 1995
PubMed
Summary

Above-knee amputation causes hip muscle atrophy and changes in muscle geometry. Fixing hip adductors is crucial to prevent contractures, especially with higher amputation levels.

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Area of Science:

  • Orthopedics
  • Reconstructive Surgery
  • Biomedical Engineering

Background:

  • Above-knee amputation (AKA) can lead to significant musculoskeletal changes in the hip.
  • Understanding these changes is vital for improving patient rehabilitation and functional outcomes.
  • Previous studies have not fully detailed the specific muscular alterations post-AKA.

Purpose of the Study:

  • To investigate the morphological and functional changes in hip muscles following above-knee amputation.
  • To identify factors contributing to contracture development after AKA.
  • To evaluate the impact of surgical techniques on muscle atrophy and joint mobility.

Main Methods:

  • Three-dimensional reconstructions were created from magnetic resonance images (MRIs) of the hip and thigh region in 12 AKA patients.

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  • Patients underwent amputation at least two years prior due to trauma or osteosarcoma.
  • Muscle atrophy and contracture development were assessed in relation to amputation level and surgical fixation.

    • Main Results:

    • Significant atrophy was observed in both cleaved (40%-60%) and intact (0-30%) hip muscles on the amputated side.
    • Muscle atrophy correlated with stump length.
    • Failure to fix the iliotibial tract increased the risk of flexion contracture and decreased hip extension torque.
    • Accurate fixation of hip adductors was necessary to prevent abduction contracture, particularly at higher amputation levels.

    Conclusions:

    • Above-knee amputation alters hip muscle geometry and leads to significant muscle atrophy.
    • Flexion contractures can develop due to decreased hip extension torque and unopposed iliopsoas action.
    • Surgical management, including precise fixation of the iliotibial tract and hip adductors, is critical for preventing contractures and optimizing function after AKA.