{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:28:02Z","timestamp":1760956082827},"reference-count":16,"publisher":"SLACK, Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[1993,8]]},"abstract":"<jats:p>ABSTRACT<\/jats:p>\n          <jats:p>Four elderly peripheral vascular insufficiency below-knee amputees, average age 58, underwent contralateral through-knee amputation for gangrene. All four became household ambulators with end-weight bearing designed prosthetic sockets and four-bar linkage knees. Gait analysis was performed with two AMTI (Newton, Mass) Biomechanics Force Platforms and a Watsmart Motion Monitoring System (Waterloo, Ontario). All four were observed to apparently \"lock\" the four-bar linkage prosthetic knee into extension during midstance and double limb support phases of gait All subjectively felt that their through-knee limb was then* more stable limb. Weight-bearing occurred during 63% of the gait cycle on the below-knee limb, 54% on the through-knee limb, and 17% in double limb support Walking propulsion, as measured by forefoot impulse, was similar in the two limbs. The first peak of vertical force, corresponding to the elevation of the center of body weight as it passes over the weight-bearing limb, averaged 98% of body weight on the through-knee limb and only 93% on the below-knee limb. The second peak, corresponding to the kinetic energy of the falling trunk and muscle function providing linear acceleration of the center of body weight during propulsion, averaged 96% of body weight on the through-knee limb, and only 73% on the below-knee limb. Progression of the center of pressure, a qualitative measure of limb stability, was more orderly hi the through-knee limbs. In a preliminary laboratory gait analysis, elderly peripheral vascular insufficiency below-knee amputees who became household walkers following contralateral through-knee amputation derived greater stability from their through-knee limbs without the expected loss of walking propulsion. The authors conclude that, 1) unilateral belowknee amputees who are projected to be marginal walkers following contralateral limb amputation may benefit from the stability afforded by through-knee amputation of the second limb; and 2) elderly patients who possess the ability the heal an amputation at the below-knee level, but project to be marginal walkers, may also benefit from the stability in walking with an end-weight bearing prosthesis afforded by through-knee amputation, without the expected loss of walking propulsion.<\/jats:p>","DOI":"10.3928\/0147-7447-19930801-05","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T13:42:30Z","timestamp":1618926150000},"page":"875-879","source":"Crossref","is-referenced-by-count":9,"title":["GAIT ANALYSIS OF DYSVASCULAR BELOW-KNEE AND CONTRALATERAL THROUGH-KNEE BILATERAL AMPUTEES: A PRELIMINARY REPORT"],"prefix":"10.3928","volume":"16","author":[{"given":"Michael S","family":"Pinzur","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devin","family":"Tornow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Meade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinash","family":"Patwardhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_1","unstructured":"1. 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Selection of patients for through-knee amputation. J Bone JoiaSurg. 1988;70A:746-750.","DOI":"10.2106\/00004623-198870050-00016"},{"key":"e_1_3_1_11_1","doi-asserted-by":"crossref","unstructured":"10. Pit\u00eczur MS Asseimeier M Smith D. Walking electromyography in active and limited walking dysvascular belowknee amputees. Orthopedics. 1991; 14:535-538.","DOI":"10.3928\/0147-7447-19910501-06"},{"key":"e_1_3_1_12_1","unstructured":"1 1 . Greene MP. Four bar linkage knee analysis. Orthotics and Proph\u00e9ties. 1983; 37:15-24."},{"key":"e_1_3_1_13_1","doi-asserted-by":"crossref","unstructured":"12. Pinzur MS Graham G Osterman H. Psychological testing and amputation rehabilitation. Ctin Orthop. 1988; 229:236-240.","DOI":"10.1097\/00003086-198804000-00033"},{"key":"e_1_3_1_14_1","doi-asserted-by":"crossref","unstructured":"13. Katoh Y Chao EYS Laughman RK Schneider E Morrey BF. Biomechanical analysis of foot function during gait and clinical applications. CUn Orthop. 1983; 177:23-33.","DOI":"10.1097\/00003086-198307000-00005"},{"key":"e_1_3_1_15_1","doi-asserted-by":"crossref","unstructured":"14. Grandy M Tosh PA. McLeish RD Smidl L. An investigation of the centres of pressure under the foot while walking. J Bone Joint Surg. 1975; 57B:98-103.","DOI":"10.1302\/0301-620X.57B1.98"},{"key":"e_1_3_1_16_1","doi-asserted-by":"crossref","unstructured":"15. Townsend MA. Biped gait stabilization via foot placement. J Biomech. 1985; 18:21-38.","DOI":"10.1016\/0021-9290(85)90042-9"},{"key":"e_1_3_1_17_1","doi-asserted-by":"crossref","unstructured":"16. Tropp H. Odenrick. Postural control in single-limb stance. 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