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Gibby

AK amputees hip osteoporosis on amputated side

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Has anyone had much experience with treating/preventing this? I'm 56 and have been AKA for 30 years. No osteo anywhere but the hip due to lack of weight bearing on the hip joint since weight is pretty much on the ischium with the prosthesis. I've been taking medication for a few years which has kept it stable but would do much better if there was a way to do some kind of weight bearing activity on this side. Is there any way to do that?

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Even though you have weight that is bearing on the ischium, you should have plenty of load on your hip also when walking. For my amp side hip I lean up against the wall with amp side shoulder hitting the wall with my prosthetic foot as close to the wall as possible. I then lift my god given leg up and hold it behind me.

See how long you can do this and continue every other day to beat your last time. This not only loads weight on your hip but also builds the gluts and stump itself. If you can count to 25 on your first try I will give you an internet high five. It's brutal when you first start out.

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Thanks for the info. Everything I've been told is that there is very limited weight bearing on the hip on the amputated side which is consistent with the osteop. I've always worn a prosthesis pretty much all my waking hours and as long as it fits have done quite a bit of walking for exercise. So walking just isn't doing it for me.

What would be the difference between leaning against a wall and holding your leg out behind vs just standing straight on your full leg and holding the prosthetic leg out behind? That is one of the yoga poses I do on a regular basis.

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If your sound leg is off the ground and all of your weight is on the prosth side you will feel it after a short time. If you don't then you are in really great shape!!!

Have you ever considered a brimless socket?

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The wall make all the difference. I said the same thing and when I incorporated that into my exsersize program I could really feel it

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Have you ever considered a brimless socket?

That could be a topic of it's own. I fought with an ischial containment socket for years and although my residuum is only about 8" I

have recently learned to use a brimless socket and love it. It's very hard at first because the muscles have to be strengthened

having not been used in years. I have been at it now for about 6 weeks and am really enjoying it more and more as I get

stronger. The wall exercise is great, thanks for posting it. With brimless I also have fewer tissue problems.

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Not sure what you mean by a brimless socket. My current socket, which is awesome, doesn't have a brim like I had in the olden days. It mainly has a little piece that extends to the ischium. My socket is really great so I can't imagine messing with it.

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Oh I see what you're saying. You're standing with all your weight on your prosthetic leg and lifting your full leg off the ground. I guess the "god given" concept went right over my head. I'll give that a try and see what that's like.

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There are two things here, I think? One is that a 'fractured hip' usually describes a fractured neck of femur (thigh bone). The other is bone density in general ...

I'm sorry to say that practically all amputees have some degree of osteopenia (i.e. low bone density) in their residual limb ... some have even developed osteoporosis (i.e. seriously low bone density). :sad:

It has to do with how we weighbear in the socket. Most amps nowadays are transfemoral or transtibial, as they've gone away from end bearing amputations ... basically, because transfemoral or transtibial sockets are easier to fit, as they don't have any nobbly bits at the end. Can you believe it?! :ohmy:

In transfemoral & transtibial sockets quite a bit of weight is taken in the soft tissues, as most amps find it difficult to directly end-bear ... because they no longer have something with a large enough surface area that can bear weight. I wonder if this method of weightbearing is why amps have so many soft tissue problems? :huh:

Anyway, bone density depends, so I am reliably informed, on how much weight is going directly through the bone and also how often ... little and often weightbearing (i.e. directly through the bone) is most the effective way to maintain or increase bone density.

So, would I imagine that standing on your amputated side against a wall would not substantially help bone density in your femur?

We can't do much about weightbearing in our sockets, but we can do other things to help maintain bone health. There are lots of helpfulwebpages on the subject, but here's one of them. :cool:

x

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Thanks for the info. I have read tons since first diagnosed with this a few years ago. I pretty much do all things good for osteop except the weight bearing on the amputated side. I like you don't think it's really possible to get much of that unless you bear weight directly on the end of the residual limb - something I would find unbearably uncomfortable.

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There's only one (possibly two?) amps, that I know of, who bear weight through their 'trans' femurs ... Eddie101 springs to mind. :smile: x

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I have a brimless socket that is now being made out of Northwestern University know for their Prosthetic School. Imagine a frame if you will with a soft rubber(yes rubber) then molded over the carbon frame. This allows for a firm hold, yet in areas where it is not needed there are very flexible areas. I have a seal in elevated socket.

The brimless is two inches below my ischeum so all the weight is on the distal. But, with the internal frame built in there is some relief from baring all the weight on the distal end. Brimless are not for everyone but I love it.

As Peter stated in an earlier post. the break-in period is the time it takes you to build a bit of muscle

Good luck to you

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Oh ya, now that you describe it I recall my prosthetist telling me about this type of socket. Something worth considering next time around.

