SUCCESSFUL PROSTHETIC FITTING OF A 73-YEAR-OLD HIP DISARTICULATION AMPUTEE PATIENT WITH CARDIOPULMONARY DISEASE

Patients with hip disarticulation (HD) require high energy expenditure for successful prosthetic ambulation. Thus, older patients are rarely fitted with an HD prosthesis. To our knowledge there are no reports o f gait analysis following successful prosthetic fitting of an elderly HD amputee patient with systemic cardiopulmonary disease. We report th e case of successful prosthetic ambulation in a 73-year-old man with H D secondary to histiosarcoma and a medical history significant for sta ble angina, chronic obstructive pulmonary disease, and diabetes mellit us. The patient underwent gait training with an endoskeletal prosthesi s and achieved ambulation to 400 feet with bilateral forearm crutches. Vicon kinematic gait analysis revealed a cadence of 44steps/min (112s teps/min normal), and double support time of 47% (26% normal). Oxygen rate during ambulation (V over dotO(2)) was 11.0mL/kg/min at velocity of .35m/sec, compared with published figures for ambulation in those w ith HD of 10.73mL/kg/min at velocity of .93m/sec. At 1-year follow-up, the patient continued to walk into church with the prosthesis. We con clude that a trial fitting of an HD prosthesis should be considered on an individual basis in elderly amputee patients. (C) 1998 by the Amer ican Congress of Rehabilitation Medicine and the American Academy of P hysical Medicine and Rehabilitation.