Prosthesis Research Articles

REABILITAÇÃO E AUTOCONFIANÇA: O PAPEL DA FISIOTERAPIA NA VIDA DE AMPUTADOS DE MEMBROS INFERIORES

Physiotherapy plays a fundamental role in the rehabilitation and adaptation process of amputees. By providing physical, emotional and educational support to amputees, multidisciplinary work enables patients to recover by promoting lost functionality until they adapt to the physical and emotional transformations and are able to live fully and actively again. In addition, the physiotherapeutic approach is multifaceted and involves several techniques, including gait training, strengthening exercises, manual therapy and psychological support. These interventions are essential to help patients overcome the challenges related to the use of the prosthesis and the recovery of functionality. Thus, the main objective of this study is to analyze the importance of physiotherapy in the rehabilitation of patients using lower limb prostheses, highlighting the gains in mobility, adaptation to the prosthetic device and quality of life, emphasizing as a focus of the problem what are the impacts of physiotherapy on the rehabilitation of lower limb amputees in terms of mobility, adaptation to the prosthesis and quality of life? This study is characterized as a mixed approach (quantitative and qualitative) field research, carried out in a rehabilitation center specialized in lower limb prostheses in Brazil. This mixed approach allowed a more comprehensive analysis, combining numerical data with subjective perceptions of the participants. Thus, continuous and personalized physiotherapy monitoring based on measurements and field research reiterated the beneficial benefits of adaptation to the prosthesis in the lower limbs when considering the fit, comfort and functionality, and when taking into account the gait training and the established strengthening exercises. Transtibial and femoral amputation has represented not only a surgical intervention, but also a long readaptation treatment, that is, a milestone in the lives of affected individuals, which brings significant challenges. Rehabilitation begins in the preoperative period, progresses to the prosthesis fitting, and continues beyond these events, being crucial for the functional/emotional recovery of patients. Understanding the various stages of treatment and having a comprehensive rehabilitation plan are essential factors for promoting a new quality of life, which is possible for amputees, as demonstrated in the evaluations completed by patients portrayed in the various graphs representing responses to the questionnaires applied. The aim is therefore to carry out continuous and personalized physiotherapy monitoring to promote significant improvements in mobility, self-confidence and quality of life of amputee patients who use lower limb prostheses; and through treatment, a key factor for successful adaptation to the prosthesis, to facilitate the return to daily activities and promote greater functional independence. The research should also demonstrate improvements in the emotional well-being of patients, with a reduction in symptoms of depression and anxiety when considering the necessary psychological monitoring.

A performance evaluation of commercially available and 3D-printable prosthetic hands: a comparison using the anthropomorphic hand assessment protocol

Despite significant technological progress in prosthetic hands, a device with functionality akin to a biological extremity is far from realization. To better support the development of next-generation technologies, we investigated the grasping capabilities of clinically prescribable and commercially available (CPCA) prosthetic hands against those that are 3D-printed, which offer cost-effective and customizable solutions. Our investigation utilized the Anthropomorphic Hand Assessment Protocol (AHAP) as a benchtop evaluation of the multi-grasp performance of 3D-printed devices against CPCA prosthetic hands. Our comparison sample included three open-source 3D-printed prosthetic hands (HACKberry Hand, HANDi Hand, and BEAR PAW) and three CPCA prosthetic hands (Össur i-Limb Quantum, RSL Steeper BeBionic Hand V3, and Psyonic Ability Hand), along with including previously published AHAP data for four additional 3D-printed hands (Dextrus v2.0, IMMA, InMoov, and Limbitless). Our findings revealed a notable grasping performance disparity, with 3D-printed prostheses generally underperforming compared to their CPCA counterparts, specifically in cylindrical, diagonal volar, extension, and spherical grips. We propose that the observed performance shortfalls are likely attributed to the design or build quality of the 3D-printed prostheses, owing to the fact that 3D-printed hands often have a lower technology readiness level for widespread use. Addressing the limitations highlighted in this work and subsequent research will play a crucial role in refining the design and functionality of both 3D-printed and CPCA prosthetic devices.

