Pröbsting E, Kannenberg A, Blumentritt S. BACK PAIN AND OSTEOARTHRITIS AS SECONDARY DISABILITIES OF LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32034 1 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) BACK PAIN AND OSTEOARTHRITIS AS SECONDARY DISABILITIES OF LOWER LIMB AMPUTATION Eva Pröbsting1*, Andreas Kannenberg2, Siegmar Blumentritt3 1 OttoBock HealthCare GmbH, Germany. 2 Otto Bock Healthcare LP, USA. 3 PFH Göttingen, Germany. * Email: Eva.Proebsting@ottobock.de DOI: https://doi.org/10.33137/cpoj.v1i2.32034 INTRODUCTION Long-term damages after lower extremity amputation have previously been analysed in three systematic reviews 5–7 showing that amputees have a higher risk for developing knee and hip osteoarthritis on the sound side. The altered gait pattern appears to increase the load on the sound side.1–3 This paper analysed the extent to which the above described assumption is supported by the scientific literature with specific focus on the risk of developing back pain and osteoarthritis in amputees. METHODS A systematic literature search (EMBASE, Medline, Journal of Prosthetics and Orthotics database) was conducted for publications that had investigated changes caused by amputations. Furthermore, the references of identified publications were also scanned for pertinent publications. All suitable articles were qualitatively analyzed and the available quantitative results were summarized. RESULTS The search identified 20 relevant studies,4-23 reporting back pain and 14 studies, 5-8, 11, 13, 20, 24-30 on osteoarthritis. The prevalence of back pain is increased for amputees in comparison to the able-bodied population. Furthermore, amputees suffer more often from clinical signs of knee and hip osteoarthritis. Nevertheless, the prevalence of radiographic signs is increased for the sound knee of the amputees. There are different reasons given in the literature for this increased risks. The altered gait 14, 17 and leg length discrepancies6, 11, 13, 20 seems to have a big influence on the back pain. For the increased prevalence of the osteoarthritis, these parameters 6, 11, 27, 28 as well as hopping 28 and standing without the prosthesis28 are contributing factors. Figure 1. Quantitative summary of the prevalence of back pain and arthritis. CONCLUSION It may be possible to reduce the risks of back pain and osteoarthritis with novel prosthetic components and by optimising prosthetic fitting. On one hand, an optimised prosthesis will be used more regularly. On the other hand, it will be exposed to greater loads and therefore the load to the locomotor system could be distributed more evenly amongst both legs. Both aspects would result in a more physiological loading of the locomotor system. SIGNIFICANCE It is often assumed that leg amputations result in a greater risk of degenerative changes to the locomotor system.24 Furthermore in one-on-one interviews amputees report on their fear of these changes. Therefore, this paper analysed the potential risk of various degenerative diseases in amputees. https://doi.org/10.33137/cpoj.v1i2.32034 mailto:Eva.Proebsting@ottobock.de https://doi.org/10.33137/cpoj.v1i2.32034 Pröbsting E, Kannenberg A, Blumentritt S. BACK PAIN AND OSTEOARTHRITIS AS SECONDARY DISABILITIES OF LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32034 2 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) REFERENCES 1. Gailey et al. 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CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32034 3 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) 29. Struyf et al. The prevalence of osteoarthritis of the intact hip and knee among traumatic leg amputees. Arch Phys Med Rehabil. 2009;90(3):440-6. doi: 10.1016/j.apmr.2008.08.220. 30. Melzer I, Yekutiel M, Sukenik S. Comparative study of osteoarthritis of the contralateral knee joint of male amputees who do and do not play volleyball. J Rheumatol. 2001;28(1):169-72. DISCLOSURE Eva Pröbsting and Andreas Kannenberg are full time employees of the OttoBock Health Care GmbH. https://doi.org/10.33137/cpoj.v1i2.32034