Health-related quality of life in amputees with a microprocessor-controlled prosthetic knee measured by the EQ-5D-5L

BACKGROUND: Enhancing health-related quality of life (HRQoL) is a fundamental objective of healthcare delivery. Individuals with amputation might encounter physical, psychological, and social challenges in daily life which might be influenced by the type of prosthetic knee provided. OBJECTIVE: To understand the experience-based HRQoL of amputees who were using a microprocessor-controlled prosthetic knee (MPK). METHODOLOGY: Amputees using an MPK for at least 3 months (C-Leg or Genium/Genium X3) participated in an online survey. In 2022 1,868 MPK user were invited to participate in the study via both desktop and mobile platforms of a German manufacturer database. HRQoL was assessed with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument. The data was analyzed descriptively and by measures of central tendency. FINDINGS: 512 participants (19.7% female, mean age 54 years (standard deviation 12.6)) responded and fully completed the EQ-5D-5L. The leading cause of amputation was trauma (56.1%), followed by tumor (15.6%) and peripheral arterial disease (PAD, 11.3%). 18.2% reported being completely problem-free. 2.9% had a hip disarticulation, 68.0% a transfemoral amputation, 26.6% a knee disarticulation and 2.5% a bilateral amputation. The share of “no problems” was 53.3% for mobility, 88.1% for self-care, 61.5% for usual activities, 25.0% for pain or discomfort, and 67.4% for anxiety/depression. The total mean index score based on the German value set was 0.84 (maximum score 1). The total mean visual analogue scale (VAS) score was 77.4 with variations observed for age and health status. CONCLUSION: Amputees with an MPK experienced very few issues in the self-care dimension but faced more challenges in the pain/discomfort and mobility dimensions. Utilities were similar to the general German norm reporting one medical condition. MPKs enable individuals to achieve quality of life outcomes that are comparable to those observed in the general population.