Tan Janice, Zilani Nafisa, Karim Rezaul, Patel Bijendra
Barts Cancer Institute, Queen Mary University of London, London, UK.
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Orthop Surg. 2025 Aug;17(8):2234-2254. doi: 10.1111/os.70086. Epub 2025 Jul 18.
Amputation has a profound impact on an individual's quality of life (QoL) and functional ability. While socket prostheses are the current first-line treatment, they often cause socket-related issues. Bone-anchored prostheses (BAP) have been introduced to address these problems and improve the amputee experience. This systematic review and meta-analysis aim to compare the QoL between bone-anchored and socket prostheses in transfemoral amputees. A systematic review and meta-analysis were conducted from November 2023 to July 2024, following PRISMA guidelines. Databases including PUBMED, EMBASE, Scopus, Cochrane, and Web of Science were searched. Studies of single-arm trial design comparing pre- and post-operative outcomes were selected based on specific inclusion and exclusion criteria. Statistical analysis was performed using inverse variance with a random effect model. The primary outcome was QoL, measured using the Questionnaire for Persons with a Transfemoral Amputation (Q-TFA) and 36-Item Short Form Survey (SF-36), and the secondary outcome was mobility, assessed by the 6-Minute Walk Test (6MWT). Subgroup analyses compared different types of BAP (Press-fit vs. Screw-type) on QoL. Thirteen NRCTs with 398 participants were included. Significant improvements in QoL were observed in all Q-TFA domains and the SF-36 Physical Component Score (PCS), but not in the SF-36 Mental Component Score (MCS). Mobility improved significantly as measured by the six-minute walk test (6MWT). No significant differences in QoL were found between Press-fit and Screw-type BAP implants. Overall, BAP significantly improve both QoL and mobility, but study limitations currently restrict their use to individuals with socket-related complications. As such, it cannot yet be universally recommended as a first-line intervention.
截肢对个人的生活质量（QoL）和功能能力有深远影响。虽然接受腔假肢是目前的一线治疗方法，但它们常常引发与接受腔相关的问题。骨锚式假肢（BAP）已被引入以解决这些问题并改善截肢者的体验。本系统评价和荟萃分析旨在比较经股骨截肢者使用骨锚式假肢和接受腔假肢后的生活质量。按照PRISMA指南，于2023年11月至2024年7月进行了一项系统评价和荟萃分析。检索了包括PUBMED、EMBASE、Scopus、Cochrane和科学网在内的数据库。根据特定的纳入和排除标准，选择了比较术前和术后结果的单臂试验设计研究。采用随机效应模型的逆方差法进行统计分析。主要结局是生活质量，使用经股骨截肢者问卷（Q-TFA）和36项简短健康调查（SF-36）进行测量，次要结局是 mobility，通过6分钟步行试验（6MWT）进行评估。亚组分析比较了不同类型的骨锚式假肢（压配式与螺旋式）对生活质量的影响。纳入了13项非随机对照试验，共398名参与者。在所有Q-TFA领域和SF-36身体成分评分（PCS）中观察到生活质量有显著改善，但在SF-36心理成分评分（MCS）中未观察到。通过6分钟步行试验（6MWT）测量，mobility有显著改善。压配式和螺旋式骨锚式假肢植入物在生活质量方面未发现显著差异。总体而言，骨锚式假肢显著改善了生活质量和mobility，但目前的研究局限性使其仅适用于有接受腔相关并发症的个体。因此，它尚未能被普遍推荐作为一线干预措施。
