The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees.
OBJECTIVE
To determine whether amputees have an increased risk of knee pain or symptomatic osteoarthritis (OA) compared with nonamputees.


METHODS
Retrospective cohort study.


METHODS
Veterans Administration Patient Treatment and Outpatient Care files.


METHODS
All male unilateral (transtibial or transfemoral) traumatic amputee patients and a random sample of male nonamputees. Patients were excluded if they were younger than 40 years, had sustained a significant injury to their knee(s), or had a rheumatic disease.


METHODS
Not applicable.


METHODS
The prevalence of knee pain and symptomatic knee OA.


RESULTS
The age and average weight-adjusted prevalence ratio of knee pain among transtibial amputees, compared with nonamputees, was 1.3 (95% confidence interval [CI], 0.7-2.1) for the knee of the intact limb and 0.2 (95% CI, .05-0.7) for the knee of the amputated limb. The standardized prevalence ratio of knee pain in the intact limb and symptomatic OA among transfemoral amputees, compared with nonamputees, was 3.3 (95% CI, 1.5-6.3) and 1.3 (95% CI, 0.2-4.8), respectively.


CONCLUSIONS
Stresses on the contralateral knee of amputees may contribute to secondary disability. Possible explanations include gait abnormalities, increased physiologic loads on the knee of the intact limb, and the hopping and stumbling behavior common in many younger amputees.
Norvell
Daniel C
DC
Health Services Research and Development, Seattle, WA, USA. dan@olympicresearch.com
Czerniecki
Joseph M
JM
Reiber
Gayle E
GE
Maynard
Charles
C
Pecoraro
Janice A
JA
Weiss
Noel S
NS
D000328:Adult; D000368:Aged; D000465:Algorithms; D000673:Amputation, Traumatic / Q000150:complications*; D000674:Amputees / Q000534:rehabilitation*; D016001:Confidence Intervals; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology*; D010146:Pain / Q000145:classification / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014728:Veterans