Article

Pain and pain-related interference with physical function have not been
thoroughly studied in individuals who have undergone knee-disarticulation
amputations. The principal aim of this study was to determine whether individuals
with knee-disarticulation amputations have worse pain and pain-related
interference with physical function than do individuals with transtibial or
transfemoral amputations. We analyzed cross-sectional survey data provided by 42
adults with lower-limb amputations. These individuals consisted of 14 adults
reporting knee-disarticulation amputation in one limb and best-matched cases (14
reporting transfemoral amputation and 14 reporting transtibial amputation) from a
larger cross-sectional sample of 472 individuals. Participants were rigorously
matched based on time since amputation, reason for amputation, age, sex, diabetes
diagnosis, and pain before amputation. Continuous outcome variables were analyzed
by one-way analysis of variance. Categorical outcomes were analyzed by Pearson
chi-square statistic. Given the relatively small sample size and power concerns,
mean differences were also described by estimated effect size (Cohen's d). Of the
42 participants, 83% were male. They ranged in age from 36 to 85 (median = 55.1,
standard deviation = 11.0). Most amputations were of traumatic origin (74%), and
participants were on average 12.4 years from their amputations at the time of the
survey. Individuals with transtibial amputation reported significantly more
prosthesis use than did individuals with knee-disarticulation amputation.
Amputation levels did not significantly differ in phantom limb pain, residual
limb pain, back pain, and pain-related interference with physical function.
Estimates of effect size, however, indicated that participants with
knee-disarticulation amputation reported less phantom limb pain, phantom limb
pain-related interference with physical function, residual limb pain, residual
limb pain-related interference with physical function, and back pain-related
interference with physical function than did participants with transtibial or
transfemoral amputations. This study demonstrated that patients with
knee-disarticulation amputation used prostheses significantly less than did
patients with transtibial amputation. However, no evidence was found that
patients with knee-disarticulation amputation have worse outcomes in terms of
pain and pain-related interference with physical function; in fact, they may have
more favorable long-term outcomes.

Langue : ANGLAIS