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I have a brimless socket that is now being made out of Northwestern University know for their Prosthetic School. Imagine a frame if you will with a soft rubber(yes rubber) then molded over the carbon frame. This allows for a firm hold, yet in areas where it is not needed there are very flexible areas. I have a seal in elevated socket.

The brimless is two inches below my ischeum so all the weight is on the distal. But, with the internal frame built in there is some relief from baring all the weight on the distal end. Brimless are not for everyone but I love it.

As Peter stated in an earlier post. the break-in period is the time it takes you to build a bit of muscle

Good luck to you

Yes, but you mention the ischium which is part of your pelvis, not your femur.

If you read here it says that most hip fractures are femoral fractures. So, you need weight to go through the femur to help improve bone density in the femur. Socket design and amputation techniques both contribute to osteopenia, which puts amputees at risk of 'hip' fracture.

Gibby sounds as though she's already doing a lot to help her bone density.

@Gibby ~ I've been told that the only thing that stops trans-femoral amps from weightbearing through their femurs, is the small surface area of the end of their femurs.

One or two amps have been able to weightbear. I think they check it's OK for them to do it first. Then they do it very gingerly; building up gradiually, starting with partial weightbearing on soft surfaces. That is the only thing I can think of that would help improve your bone density.

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There's only one (possibly two?) amps, that I know of, who bear weight through their 'trans' femurs ... Eddie101 springs to mind. :smile: x

Lizzie2, am so glad you are back on the forum...been a long time. I saw where you have been having some problems on facebook., feel better soon. :happy:

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Lizzie2, am so glad you are back on the forum...been a long time. I saw where you have been having some problems on facebook., feel better soon. :happy:

Thanks, Ann. Things have been pretty tough lately, I have to say ... :blink:

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I have a brimless socket that is now being made out of Northwestern University know for their Prosthetic School. Imagine a frame if you will with a soft rubber(yes rubber) then molded over the carbon frame. This allows for a firm hold, yet in areas where it is not needed there are very flexible areas. I have a seal in elevated socket.

The brimless is two inches below my ischeum so all the weight is on the distal. But, with the internal frame built in there is some relief from baring all the weight on the distal end. Brimless are not for everyone but I love it.

As Peter stated in an earlier post. the break-in period is the time it takes you to build a bit of muscle

Good luck to you

Yes, but you mention the ischium which is part of your pelvis, not your femur.

If you read here it says that most hip fractures are femoral fractures. So, you need weight to go through the femur to help improve bone density in the femur. Socket design and amputation techniques both contribute to osteopenia, which puts amputees at risk of 'hip' fracture.

Gibby sounds as though she's already doing a lot to help her bone density.

@Gibby ~ I've been told that the only thing that stops trans-femoral amps from weightbearing through their femurs, is the small surface area of the end of their femurs.

One or two amps have been able to weightbear. I think they check it's OK for them to do it first. Then they do it very gingerly; building up gradiually, starting with partial weightbearing on soft surfaces. That is the only thing I can think of that would help improve your bone density.

Yes I kn ow where the Ischium is I am AKA and I wear a brimless socket which the top brim is two below my Ischium (by my pelvis)

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I have a brimless socket that is now being made out of Northwestern University know for their Prosthetic School. Imagine a frame if you will with a soft rubber(yes rubber) then molded over the carbon frame. This allows for a firm hold, yet in areas where it is not needed there are very flexible areas. I have a seal in elevated socket.

The brimless is two inches below my ischeum so all the weight is on the distal. But, with the internal frame built in there is some relief from baring all the weight on the distal end. Brimless are not for everyone but I love it.

As Peter stated in an earlier post. the break-in period is the time it takes you to build a bit of muscle

Good luck to you

Yes, but you mention the ischium which is part of your pelvis, not your femur.

If you read here it says that most hip fractures are femoral fractures. So, you need weight to go through the femur to help improve bone density in the femur. Socket design and amputation techniques both contribute to osteopenia, which puts amputees at risk of 'hip' fracture.

Gibby sounds as though she's already doing a lot to help her bone density.

@Gibby ~ I've been told that the only thing that stops trans-femoral amps from weightbearing through their femurs, is the small surface area of the end of their femurs.

One or two amps have been able to weightbear. I think they check it's OK for them to do it first. Then they do it very gingerly; building up gradiually, starting with partial weightbearing on soft surfaces. That is the only thing I can think of that would help improve your bone density.

Yes I kn ow where the Ischium is I am AKA and I wear a brimless socket which the top brim is two below my Ischium (by my pelvis)

I'm not being funny, but if that's the case, you'll understand that as your ischium is part of your pelvis, it's not your hip. So, weight will still be partly taken by the soft tissues and not through the femur.

I also have what you call a brimless socket ... that's how I know. :rolleyes:

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