What You Should Know Before Getting a Prosthetic Leg

Prosthetic legs, or prostheses, can help people with leg amputations get around more easily. They mimic the function and, sometimes, even the appearance of a real leg. Some people still need a cane, walker, or crutches to walk with a prosthetic leg, while others can walk freely.

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If you have a lower limb amputation, or you will soon, a prosthetic leg is probably an option you're considering. That said, a few important factors merit attention before making your choice.

Not Everyone Benefits from a Prosthetic Leg

While many individuals adapt well to their prosthetic legs, it is important to acknowledge that not everyone is a suitable candidate for this solution. Therefore, consider the following questions to discuss with your doctor:

• Is there enough soft tissue to cushion the remaining bone?
• How much pain are you experiencing?
• How is the condition of the skin on the limb?
• What range of motion does the residual limb have?
• Is your other leg healthy?
• What was your activity level prior to the amputation?
• What are your mobility aspirations?

Additionally, the type of amputation, whether above or below the knee, can significantly impact your experience with a prosthetic leg. Generally, below-the-knee prostheses are easier to use compared to above-the-knee ones. When the knee joint remains intact, moving the prosthetic leg takes less effort, leading to greater mobility.

The underlying reasons for the amputation also come into play, as they can affect the condition of the residual limb. For example, someone who was fit and active but lost a limb to a car accident may find it easier to manage a prosthesis than someone who lost their leg due to complications from diabetes or peripheral vascular disease.

Ultimately, your situation is unique. It is essential to collaborate with your healthcare professional regarding the decision to proceed with obtaining a prosthesis.

Prosthetic Legs Are Not One Size Fits All

When your doctor prescribes a prosthetic leg, you might feel uncertain about how to proceed. Understanding how various parts of a prosthetic work together can help clarify your options:

• The prosthetic leg itself is composed of lightweight yet robust materials. Depending on the amputation location, the leg may have functional knee and ankle joints or not.
• The socket is a custom mold of your residual limb that fits snugly, connecting the prosthetic leg to your body.
• The suspension system holds the prosthesis in place via methods such as sleeve suction, vacuum suspension, or distal locking through a pin or lanyard.

Numerous options are available for each component, each with its own advantages and disadvantages. Therefore, it’s crucial to collaborate closely with your prosthetist, a professional specializing in prosthetic limbs. This relationship can be long-term, and you will likely have frequent appointments, especially during the initial adaptation phase.

Rehabilitation Is an Ongoing, Collaborative Process

Once you’ve decided on the components for your prosthetic leg, you’ll need to engage in rehabilitation. This will involve strengthening your legs, arms, and cardiovascular system while learning to walk with your new limb. You will work in tandem with rehabilitation physicians, physical therapists, and occupational therapists to create a rehab plan tailored to your mobility goals. Keeping your healthy leg strong is vital since, despite advancements in prosthetic technology, there is no substitute for a healthy leg.

Getting Used to a Prosthetic Leg Isn’t Easy

Adapting to a prosthetic leg can pose challenges. Even after completing initial rehabilitation, you might encounter issues that your prosthetist and rehab team can help manage. Typical concerns include:

• Excessive sweating (hyperhidrosis) can impact the fit of the prosthesis and cause skin problems.
• Changing residual limb shape may occur during the first year post-amputation as tissues settle into a more permanent configuration, influencing socket fit.
• Weakness in the residual limb could hinder your ability to use the prosthesis for extended durations.
• Phantom limb pain can be intense enough to affect your ability to utilize the prosthesis.

A Note on Phantom Limb Pain

Phantom limb pain, which feels as if it originates from the amputated limb, can be a significant issue after an amputation. Studies suggest that around 80% of amputees encounter this discomfort, which may not always have a clear source, although pre-amputation pain in the limb can be a risk factor. Techniques such as mirror therapy, where users perform exercises using a mirror, may alleviate some types of phantom limb pain by tricking the brain into perceiving the missing limb as still present, which in some cases can lessen the pain.

In some instances, phantom limb pain may result from underlying conditions affecting the residual limb, such as sciatica or neuroma, and treating these issues can provide relief.

Your Leg Prosthesis Needs May Change

Eventually, you may find yourself feeling less functional with your current leg prosthesis than desired. This could happen if your residual limb stabilizes and you’re ready to transition from a temporary prosthesis to a more durable option lasting three to five years, or if you’ve become more active than your existing prosthesis accommodates. Signs that you should consult your prosthetist include new pain, discomfort, or reduced stability with your device.

Your prosthetist may suggest modifications to your current equipment, or even recommend a completely new prosthetic leg, which typically occurs every three to five years. If you receive new components, take the time to understand their functionality. Physical therapy can be beneficial in adapting to the new features or your new prosthetic leg.

Prosthetic Leg Technology Is Always Evolving

Prosthetic limb technology continuously advances, with notable developments including microprocessor-driven and activity-specific components.

• Microprocessor joints utilize computer chips and sensors to facilitate a more natural gait and can switch modes for different conditions, like walking on flat surfaces versus maneuvering stairs.
• There are also specialized prosthetic legs for different activities, such as running, swimming, or even showering, allowing for flexible use. Sometimes, your regular prosthetic leg can be adapted to serve multiple purposes by your prosthetist.
• Osseointegration surgery presents another option where a metal implant is anchored directly into the bone, eliminating the need for a socket. This method allows the prosthetic leg to connect directly to the implant, potentially enhancing mobility and sensory perception. However, this surgery is not suitable for everyone and is still being researched.

Remember, you’re not navigating the multitude of prosthetic leg options alone. Your care team will support you in weighing the pros and cons of each choice to find the ideal prosthetic leg suited to your lifestyle.

Johns Hopkins Comprehensive Amputee Rehabilitation Program

Having the support of a dedicated team of experts is essential when recovering from the amputation of a limb. At Johns Hopkins, our team of physiatrists, orthotists, prosthetists, physical and occupational therapists, rehabilitation psychologists, and other specialists collaborates to develop your personalized rehabilitation plan.

Learn more about our amputee rehabilitation program

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