Multifocal Electroretinography Changes in Patients with Late-Stage Age-Related Macular Degeneration (AMD) After Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT): A Case Series

The smaller-incision new-generation implantable miniature telescope (SING IMT) represents an advancement over the previous model, WA-IMT, serving as a unilateral prosthetic device for patients with late-stage age-related macular degeneration (AMD). Purpose: This study aims to report changes in multifocal electroretinography (mfERG) 6 months post–SING IMT implantation. Methods: In this case series, we prospectively evaluated a cohort of phakic patients with late-stage AMD who underwent SING IMT implantation at the Ophthalmology Unit, University of Bari Aldo Moro, Italy. We assessed best-corrected distance visual acuity (BCDVA) and best-corrected near visual acuity (BCNVA) preoperatively and at 6 months postoperatively. Additionally, mfERGs were conducted using Retimax (CSO, Florence, Italy). Results: All four treated patients showed an increase in both BCDVA and BCNVA at the 6-month follow-up. Additionally, all eyes demonstrated increased P1 density at this time point, with the greatest augmentation observed at the central fixation point, gradually diminishing across the five concentric rings. While all patients displayed a general increase in P1 amplitude, the third patient exhibited a slight decrease in the foveal region. Conclusions: In this case series with four cases, the new generation implantable miniature telescope, SING IMT, demonstrates promising results in enhancing mfERG parameters in patients with late-stage AMD. Six months post-surgery, we observed an augmentation in both P1 density and amplitude, predominantly at the fixation point and gradually tapering in the surrounding concentric rings.

Solid-State Nanopores for Spatially Resolved Chemical Neuromodulation.

Most neural prosthetic devices are based on electrical stimulation, although the modulation of neuronal activity by a localized chemical delivery would better mimic physiological synaptic machinery. In the past decade, various drug delivery approaches attempted to emulate synaptic transmission, although they were hampered by poor retention of their cargo while reaching the target destination, low spatial resolution, and poor biocompatibility and stability of the materials involved. Here, we propose a planar solid-state device for multisite neurotransmitter translocation at the nanoscale consisting of a nanopatterned ceramic membrane connected to a reservoir designed to store neurotransmitters. We achieved diffusion-mediated glutamate stimulation of primary neurons, while we showed the feasibility to translocate other molecules through the pores by either pressure or diffusion, proving the versatility of the proposed technology. Finally, the system proved to be a promising neuronal stimulation interface in mice and nonhuman primates ex vivo, paving the way toward a biomimetic chemical stimulation in neural prosthetics and brain machine interfaces.

Spatially Localized Visual Perception Estimation by Means of Prosthetic Vision Simulation.

Retinal prosthetic devices aim to repair some vision in visually impaired patients by electrically stimulating neural cells in the visual system. Although there have been several notable advancements in the creation of electrically stimulated small dot-like perceptions, a deeper comprehension of the physical properties of phosphenes is still necessary. This study analyzes the influence of two independent electrode array topologies to achieve single-localized stimulation while the retina is electrically stimulated: a two-dimensional (2D) hexagon-shaped array reported in clinical studies and a patented three-dimensional (3D) linear electrode carrier. For both, cell stimulation is verified in COMSOL Multiphysics by developing a lifelike 3D computational model that includes the relevant retinal interface elements and dynamics of the voltage-gated ionic channels. The evoked percepts previously described in clinical studies using the 2D array are strongly associated with our simulation-based findings, allowing for the development of analytical models of the evoked percepts. Moreover, our findings identify differences between visual sensations induced by the arrays. The 2D array showed drawbacks during stimulation; similarly, the state-of-the-art 2D visual prostheses provide only dot-like visual sensations in close proximity to the electrode. The 3D design could offer a technique for improving cell selectivity because it requires low-intensity threshold activation which results in volumes of stimulation similar to the volume surrounded by a solitary RGC. Our research establishes a proof-of-concept technique for determining the utility of the 3D electrode array for selectively activating individual RGCs at the highest density via small-sized electrodes while maintaining electrochemical safety.

