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Beitragstitel Transfemoral amputation: assessment before and after a new distal weight-bearing implant
Beitragscode P112
Autoren
  1. Gorki Carmona Hôpitaux Universitaires de Genève Vortragender
  2. Alain Lacraz Hôpitaux Universitaires de Genève
  3. Axel Gamulin Hôpitaux Universitaires de Genève
  4. Hala Kutaish HUG - Hôpitaux Universitaires de Genève
  5. Alice BONNEFOY Hôpitaux Universitaires de Genève et Universités de Genève
  6. Stéphane Armand Geneva University Hospitals and University of Geneva
  7. Mathieu Assal Centre ASSAL de Médecine et de Chirurgie du Pied
Präsentationsform Poster
Themengebiete
  • A08 - Grundlagenforschung
Abstract BACKGROUND
Individuals with a transfemoral amputation may experience limitations in activities of daily living due to reduced mobility and prosthesis-related problems with several hard socket designs. In this context, we proposed a new internal femoral implant that allows for distal weight-bearing. This implant, named MAKAN®, was developed at the University Hospitals of Geneva with improvement of the gait and the use of the prosthetics satisfaction as goals.

AIM
To assess change in gait quality, mobility, physical function, pain and satisfaction with use in daily life before-and-after MAKAN® implantation using validated outcome measurement tools.

METHODS
A 64-year-old with a left traumatic amputation underwent clinical gait analysis (CGA) with a traditional hard socke tprosthesis including the ischial tuberosity, and 6 months after MAKAN® implantation. The CGA was performed with shoes and sticks.at different walking speeds Spatio-temporal parameters, including kinematics of the hip, knee and ankle were calculated and compared. In addition, the patient underwent several tests, including 6-minutes walk test (6-WT), TUG, Tinetti, and Short Physical Performance Battery (SPPB). Patient satisfaction with use of the prosthesis (Satpro) and the level of pain (AVS) were evaluated at each session

RESULTS
At the second evaluation, CGA was higher on the MAKAN® side (0.64 ± 0.03 m/s vs. 0.56 ± 0.04 m/s). We observed also a better ankle and knee kinematic for the sound side. For the left side, we observed a better angle foot progression and hip kinematic. The step width was lower at second CGA (0.13 ± 0.01m vs. 0.21 ± 0.01m) and the Tinetti test evolved from 22 to 25 points, reflecting a better equilibrium. The 6-WT improved by 45.5 % (165 to 240 m). The SPPB was 2 points improved (7 to 9). TUG was realized in 18 seconds instead of 23 with traditional hard socket. AVS went from 4 to 2: There was no difference with Satpro.

DISCUSSION AND CONCLUSION
The use of the MAKAN® prosthesis produced improvements for the patient in terms of gait quality, speed and distance of walking, equilibrium, physical function and level of pain. We did not observe any difference concerning patient satisfaction with use of the MAKAN®