FUNCTIONAL IMPROVEMENTS MEASURED BY THE CONTINUOUS-SCALE PHYSICAL FUNCTIONAL PERFORMANCE TEST IN A UNILATERAL TRANSFEMORAL AMPUTEE FOLLOWING SOUND SIDE KNEE ARTHROPLASTY: A CASE STUDY

Abstract

Osteoarthritis is common in the sound limb of persons with a transfemoral amputation (TFA) due to gait abnormalities and increased load on the knee when ambulating with or without aprosthesis. Commonly, a sound-limb total knee arthroplasty (TKA) is required to decrease pain and improve physical function. This case report discusses physical functional outcomes in a person with a TFA following sound limb TKA as measured by the Continuous-Scale Physical Functional Performance Test 10 (CS-PFP 10). A patient with a right TFA underwent a left TKA to improve functional performance. The purpose of this case was to quantify functional changes measured by the CS-PFP 10 at one week pre-TKA and one, three, six, twelve, and eighteen months post-TKA. Skilled standard care physical therapy was immediately implemented post-TKA, which included therapeutic interventions and electrotherapeutic modalities. Additionally, a whole-body high-intensity strengthening program was introduced at eighteen weeks post-operative (post-op) as an adjunct to return the patient to his prior level of function as a CrossFit® athlete.All five CS-PFP 10 domains demonstrated continuous improvement, while the rate of perceived exertion decreased. At one week post-op, the patient’s CS-PFP 10 score indicated an increased likelihood of functional dependence. However, by eighteen months, the patient achieved a total CS-PFP 10 score in the 75 to 90 range, indicating independent function likely. The CS-PFP 10 is a valid instrument to measure improvement in activities of daily living (ADL) in specified functional domains and overall function. Following this patient post-operatively through rehabilitation, the CS-PFP 10 revealed objective improvements demonstrating that sound limb total joint arthroplasty and physical therapy can greatly improve function. These interventions are a viable course of treatment in the presence of contralateral functional impairment in patients with TFA.The CS-PFP 10 is a valid instrument to accurately measure improvements in ADLs in specified functional domains and overall function in the patient population with a TFA followingsound limb TKA.