Patient Education in Health Care: Exploring Strategies for Effective Comprehension, Recall, and Compliance

ABSTRACT Introduction Patient education is recognized to be essential in orthotic and prosthetic care. However, there are no current standardized methods of educating patients. This literature review looked at the most effective current methods of educating patients in terms of comprehension, recall, and compliance. Methods Inclusion and exclusion criteria for articles were determined. Search strategy was developed using keywords, MeSH terms, and Boolean operators and applied to three different databases (Medline Ovid, Embase, and Web of Science). Results After searching on Medline Ovid, Embase, and Web of Science, 833 articles were found after deduplication, with 49 articles included in the final review. Conclusions The review found that delivering the education in terms of behavioral advice and multimodal methods was the most effective. Patients’ preference of education delivery, mood, attitude toward their condition, and relationship with their provider also need to be considered. Further research needs to be done on effective methods of delivering patient education. Clinical Relevance This research has the potential to lead to future studies in educating patients who utilize orthotic and prosthetic devices. The aim of the project is to eventually standardize or create best practice guidelines for patient education in the field of Orthotics and Prosthetics with the intent of improving comprehension, recall, and compliance.

Parametric analysis of 3D printing parameters on stiffness and hysteresis characteristics of pediatric prosthetic foot coupon samples

Background: This research paper presents a comprehensive parametric study that investigates the influence of various 3D printing parameters on the mechanical properties of a pediatric prosthetic keel using coupon samples. Objective: To analyze how 3D printing parameters impact upon on 2 crucial mechanical properties: stiffness and hysteresis. Methods: Key 3D printing parameters including the amount of continuous carbon fiber layers, fiber distribution, and matrix fill pattern, are systematically varied, and mechanically tested through compression to analyze the results. Results: The results demonstrate the substantial impact that printing parameters have on the mechanical characteristics of 3D-printed pediatric prosthetic feet. Notably, the selection of these parameters for the prosthetic keel plays a pivotal role in shaping the overall performance and functionality of the prosthetic foot, emphasizing the need for precise parameter optimization in pediatric prosthetic design, if 3D printing is the manufacturing process. Conclusions: The findings of this study contribute to a better understanding of the manufacturing process for pediatric prosthetic feet via 3D printing and offer valuable insights for optimizing their design. By identifying the ideal combination of 3D printing parameters that yield the desired stiffness and minimize hysteresis, we aim to enhance the performance and comfort of pediatric prosthetic devices, ultimately improving the quality of life for young users.

A Multi-Scale CNN for Transfer Learning in sEMG-Based Hand Gesture Recognition for Prosthetic Devices.

Advancements in neural network approaches have enhanced the effectiveness of surface Electromyography (sEMG)-based hand gesture recognition when measuring muscle activity. However, current deep learning architectures struggle to achieve good generalization and robustness, often demanding significant computational resources. The goal of this paper was to develop a robust model that can quickly adapt to new users using Transfer Learning. We propose a Multi-Scale Convolutional Neural Network (MSCNN), pre-trained with various strategies to improve inter-subject generalization. These strategies include domain adaptation with a gradient-reversal layer and self-supervision using triplet margin loss. We evaluated these approaches on several benchmark datasets, specifically the NinaPro databases. This study also compared two different Transfer Learning frameworks designed for user-dependent fine-tuning. The second Transfer Learning framework achieved a 97% F1 Score across 14 classes with an average of 1.40 epochs, suggesting potential for on-site model retraining in cases of performance degradation over time. The findings highlight the effectiveness of Transfer Learning in creating adaptive, user-specific models for sEMG-based prosthetic hands. Moreover, the study examined the impacts of rectification and window length, with a focus on real-time accessible normalizing techniques, suggesting significant improvements in usability and performance.

