Patient preference and gait efficiency in a geriatric population with transfemoral amputation using a free-swinging versus a locked prosthetic knee joint

Objective: To investigate patient preference, walking speed, and prosthetic use in a geriatric population with transfemoral amputation using a free-swinging prosthetic knee or a locked knee joint. Design: Before-after trial. Setting: Ambulatory patients at an amputee rehabilitation facility. Participants: A convenience sample of 14 geriatric individuals with a unilateral dysvascular transfemoral amputation (age range, 61-80y), who were using a prosthesis with a free-swinging knee in the community. 3 months after discharge from an amputee rehabilitation program. Intervention: Change from a free-swinging knee to a locked knee. Main Outcome Measures: Patient preference, distance walked in 2 minutes, and prosthetic use as measured by the Houghton Scale. Results: Eleven of 14 participants preferred the locked knee. Irrespective of preference, the mean 2-minute walk distance was 44.9 +/- 28.9m with the free-swinging knee and 54.4 +/- 35m with the locked knee (P = .001). Prosthetic use was greater with the locked knee (7.8 +/- 2.2) than with the free-swinging knee (6.6 +/- 2.5) (P = .01). Conclusions: Most geriatric participants with transfemoral amputation preferred locked knees and walked faster and used their prostheses more when using a locked knee prosthesis.