Ultrasonographic assessment of the quadriceps muscle and femoral cartilage in transtibial amputees using different prostheses

Abstract

Background: In patients with lower limb amputations, gait alteration, increased loading on the intact extremity, and use of prosthesis may lead to joint degeneration. Objective: To explore the effects of prosthesis type on quadriceps muscle and distal femoral cartilage thicknesses in transtibial amputees. Study design: A cross-sectional study. Methods: A total of 38 below-knee amputees were enrolled in the study, of which 13 patients were using vacuum system type prosthesis and 25 patients were using silicon liner pin system prosthesis. Patients' femoral cartilage and quadriceps muscle thickness measurements were performed using musculoskeletal ultrasound. Results: When compared with the intact sides, cartilage and rectus femoris, vastus intermedius, and vastus medialis muscle thickness values were significantly decreased on the amputee sides (all p < 0.05). Clinical characteristics and ultrasound measurements were similar between the two groups except the lateral and medial femoral condyle thicknesses, thinner in the silicon liner pin system users (both p < 0.05). Conclusion: The distal femoral cartilage and quadriceps muscle thicknesses were found to be decreased on the amputated sides, and the negative impact on the cartilage seemed to be worse in the silicon liner pin system users. Clinical relevance This study might provide another argument as regards the preference of vacuum system type prosthesis to prevent possible knee osteoarthritis due to cartilage thinning in adult transtibial amputees. ©The International Society for Prosthetics and Orthotics 2015.