Mothers’ perspectives on the use and acceptability of 3d printed prosthesis by their children with congenital upper limb difference in India: a qualitative study

Purpose Children with congenital upper limb difference (CULD) in India have limited access to treatment with conventional prostheses. 3D printed prosthetic devices (3DPP) can function as transitional prostheses for growing children with congenital transverse deficiency. They are low-cost and the designs are easily customized. However, functional outcomes, access, and acceptability are still unexplored in many clinical settings. This qualitative study sought perspectives from Indian mothers of children with CULD using 3DPP for the first time. The objective was to enhance understanding of 3DPP acceptability and to explore how their children utilized these devices. Method Semi-structured interviews were conducted with seven mothers of children aged 3 to 11 years with varying levels of CULD who had been fitted with a 3DPP for at least 1 month prior. The interviews aimed to gather insights into the children’s daily experiences with the devices and the mothers’ perceptions of 3DPP. Thematic analysis was carried out using an inductive approach. Results Four major themes were identified through thematic analysis. They were: 1. Design and functionality of 3DPP, 2. Adaptation patterns, 3. Social attitudes and perceptions, and 4. Access to the Center for congenital hand differences: location and its services. Conclusion Our study explores the early-stage use and acceptance of 3DPP in India. Mothers reported several reasons for prosthesis abandonment including functional limitations, pain, and unmet expectations. The acceptability of 3DPP was moderate among close family, but social stigmatization was still a barrier to continued use. Addressing these issues and offering tailored solutions could be important to achieve successful 3DPP adaptation.

Comparison of SEMG-Based Hand Gesture Classifiers

Machine learning techniques have shown success in classifying hand gestures. As the prevalence of prosthetic devices continues to rise, the adoption of non-invasive technologies, such as surface electromyography (sEMG), becomes paramount. This study systematically assesses the isolated influence of classification algorithms within hand gesture recognition (HGR) systems using sEMG data and dynamic time warping (DTW) based features. This approach effectively handles temporal variations in sEMG signals by leveraging DTW, ensuring input features are invariant to gesture speed. Six supervised learning classifiers were evaluated: the multilayer perceptron, support vector machine, logistic regression, linear discriminant analysis, k-nearest neighbors, and decision tree. Cross-validation was employed to fine-tune the segmentation hyperparameters, significantly improving results. To ensure reproducibility, the source code has been made available, the proposed system design has been detailed, and the evaluation protocols have been described. Our findings indicate that logistic regression outperformed other classifiers in this setup, achieving 95.2% accuracy in classifying six hand movements from ten healthy individuals, representing a 1.6% improvement over the best previously reported performance using the same publicly available dataset. Future research will assess the proposed HGR system’s generalization capability on larger datasets suitable for training more complex classifiers, including deep learning models.

Evidence-Based Data on the Diagnostic Role and Clinical Usefulness of [18F]FDG PET/CT in Endocarditis and Cardiac Device Infections.

Infective endocarditis and infection of cardiac devices are conditions characterized by high morbidity and mortality, thus requiring a prompt diagnosis. Advanced imaging modalities are often required in the management of infectious endocarditis according to guidelines. The aim of this review is to collect and describe evidence-based knowledge about the diagnostic role and clinical usefulness of [18F]FDG PET/CT in endocarditis and cardiac device infections based on published systematic reviews and meta-analyses on this topic and on recent guidelines. [18F]FDG PET/CT is recommended only in selected cases. This imaging method has good diagnostic accuracy in detecting prosthetic valve endocarditis and cardiac device infection. Furthermore, it can identify extra-cardiac infectious foci changing the clinical management in a significant percentage of cases.

Knowledge and Practice of Contact Lens Users in Eastern Province, Saudi Arabia.

Introduction Contact lenses (CLs) are temporary prosthetic devices designed to fit directly on the cornea and are commonly used to correct refractive errors. Since CLs are easily accessible, the users might lack the basic knowledge of the safety and complications of such products. Investigating the patterns and behaviors related to using CLs can identify the factors that potentially play a role in developing complications. Aim This study aimed to evaluate the awareness and utilization of lens care products among CL wearers. Subject and methods This observational cross-sectional study was conducted among adult women in the Eastern Province of Saudi Arabia. A self-administered questionnaire was distributed among women using an online survey. The questionnaire includes demographic characteristics, knowledge, practices, reasons, causes, and side effects of CLs. Results Of the 393 women, 68.4% were aged between 18 and 30 years. The most common source of CL information was a social circle (27%). Interestingly, parties and occasions were the most influencing factors (83.7%), while dryness of the eyes was the most common side effect (52.2%). According to the result, the rate of regular CL wearers was 16% and significant predictors of regular CL wearers were wearing CL due to medical and cosmetic reasons. Conclusion The use of CLs was common in women living in the Eastern Province. Independent predictors of regular CL use were eyeglass use, wearing of CL for cosmetic and medical purposes, and sleeping with CL, while dryness of the eye could be the most critical risk factor for daily use of CL. Prospective studies in nature are needed to determine its cause and effect.

