Medical School Hannover, Germany

Transcutaneous osseointegrated prosthetic systems (TOPS) have been used as an alternative method to the

external artificial limbs for patients with limb amputation. Patients with transfemoral amputations very often

suffer from pain in the region of their lateral hip following rehabilitation with TOPS after starting full weight

bearing. We suppose a dependency between this pain and the malposition of the residual femur bone which tends

to abduction. When socket prosthesis is used, weight bearing doesn’t have a direct effect on the bone. The energy

is spread to the soft tissue. Due to the inevitable missing at least of parts of the mm. adductoris, there often exists a

lateral deviation of the residual femur. Additionally, there is an atrophy and contraction of the muscles surrounding

the hip joint. Using TOPS, the patients perform full weight bearing direct to the bone which comes much closer to

physiological walking. At the same time, the lateral muscle groups are getting under painful tension. In our study

we are going to investigate a correlation between the development of pain enclosing the hip joint and the changed

angle of abduction comparing it to the former use of socket prosthesis. We would like to show that physiotherapy in

advance might reduce or even eliminate the pain.