Determining K-levels Following Transtibial Amputation

Abstract

Objectives: This is a prospective feasibility study of nine subjects recruited 1-3 days following transtibial amputation, from October 2013 to October 2014. The investigators assessed the accuracy of the K-level provided by an experienced clinician 6 weeks following amputation, by comparing it to an Amputee Mobility Predictor (AMP) determined K-level at 6 weeks following amputation and the subjects' actual K-level 6 months post-operatively. Methods: This study obtained an AMPnoPRO and Short Form-36 (SF-36) prior to prosthetic fitting on a series of consecutive patients who underwent transtibial level amputation. The main outcome measures were clinician-predicted K-levels, AMPnoPRO scores, SF-36 results 6 weeks post-amputation, and actual K-level function at 6 months post-amputation. Results: In 7 of 9 cases, the physician predicted K level was accurate as compared to the subjects' K-level at their 6-month follow-up, whereas the AMP predicted K-level was accurate in 4 of 9 cases. Data from the SF-36 revealed marked variance in our subjects from the societal norm for physical functioning, emotional health, and social functioning. Conclusions: The AMPnoPRO is an established, objective tool used for predicting K-levels. In comparison, predictions made by an experienced clinician were very accurate. This is the first prospective study to assess the determination of K-levels in people with lower extremity amputation before receiving their initial prosthesis.