A Cooperative game theory-based feature selection for efficient hand grasp classification using minimal number of sEMG signals

Deploying bio-electrical signals and image processing (visual) techniques are the two popular means to provide input to generate grasp control for robotic and prosthetic devices. Visual perception-based techniques rely on computationally expensive image processing algorithms and are affected by lighting conditions. In contrast, grasp control based on bio-electric signals such as surface electromyography (sEMG) is invariant to lighting conditions. It can reflect human intent to hand motion or grasp with lesser computational costs. In this article, we propose an efficient machine-learning pipeline to classify hand grasp using a minimal number of sEMG sensors. A cooperative game theory-based feature selection technique is applied to find the representative feature subset. The feature selection method uses a modified marginal contribution based on the class distribution coefficient to generate feature ranking. This feature ranking is further used to find the most representative feature subset from the extracted feature set. Our proposed pipeline has been evaluated on a benchmark dataset and has achieved a classification accuracy of 98.20%, using single-channel EMG when coupled with the XGBoost classifier. Thorough assessments were conducted to confirm the reliability of the results obtained. Our proposed pipeline holds the potential to facilitate the development of cost-effective sEMG prosthetics.

Benign Soft Tissue Tumors of oral cavity, relevance to prosthodontics – Laconic Review.

The influence of oral soft tissue tumors on the surrounding structures and oral tissues makes them a considerable problem in prosthodontic treatment, regardless of their malignancy. Maintaining functional rehabilitation with prosthetic devices while addressing the tumor pathology is a delicate balance in the therapy of malignant tumors. Prosthodontics is relevant in this situation in a number of ways. Long-term side effects from cancer therapies, especially radiation therapy, can include mucositis, osteoradionecrosis, and xerostomia. The efficacy of prosthetic treatments may be significantly impacted by these negative effects. Patients with soft tissue tumors in the mouth cavity can greatly benefit from prosthodontic treatment, despite its difficulties. There is not much literature is available on the relevance of soft tissue tumors in various prosthodontic treatment procedures. Hence this laconic review aimed to discuss about various soft tissue tumors which are related to prosthodontic treatment and different precautions to be taken during prosthodontic procedures.

Piloting a Novel Computational Framework for Identifying Prosthesis-Specific Contributions to Gait Deviations.

This paper introduces a novel computational framework for evaluating above-knee prostheses, addressing a major challenge in gait deviation studies: distinguishing between prosthesis-specific and patient-specific contributions to gait deviations. This innovative approach utilizes three separate computational models to quantify the changes in gait dynamics necessary to achieve a set of ideal gait kinematics across different prosthesis designs. The pilot study presented here employs a simple two-dimensional swing-phase model to conceptually demonstrate how the outcomes of this three-model framework can assess the extent to which prosthesis design impacts a user's ability to replicate the dynamics of able-bodied gait. Furthermore, this framework offers potential for optimizing passive prosthetic devices for individual patients, thereby reducing the need for real-life experiments, clinic visits, and overcoming rehabilitation challenges.

Multiplexed Piezoelectric Electronic Skin with Haptic Feedback for Upper Limb Prosthesis

AbstractUpper limb amputation severely impairs tactile perception, limiting daily activities. Developing a near‐natural replacement with prosthetic devices requires improving user sensory experiences during object interactions. The ideal upper limb prosthesis should provide real‐time sensory feedback, mirroring natural experiences. Current prostheses struggle with providing adequate tactile feedback due to sensory limitations. Inspired by the sensory properties of skin, we present a micro‐fabricated, multiplexed electronic skin (e‐skin) with actuators for sensory feedback in upper limb amputation. The piezoelectric‐capacitive sensor array detects static pressure, temperature, vibration, and texture, with integrated actuators stimulating the skin to provide real‐time feedback. The sensors integrate with actuators via readout electronics, making the system standalone and easy to use. The flexible, compact sensor array design (two pixels within a 1 cm² footprint) detects a wide range of pressure (0.5–10 kPa), temperature (22–60 °C), vibration (35–100 Hz), and texture (2.5–45 Hz), suitable for daily use. The e‐skin, attached to a prosthetic finger, is tested for feasibility on human volunteers with wrist‐mounted actuators. Statistics are used to quantitatively assess system performance. The integration of multiplexed sensors and actuators enhances tactile feedback, improving the quality of life for people with upper limb amputations.

