Functional Outcomes of Individuals Undergoing the Ewing Amputation.

OBJECTIVE

To assess the postoperative performance of patients who have undergone the Ewing amputation (EA) on physical function tests and patient-reported outcome measures compared to their own preoperative state, as well as to normative data from non-EA transtibial amputees (TTAs) and able-bodied community adults (ABAs).`

DESIGN

Intervention cohort study with a follow-up of approximately 1 year.

SETTING

Tertiary/quaternary care academic medical center.

PARTICIPANTS

N=22 patients aged 18-65 years who were candidates for elective transtibial amputation after failed attempts at limb salvage.

INTERVENTIONS: The EA is a novel approach to transtibial amputation incorporating the construction of agonist-antagonist myoneural interfaces.

MAIN OUTCOME MEASURES: Performance-based physical function tests and patient-reported outcome measures.

RESULTS

A total of 22 patients with 26 EAs were studied. Over half of the studied EA patients were biological men (13, 59%), and the mean age of the intervention population was 40.6±12.9 years. All EA patients progressed to prosthetic fitting, with a mean time of 65±25 days. Functional testing was performed at a mean interval of 112±69 days prior to and 347±141 days after amputation. EA patients demonstrated statistically significant (P<.01) improvements on all functional outcome measures and patient-reported outcome measures with the exception of functional reach (P=.1222) when compared to themselves prior to amputation. EA patients demonstrated statistically significantly better performance on the 10-meter walk test, timed Up and Go, 6-minute walk test, and functional reach test than normative data from the TTA population (P<.05), and equivalent performance to ABA patients on the 10-meter walk test and timed Up and Go (P>.5).

CONCLUSIONS

Patient performance on functional outcome measures improved after undergoing the EA and associated rehabilitation interventions. Additionally, EAs performed better on several physical function outcome measures postoperatively when compared to TTAs and were equivalent to ABAs on several of the same measures.