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Publication Date


Publication Title

Acta Scientific Orthopaedics



Medical Subject Headings

Physical Therapy, Prosthetics, Amputation


Abstract Background: There is a rising number of individuals undergoing lower extremity amputation (LEA) and is associated with increased risk of comorbidities. Osteoarthritis (OA) and Degenerative Joint Disease (DJD) are conditions that cause reduction in an individual’s function, independence, and quality of life.

Research Design: A search of multiple databases using terms associated with possible functional declines as evidenced by the International Classification of Functioning, Disability and Health (ICF), followed by assessment of evidence using the PEDro scoring method will be conducted. Multiple reviewers will screen, sort, rate and extract data from articles.

Methods: A computer-aided literature search of PubMed, CINAHL, and Google Scholar was performed to identify studies published beginning in 2009 that investigated factors that contribute to degenerative changes in the contralateral limb of a unilateral LEA.

Results: A total of 21 studies were selected from a total of 56 collected studies. Predictors of osteoarthritis (OA) following lower limb amputation include age, etiology, level of amputation, gender, Body Mass Index (BMI), comorbidity, pain, phantom pain, streng and OA. The impact of ground reaction forces on the sound limb varies between studies. In general, poor gait mechanics and resulting compensatory mechanisms are significant contributors to the occurrence of OA.

Conclusion: There is a dearth of information relating to the prevention of degenerative changes in those with LEA and protocols for pain management and training pre- and post-joint replacement. The incidence of OA in the contralateral limb is still not fully understood. Further investigation into the biomechanics of compensatory mechanisms is necessary to fully understand the functional impact on the population. It is imperative to develop thorough physical therapy protocols for individuals in early onset of OA and those undergoing joint replacement due to degeneration.





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Originally published as:

Donnelly KM, Davis C, Liotta N, Perkins A, Agrawal, V, Highsmith J & Love S. Assessing ground reaction forces and degenerative changes of sound limb in unilateral lower extremity amputees: A systematic review. Acta Scientific Orthopaedics. 2022;5(9):10-27. 2022.

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