ALVEOLOPLASTIA, CIRURGIA PRÉ-PROTÉTICA PARA REGULARIZAÇÃO DE REBORDO ALVEOLAR MANDIBULAR: RELATO DE CASO

Surgical interventions may be necessary for the adequate adaptation of prosthetic devices, for example, in cases of irregular alveolar ridges, which generally appear after tooth extractions. Such changes make it difficult or even prevent satisfactory oral rehabilitation. In this sense, the present work aims to carry out a literature review as well as describe a clinical case report on pre-prosthetic surgery, aiming to regularize the mandibular alveolar ridge, through alveoloplasty. In short, pre-prosthetic surgeries allow for good seating of the prostheses, providing comfort and harmony with the other orofacial components. Therefore, alveoloplasty is safe and effective, whose ridge leveling allows significant success in oral rehabilitation, as it provides a well-adapted, stable and retentive prosthesis, consequently restoring aesthetics, chewing function, phonetic readjustment, well-being and quality of life to patients.

Enhancement of antimicrobial properties of plasma electrolytic oxidation coatings on aluminum alloy surfaces with CuO nanoparticles

A coating containing copper oxide/cuprous oxide (CuO/Cu2O) nanoparticles with excellent antimicrobial properties was synthesized on the surface of an aluminum alloy substrate by plasma electrolytic oxidation (PEO) technology. This study focuses on the impact of incorporating CuO nanoparticles on the coating's composition, microstructure, mechanical properties, corrosion resistance, and antimicrobial efficacy. EDS and XPS analyses confirmed that the primary components of the coating are Al2O3 and Cu2O/CuO, with the Cu element predominantly located in the micropores and microcracks of the coating. The inclusion of CuO nanoparticles significantly increased the coating's thickness, hardness, and densification while reducing surface roughness. Electrochemical tests and antimicrobial experiments demonstrated that the PEO coating with added CuO nanoparticles exhibited excellent corrosion resistance, with an antimicrobial rate against Staphylococcus aureus reaching 99.06 %, compared to 45.12 % for the ordinary PEO coating. The study also investigated the effects of key process parameters (positive voltage, negative voltage, duty cycle, and CuO nanoparticle concentration) on the coating's antimicrobial rate, identifying optimal parameters for maximum antimicrobial performance. Studies have shown that the incorporation of CuO nanoparticles effectively enhances the overall performance of PEO coatings, particularly in terms of antibacterial and corrosion resistance. The process parameters mainly influence the antimicrobial properties of the coating by affecting the state and content of Cu. This coating shows promising application prospects in medical devices, such as orthopedic external fixation frames, microsurgical instruments, and prosthetic devices.

Design and development of an EMG controlled transfemoral prosthesis

Electromyography (EMG) signals are biomedical signals that measure electrical currents generated by the activity of muscles when they contract. EMG is essential for optimizing the control of various prosthetic devices, particularly for transfemoral amputees, where the complexity of muscle signal integration presents significant challenges. The proposed study aims to develop a prosthetic knee that actuates in real-time using the EMG signals from the amputee’s residual limb. Pre-processing techniques are employed to obtain EMG signals from the femoris and vastus muscle targets in the transfemoral region. Moving average filters and Butterworth bandpass filters are implemented to process the raw signals. Sliding windows of various widths were applied for feature extraction. The window size of 200 ms is determined for our study based on the outcomes of the t-SNE plots and the corresponding silhouette scores. After the extraction of the pertinent features, several supervised classifier algorithms are put into practice to classify the knee flexion and extension motion. The k-nearest Neighbor (KNN) algorithm, with an accuracy rating of 80 %, proved to be suitable for motor control. Real-time control is implemented using the Raspberry Pi board to power the prosthesis allowing above-the-knee amputees to voluntarily move the leg back and forth. The EMG signals are then extracted and used to drive the DC motor. The prosthesis would therefore be able to move more precisely since the EMG readings are being gathered in real-time. Thus, this work can enhance the patient’s comfort with the ease of carrying out knee movements.

