Ambulation Ability and Quality of Life in Subjects With Transfemoral Amputation: A Comparison Between Osseointegration and Socket Prostheses

Hendrik Van de Meent, MD, PhD,a Maria T. Hopman, PhD,b Jan Paul Fro ̈lke, MD, PhDc

Despite advances in reducing the friction and load-bearing drawbacks of socket prostheses, chronic skin problems continue to affect 1/3 of transfemoral amputees using this type of artificial limb.
Osseointegration avoids these problems since the prosthetic limb is directly connected to the human skeleton. Among the advantages of osseointegration we find: better control and stability, better fixation, greater comfort in a sitting position, greater range of movement of the hip, better perception of the body, recovery of proprioception, increased ability to walk, better functional capacity and general improvement in quality of life.
This study aims to compare ambulation ability and quality of life of 22 subjects before and after their osseointegration procedure. The average age of the participants was 46.5 years, the time since their amputation was 16.4 years, and the causes of amputation were trauma (n=20) and tumors (n=2). The measures taken into account were: Questionnaire for People with Transfemoral Amputees (Q-TFA) score, prosthesis use (hours per week), ambulation ability (6-minute test), Up & Forward time (time to get up from the chair) & oxygen consumption during ambulation.

All patients significantly increased the use of their prosthesis and their quality of life (Table 2).

  • Q-TFA note: osseointegration (63) vs. lace (39)
  • Prosthesis use: osseointegration (101 h/week) vs. lace (56 hrs/week).
  • 6-minute test: osseointegration (423 meters) vs. lace (321 meters)
  • Up and Forward Time: osseointegration (8 sec) vs. lace (15 sec)
  • Oxygen consumption: osseointegration (1093 ml/min) vs. lace (1330ml/min)
Osseointegration increases ambulation and quality of life for individuals with transfemoral amputations who have limb and skin-related problems due to the use of socket prostheses.