Akkaya Nuray, Akkaya Semih, Özçakar Levent, Demirkan Fahir, Kiter Esat, Konukcu Sibel, Ardic Fusun
Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Pamukkale University, Denizli, Turkey.
Prosthet Orthot Int. 2013 Aug;37(4):268-74. doi: 10.1177/0309364612464233. Epub 2012 Nov 9.
Lower limb amputation sometimes predisposes to degenerative secondary disorders.
To evaluate the distal femoral cartilage thicknesses of patients with unilateral transtibial amputations using ultrasound and to investigate the relationship between cartilage thickness and disease-related parameters.
Cross-sectional study.
Twenty-four unilateral transtibial amputees (mean age: 46.4 ± 8.5 years, range: 28-60 years) were evaluated. Duration of prosthesis use (years) and daily walking time with prosthesis (hours) were recorded. Functional status was assessed by gate velocity (m/s), and 6-min walking distance (m) with prosthesis. Ultrasound was used to measure distal femoral cartilage thicknesses bilaterally at medial/lateral condyles and the intercondylar areas. The percentages of cartilage loss (of the amputee-side in comparison with the nonamputee-side) were calculated.
Compared to the nonamputee-sides, distal femoral cartilage was significantly thinner at lateral condyles and the intercondylar areas on the amputee-sides (p < 0.05). Significant positive correlations were detected between the percentage of cartilage loss (at all three sites of measurement) and gate velocity, 6-min walking distance, and daily walking time with prosthesis (all p < 0.05).
Future prospective controlled studies are warranted to determine the principles of optimum prosthetic use regarding its possible effects on the femoral cartilage of amputee patients.
The correlations between the cartilage loss in the amputee extremity with faster gait and longer daily prosthetic use suggest that abnormal gait patterns might increase the loading on the amputated extremity.
下肢截肢有时易引发退行性继发性疾病。
使用超声评估单侧经胫骨截肢患者的股骨远端软骨厚度，并研究软骨厚度与疾病相关参数之间的关系。
横断面研究。
对24名单侧经胫骨截肢者（平均年龄：46.4±8.5岁，范围：28 - 60岁）进行评估。记录假体使用时长（年）和使用假体的每日步行时间（小时）。通过步速（米/秒）和使用假体的6分钟步行距离（米）评估功能状态。使用超声双侧测量股骨远端内侧/外侧髁及髁间区域的软骨厚度。计算软骨损失百分比（截肢侧与非截肢侧相比）。
与非截肢侧相比，截肢侧股骨远端外侧髁和髁间区域的软骨明显更薄（p < 0.05）。在软骨损失百分比（所有三个测量部位）与步速、6分钟步行距离和使用假体的每日步行时间之间检测到显著正相关（均p < 0.05）。
有必要进行未来的前瞻性对照研究，以确定最佳假体使用原则及其对截肢患者股骨软骨可能产生的影响。
截肢肢体的软骨损失与更快的步态和更长的每日假体使用时间之间的相关性表明，异常步态模式可能会增加截肢肢体的负荷。