What Are the Factors Associated With Revision Surgery on the Residual Limb and Functional Results in Patients With Posttraumatic Lower Limb Amputations?

Lower limb amputations performed after trauma are associated with a high risk of revision surgery. While the factors influencing revision surgery in the upper limbs have been studied, no studies have analyzed these factors in the lower limbs. Existing explanations for these revision surgeries are unclear, often leaving patients uninformed. Surgeons also lack the tools to explain the factors that influence repeat operations to patients. Therefore, the aim of this study was to provide surgeons with some answers so they can inform their patients undergoing posttraumatic lower limb amputation, whether military or civilian. (1) What was the survivorship of the initial amputation free from any revision surgery? (2) What patient- and injury-related factors were associated with revision amputation? (3) Do these factors influence functional outcomes in these patients? A single-center, retrospective study was conducted between January 2010 and February 2020 on patients who had undergone traumatic lower limb amputation. Between January 2010 and February 2020, 322 patients underwent amputation or were followed up at Percy Military University Hospital. Thirty-one patients had undergone amputation at another center, 178 had undergone amputation for nontraumatic reasons, and 27 patients had only upper limb amputations. Of those remaining, 1 died before 6 months, and 6% (5 of 86) were not fitted with a prosthesis, leaving 99% (85 of 86) for survivorship free from revision analysis and 93% (80 of 86) for functional endpoints analysis in this retrospective study at a median of 6.5 years (IQR 5 to 9) following the index amputation. The median age at the time of amputation was 31 years (IQR 26 to 52), 85% (72 of 85) of patients were men, and 31% (26 of 85) were military personnel. Revision surgery was defined as surgery performed at or after 6 months to ensure that the residual limb was healed and fitted with a prosthesis. Revision procedures performed before 6 months (median 2 [IQR 0 to 7]) were considered as part of the initial residual limb formation surgery. We performed Kaplan-Meier survivorship analysis for the time free from revision amputation from 6 months after amputation. We considered the competitive risk of death using a Fine-Gray model by an ascending stepwise procedure. To answer our third research question, we performed a chart review and assessed patients' use of prostheses and assistive devices and the percentage of patients who returned to work. An ordinal logistic regression was used to analyze the factors influencing functional outcome using an ascending stepwise procedure. A total of 85 patients (94 limbs) were included, of whom 25 (27 limbs) underwent a revision surgery on the residual limb > 6 months after amputation. Kaplan-Meier survival estimates indicated that 5 years after the initial amputation 64% (95% confidence interval 53% to 77%) of the patients remained free from revision surgery on their residual limb. Factors associated with increased odds of revision amputation were smoking (subdistribution HR 2.6 [95% CI 1.2 to 5.8]; p = 0.02) and an age of > 50 years (subdistribution HR 0.3 [95% CI 0.1 to 0.8]; p = 0.01). Ninety-four percent (80 of 85) of patients were fitted with prostheses, and 40% (32 of 80) of patients used material or human assistance for simple activities of daily living. Seventy-one percent of patients (57 of 80) had returned to work. Ordinal logistic regression revealed an association between preinjury sports activity and the absence of need for assistance in daily activities (OR 9 [95% CI 2.9 to 31.8]; p < 0.001). Smoking appeared to be an associated risk factor for residual limb revision surgery in posttraumatic lower limb amputations and is potentially modifiable. Being at least 50 years of age seemed to be associated with a lower incidence of revision surgery, which is probably linked to lower functional demands made on limbs beyond this age. Our study showed a remarkable rate of fitting with a prosthetic device, with an improved functional result if the patient was athletic before the trauma. These results provide more precise information on the care pathway to be considered for each patient. A study with a much larger sample would make it possible to assess the risk factors for the occurrence of each complication involving revision surgery. Level III, therapeutic study.