title: Socket versus bone-anchored trans-femoral prostheses: hip range of motion and sitting comfort.
abstract: This is the first study to report on hip range of motion (ROM) among active prosthesis users, when wearing and not wearing a trans-femoral socket prosthesis and to compare with individuals rehabilitated with an osseointegrated bone-anchored prosthesis. In addition, discomfort when sitting with the prosthesis is reported in both groups. The study group all had a non-vascular amputation and were divided into those supplied with a socket prosthesis (S group) (n = 43, mean age 51 years, 74% men) or a bone-anchored prosthesis (OI group) (n = 20, mean age 46 years, 75% men). Active hip ROM was measured with a goniometer, and self-reported problems with discomfort when sitting were recorded. The hip motion decreased in all directions when wearing the socket prosthesis compared to without it (P < 0.001 for all directions), and 37% of the subjects had less than 90 degrees of hip flexion when wearing their prosthesis. Discomfort when sitting was reported among 44% (n = 19) in the S group and was more common among individuals with less than 90 degrees of hip flexion motion (P= 0.025). In the OI group, no restriction in hip motion was measured with the prosthesis, and no subject had less than 90 degrees of flexion and 5% (n = 1) reported discomfort when sitting. This study shows that a trans-femoral prosthetic socket significantly reduces the ROM of the hip and that discomfort when sitting is common among individuals wearing such prostheses. Further, the study confirms that individuals using a bone-anchored prosthesis have no restricted hip motion with the prosthesis and report very few problems with discomfort when sitting.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden. kerstin.hagberg@vgregion.se
authors.forename: K
authors.initials: K
authors.lastname: Hagberg
authors.forename: E
authors.initials: E
authors.lastname: Häggström
authors.forename: M
authors.initials: M
authors.lastname: Uden
authors.forename: R
authors.initials: R
authors.lastname: Brånemark
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006621:Hip Joint / Q000502:physiology*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D016059:Range of Motion, Articular