title: Ultrasonographic assessment of the quadriceps muscle and femoral cartilage in transtibial amputees using different prostheses.
abstract: BACKGROUND
  In patients with lower limb amputations, gait alteration, increased loading on the intact extremity, and use of prosthesis may lead to joint degeneration.
  
  
  OBJECTIVE
  To explore the effects of prosthesis type on quadriceps muscle and distal femoral cartilage thicknesses in transtibial amputees.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  A total of 38 below-knee amputees were enrolled in the study, of which 13 patients were using vacuum system type prosthesis and 25 patients were using silicon liner pin system prosthesis. Patients' femoral cartilage and quadriceps muscle thickness measurements were performed using musculoskeletal ultrasound.
  
  
  RESULTS
  When compared with the intact sides, cartilage and rectus femoris, vastus intermedius, and vastus medialis muscle thickness values were significantly decreased on the amputee sides (all p < 0.05). Clinical characteristics and ultrasound measurements were similar between the two groups except the lateral and medial femoral condyle thicknesses, thinner in the silicon liner pin system users (both p < 0.05).
  
  
  CONCLUSIONS
  The distal femoral cartilage and quadriceps muscle thicknesses were found to be decreased on the amputated sides, and the negative impact on the cartilage seemed to be worse in the silicon liner pin system users.
  
  
  CONCLUSIONS
  This study might provide another argument as regards the preference of vacuum system type prosthesis to prevent possible knee osteoarthritis due to cartilage thinning in adult transtibial amputees.
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
authors.forename: Şule
authors.initials: Ş
authors.lastname: Şahin Onat
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
authors.forename: Fevziye Ünsal
authors.initials: FÜ
authors.lastname: Malas
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey gokhantuna06@gmail.com.
authors.forename: Gökhan Tuna
authors.initials: GT
authors.lastname: Öztürk
authors.affiliation: Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey.
authors.forename: Nuray
authors.initials: N
authors.lastname: Akkaya
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kara
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Özçakar
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D001186:Artificial Limbs; D002356:Cartilage / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging*; D013977:Tibia; D014463:Ultrasonography; D016474:Weight-Bearing
keywords: Amputee; cartilage; muscle; prosthesis; transtibial