ArticlePM & R : the journal of injury, function, and rehabilitation2019
Low Back Pain in Adults With Transfemoral Amputation: A Retrospective Population-Based Study.
Article in PM & R : the journal of injury, function, and rehabilitation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Outcomes following major dysvascular lower limb amputation: an updated systematic review.BMC cardiovascular disorders · 2026Pooled it
- Assessment and characterization of back pain and biopsychosocial influences in lower limb amputation: scoping review.Pain reports · 2026Review
- Symmetry Function: The Differences between Active and Non-Active Above-the-Knee Amputees.Sensors (Basel, Switzerland) · 2022Article
- Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee.Journal of neuroengineering and rehabilitation · 2021Article
- Prevalence of postamputation pain and its subtypes: a meta-analysis with meta-regression.Pain reports · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundLow back pain (LBP) is common among individuals with transfemoral amputation (TFA) and has a negative impact on quality of life. Little is known about health care utilization for LBP in this population and whether utilization varies by amputation etiology.
objectiveTo determine if individuals with TFA have an increased likelihood of seeking care or reporting symptoms of acute or chronic LBP during physician visits after amputation compared with matched individuals without amputation.
designRetrospective cohort.
settingOlmsted County, Minnesota (2010 population: 144 248).
participantsAll individuals with incident TFA (N = 96), knee disarticulation, and transfemoral amputation residing in Olmsted County between 1987 and 2014. Each was matched (1:10 ratio) with non-TFA adults on age, sex, and duration of residency. Individuals were divided by etiology of amputation: dysvascular and trauma/cancer.
interventionsNot applicable. MAIN OUTCOME MEASUREMENTS: Death and presentation for evaluation of LBP (LBP event) while residing in Olmsted County. LBP events were identified using validated International Classification of Diseases, Ninth Revision (ICD-9) codes and corresponding Berkson, Hospital International Classification of Diseases Adapted (HICDA), and ICD-10 diagnostic codes. Hurdle and competing-risk Cox proportional hazard models were used.
resultsHaving a TFA of either etiology did appear to correlate with increased frequency of LBP events, although this association was only statistically significant within the dysvascular TFA cohort (dysvascular TFA cohort: relative risk [RR] 1.80, 95% confidence interval [CI] 1.07-3.03, median follow-up 0.78 years; trauma/cancer TFA cohort: RR 1.14, 95% CI 0.58-2.22, median follow-up 7.95 years). In time to event analysis, dysvascular TFA had an increased risk of death and event. Obesity did not significantly correlate with increased frequency of LBP events or time to event for either cohort. At any given point in time, individuals with TFA of either etiology who had phantom limb pain were 90% more likely to have an LBP event (hazard ratio [HR] 1.91, 95% CI 1.11-3.31). Conditional on not dying and no LBP event within the first 2.5 years, individuals with prosthesis had a decreased risk of LBP events in subsequent years.
conclusionsRisk of LBP events appears to vary by TFA etiology. Obesity did not correlate significantly with increased frequency of LBP event or time to event. Phantom limb pain correlated with decreased time to LBP event after amputation. The association between prosthesis receipt and LBP events is ambiguous. LEVEL OF EVIDENCE: III.
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Registered trials
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