The prevalence of osteoarthritis: Higher risk after transfemoral amputation?-A database analysis with 1,569 amputees and matched controls

PLoS One. 2019 Jan 22;14(1):e0210868. doi: 10.1371/journal.pone.0210868. eCollection 2019.

Abstract

Background: Several studies have shown that patients with a unilateral amputation have an increased risk of developing osteoarthritis (OA) in the knee of their sound leg. OBJECTIVE: The first objective was to investigate whether amputees are more frequently affected by gon-, cox- or polyarthritis as well as back pain or spinal disorders. We hypothesized that mobile and active transfemoral amputees more often experience OA and spinal disorders than non-amputees. The second objective was to compare the mean age of the patients with OA.

Patients: Patients with a unilateral transfemoral amputation (n = 1,569) and five abled-body control groups (each n = 1,569) matched in terms of age and gender resulting in total of 9,414 participants.

Methods: Groups were analyzed regarding the prevalence of six selected diagnoses regarding musculoskeletal disorders.

Results: A significantly decreased prevalence of OA and specific disorders of the spine in transfemoral amputees compared to a control group was found. The amputees with OA are significantly younger than patients with OA in the control group.

Conclusion: The results from the presented study contradict previously published literature. Apparently circumstances of life play an important role, like physical work and strenuous activities which are likely to be underrepresented in the amputee group. The results of the study need to be used cautiously due to the major limitation of the study which is the lack of detail in individual patients caused by the methodology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / adverse effects*
  • Amputees*
  • Arthritis / epidemiology
  • Arthritis / etiology
  • Back Pain / epidemiology
  • Back Pain / etiology
  • Case-Control Studies
  • Child
  • Female
  • Femur / surgery*
  • Germany / epidemiology
  • Humans
  • Leg
  • Male
  • Middle Aged
  • Osteoarthritis / epidemiology*
  • Osteoarthritis / etiology*
  • Osteoarthritis, Hip / epidemiology
  • Osteoarthritis, Hip / etiology
  • Osteoarthritis, Knee / epidemiology
  • Osteoarthritis, Knee / etiology
  • Prevalence
  • Risk Factors
  • Spinal Diseases / epidemiology
  • Spinal Diseases / etiology
  • Spinal Osteochondrosis / epidemiology
  • Spinal Osteochondrosis / etiology
  • Young Adult

Grants and funding

The study was funded by Federal Ministry of Education and Research (BMBF FKZ 13EZ1112A-C “meb-GO - Messtechnikbasierte Gangbildoptimierung bei transfemoral Amputierten”). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.