Resting TcPO2 levels decrease during liner wear in persons with a transtibial amputation.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 02 02 2020
accepted: 16 09 2020
entrez: 28 9 2020
pubmed: 29 9 2020
medline: 20 11 2020
Statut: epublish

Résumé

In our clinic, a substantial number of patients present with transtibial residual limb pain of no specific somatic origin. Silicone liner induced tissue compression may reduce blood flow, possibly causing residual limb pain. Thus, as a first step we investigated if the liner itself has an effect on transcutaneous oxygen pressure (TcPO2). Persons with unilateral transtibial amputation and residual limb pain of unknown origin were included. Medical history, including residual limb pain, was recorded, and the SF-36 administered. Resting TcPO2 levels were measured in the supine position and without a liner at 0, 10, 20 and 30 minutes using two sensors: one placed in the Transverse plane over the tip of the Tibia End (= TTE), the other placed in the Sagittal plane, distally over the Peroneal Compartment (= SPC). Measurements were repeated with specially prepared liners avoiding additional pressure due to sensor placement. Statistical analyses were performed using SPSS. Twenty persons (9 women, 11 men) with a mean age of 68.65 years (range 47-86 years) participated. The transtibial amputation occurred on average 43 months prior to study entry (range 3-119 months). With liner wear, both sensors measured TcPO2 levels that were significantly lower than those measured without a liner (TTE: p < 0.001; SPC: p = 0.002) after 10, 20 and 30 minutes. No significant differences were found between TcPO2 levels over time between the sensors. There were no significant associations between TcPO2 levels and pain, smoking status, age, duration of daily liner use, mobility level, and revision history. Resting TcPO2 levels decreased significantly while wearing a liner alone, without a prosthetic socket. Further studies are required to investigate the effect of liner wear on exercise TcPO2 levels.

Sections du résumé

BACKGROUND
In our clinic, a substantial number of patients present with transtibial residual limb pain of no specific somatic origin. Silicone liner induced tissue compression may reduce blood flow, possibly causing residual limb pain. Thus, as a first step we investigated if the liner itself has an effect on transcutaneous oxygen pressure (TcPO2).
METHODS
Persons with unilateral transtibial amputation and residual limb pain of unknown origin were included. Medical history, including residual limb pain, was recorded, and the SF-36 administered. Resting TcPO2 levels were measured in the supine position and without a liner at 0, 10, 20 and 30 minutes using two sensors: one placed in the Transverse plane over the tip of the Tibia End (= TTE), the other placed in the Sagittal plane, distally over the Peroneal Compartment (= SPC). Measurements were repeated with specially prepared liners avoiding additional pressure due to sensor placement. Statistical analyses were performed using SPSS.
RESULTS
Twenty persons (9 women, 11 men) with a mean age of 68.65 years (range 47-86 years) participated. The transtibial amputation occurred on average 43 months prior to study entry (range 3-119 months). With liner wear, both sensors measured TcPO2 levels that were significantly lower than those measured without a liner (TTE: p < 0.001; SPC: p = 0.002) after 10, 20 and 30 minutes. No significant differences were found between TcPO2 levels over time between the sensors. There were no significant associations between TcPO2 levels and pain, smoking status, age, duration of daily liner use, mobility level, and revision history.
CONCLUSION
Resting TcPO2 levels decreased significantly while wearing a liner alone, without a prosthetic socket. Further studies are required to investigate the effect of liner wear on exercise TcPO2 levels.

Identifiants

pubmed: 32986780
doi: 10.1371/journal.pone.0239930
pii: PONE-D-20-03066
pmc: PMC7521692
doi:

Substances chimiques

Silicones 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0239930

Déclaration de conflit d'intérêts

ConReha GmbH provides research support within the field of Clinical Sciences. The company provided support in form of salary for the author MRM. Neither the author nor the company have commercial interests, patents, products in development or marketed in relation to the topic of the study. The commercial affiliation of the author does not alter our adherence to PLOS ONE policies on sharing data and materials.

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Auteurs

Martin C Berli (MC)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

Michèle Jundt-Ecker (M)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

Margrit R Meier (MR)

ConReha GmbH, Buttikon, Switzerland.

Michael Hofer (M)

Rehaklinik Bellikon, Bellikon, Switzerland.

Madlaina Schöni (M)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

Tobias Götschi (T)

Department of Orthopaedic Surgery, Institute for Biomechanics, University of Zurich, ETH Zurich, Balgrist Campus, Zurich, Switzerland.

Ilker Uçkay (I)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

Thomas Böni (T)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

Felix W A Waibel (FWA)

Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland.

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Classifications MeSH