Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Report Volume 5 Issue 1

Physical Therapy Interventions and Outcomes in a Patient with Transfemoral Amputation Following Sound Side Total Knee Arthroplasty: A Case Report

Scott Love1*, Jenna Yent1, Clair V Kean1, Nicole A Liotta1, Debra Gray1 and M Jason Highsmith2-4

1University of St. Augustine, Doctor of Physical Therapy Program, St. Augustine, FL, USA
2University of South Florida, Morsani College of Medicine, School of Physical Therapy and Rehabilitation Sciences, Tampa, FL, USA
3U.S. Department of Veterans Affairs, Rehabilitation and Prosthetic Services (10P4R), Orthotic and Prosthetic Clinical Services, Tampa, FL, USA
4U.S. Army Reserves, 319th Minimal Care Detachment, SP Corps, Pinellas Park, FL, USA

*Corresponding Author: Scott Love, Assistant Professor, University of St. Augustine, Doctor of Physical Therapy Program, St. Augustine, FL, USA.

Received: October 08, 2021; Published: December 14, 2021


Background: Following a transfemoral amputation (TFA), osteoarthritis (OA) on the sound limb may occur secondary to overuse. Potential causative factors include gait abnormalities, increased knee load, and performing hopping activities without a prosthesis. Unilateral TFA patients may require a total knee arthroplasty (TKA) to improve function.

Case Description and Methods: A 56-year-old male with a TFA who was diagnosed with left knee OA and was classified as a limited community ambulator underwent a TKA to restore function. The purpose of this case report is to determine the benefits of standard physical therapy (PT) augmented by a high intensity, whole-body strengthening program. PT examinations, interventions, and outcomes were analyzed from one-week pre-TKA to one-year post-TKA. Multiple outcome measures were utilized to assess progress including the Single Leg Stance Test (SLST), Four Square Step Test (FSST), Timed Up and Go Test (TUG), and Six Minute Walk Test (6MWT).

Findings: Patient achieved functional independence, normalized gait, lower extremity strength, and lower extremity active range of motion (AROM) goals.

Outcomes and Conclusion: The results of the TUG and FSST from the patient equaled those of non-amputees. The standard PT protocols post-TKA contributed to the patient’s success, while the high intensity, whole-body strengthening program contributed to patient’s achievements.

Clinical Relevance Statement: This case study suggests rehabilitation interventions in a relatively healthy unilateral TFA with sound limb TKA may be appropriate at a higher level of intensity, than typically prescribed, to regain functional independence.

Keywords: Lower Extremity Amputee; Prosthesis; Range of Motion; Rehabilitation; Timed Up and Go; Total Knee Replacement; 6MWT


  1. Lusardi M., et al. “Orthotics and Prosthetics in Rehabilitation”. 3rd St. Louis, MO: Amirsys/Elsevier Saunders (2013).
  2. Angoules A., et al. “Necrotising fasciitis of upper and lower limb: a systematic review”. Injury 38 (2007): S18-25.
  3. Heidari B. “Knee osteoarthritis prevalence, risk factors, pathogenesis and features: part I”. Caspian Journal of Internal Medicine 2 (2011): 205-212.
  4. Bae T., et al. “Dynamic analysis of above-knee amputee gait”. Clinical Biomechanics 22 (2007): 557-566.
  5. Norkin C and White D. “Measurement of Joint Motion A Guide To Goniometry”. 4th Philadelphia, PA: F.A. Davis Company (2009).
  6. Kendall F., et al. “Muscles Testing And Function With Posture And Pain”. 5th Baltimore, MD: Lippincott Williams and Wilkins (2005).
  7. Shirley Ryan Ability Lab.
  8. Langford Z. “The four square step test”. Journal of Physiotherapy 61 (2015): 162.
  9. Reid L., et al. “Going Places: Does the Two-Minute Walk Test Predict the Six-Minute Walk Test in Lower Extremity Amputees?” Journal of Rehabilitation Medicine 3 (2015): 256-261.
  10. Bellew J., et al. “Michlovitz’s Modalities for Therapeutic Intervention”. 6th Philadelphia, PA: F.A. Davis Company (2016).
  11. Agrillo J., et al. “Rehabilitation Protocol: Total Knee Arthroplasty (TKA)”. Lahey Hospital and Medical Center (2015).
  12. Neumann D., et al. “Kinesiology Of The Musculoskeletal System”. 3rd St. Louis, MO: ELSEVIER (2017).
  13. Gouelle A and Highsmith M. “Compléter l’interprétation Des Tests Cliniques Usuels Par Analyse Métrologique: Performance et Stratégie au Four Square Step Test Chez L’amputé Transfémoral”. Neurophysiologie Clinique 48 (2018): 328-329.


Citation: Scott Love., et al. “Physical Therapy Interventions and Outcomes in a Patient with Transfemoral Amputation Following Sound Side Total Knee Arthroplasty: A Case Report".Acta Scientific Orthopaedics 5.1 (2022): 05-10.


Copyright: © 2022 Scott Love., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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