Acta Scientific Orthopaedics
Background: Following a transfemoral amputation (TFA), osteoarthritis (OA) on the sound limb may occur secondary to overuse. Potential causative factors include gait abnormalities, increased knee load, and performing hopping activities without a prosthesis. Unilateral TFA patients may require a total knee arthroplasty (TKA) to improve function.
Case Description and Methods: A 56-year-old male with a TFA who was diagnosed with left knee OA and was classified as a limited community ambulator underwent a TKA to restore function. The purpose of this case report is to determine the benefits of standard physical therapy (PT) augmented by a high intensity, whole-body strengthening program. PT examinations, interventions, and outcomes were analyzed from one-week pre-TKA to one-year post-TKA. Multiple outcome measures were utilized to assess progress including the Single Leg Stance Test (SLST), Four Square Step Test (FSST), Timed Up and Go Test (TUG), and Six Minute Walk Test (6MWT).
Findings: Patient achieved functional independence, normalized gait, lower extremity strength, and lower extremity active range of motion (AROM) goals.
Outcomes and Conclusion: The results of the TUG and FSST from the patient equaled those of non-amputees. The standard PT protocols post-TKA contributed to the patient’s success, while the high intensity, whole-body strengthening program contributed to patient’s achievements.
Clinical Relevance Statement: This case study suggests rehabilitation interventions in a relatively healthy unilateral TFA with sound limb TKA may be appropriate at a higher level of intensity, than typically prescribed, to regain functional independence.
Love S, Gray D, Yent J, Highsmith MJ. Physical Therapy Interventions and Outcomes in a Patient with Transfemoral Amputation Following Sound Side Total Knee Arthroplasty: A Case Report. Acta Scientific Orthopaedics. 2022; 5(1):5-10.