JHSM
Journal of Health Sciences and Medicine

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Original Article
Analysis of static pelvic tilt variations in transfemoral prosthesis users: comparison of different socket designs with healthy controls
Abstract
Aims: The aim of this study was to investigate pelvic tilt angles in patients with transfemoral prosthesis, considering different socket designs, and to compare them with healthy controls.
Methods: In this cross-sectional study, 28 male participants were enrolled, including 14 unilateral transfemoral prosthesis users (prosthesis group) and 14 demographically similar healthy subjects (control group). Pelvic tilt angles in both sagittal and frontal planes were measured using a digital inclinometer mounted on a two-arm caliper.
Results: All participants had anterior pelvic tilt. Within the prosthesis group, there was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side (p=0.106, effect size (ES)=0.464; p=0.055, ES=-0.564, respectively). There was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side of the participants using both quadrilateral socket design and ischial containment socket designs (p=0.499, ES=-0.256; p=0.128, ES=-0.575; p=0.063, ES=-0.703; p=0.612, ES=-0.192, respectively). However, a significant difference was found in both the right and left anterior pelvic tilt angles and the lateral pelvic tilt angles between the prosthesis group and the control group (p=0.001, ES=-0.582; p<0.001, ES=-0.635; p<0.001, ES=-0.797, respectively).
Conclusion: The findings reveal that while anterior pelvic tilt is present in all participants, significant differences exist between prosthesis users and healthy individuals in both anterior and lateral pelvic tilt angles. These results underscore the importance of considering pelvic alignment in the design and fitting of prostheses, potentially in forming clinical practices to enhance the comfort and functionality for transfemoral prosthesis users.

Keywords : Transfemoral prostheses, pelvic tilt angle, anterior pelvic tilt, lateral pelvic tilt

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1. Preece SJ, Willan P, Nester CJ, Graham-Smith P, Herrington L, Bowker P. Variation in pelvic morphology may prevent the identification of anterior pelvic tilt. J Man Manip Ther. 2008;16(2):113-117. doi:10.1179/ 106698108790818459
2. Suits WH. Clinical measures of pelvic tilt in physical therapy. Int J Sports Phys Ther. 2021;16(5):1366-1375. doi:10.26603/001c.27978
3. Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther. 2011;16(6):646-648. doi:10.1016/j.math.2011.04.006
4. Crossley KM, Schache AG, Ozturk H, Lentzos J, Munanto M, Pandy MG. Pelvic and hip kinematics during walking in people with patellofemoral joint osteoarthritis compared to healthy age-matched controls. Arthritis Care Res (Hoboken). 2018;70(2):309-314. doi:10.1002/acr.23261
5. Kr&oacute;l A, Polak M, Szczygiel E, W&oacute;jcik P, Gleb K. Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. J Back Musculoskelet Rehabil. 2017;30(4):699-705. doi:10.3233/BMR-140177
6. Kuwahara W, Kurumadani H, Tanaka N, et al. Correlation between spinal and pelvic movements during gait and aggravation of low back pain by gait loading in lumbar spinal stenosis patients. J Orthop Sci. 2019;24(2):207-213. doi:10.1016/j.jos.2018.09.002
7. Gailey R, Allen K, Castles J, Kucharik J, Roeder M. Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev. 2008;45(1):15-29. doi:10.1682/jrrd.2006.11.0147
8. Kar Z, Kutlu A. Investigation of body ımage and quality of life of patients with lower limb amputation: problems experienced of patients. Niger J Clin Pract. 2023;26(11):1685-1695. doi:10.4103/njcp.njcp_307_23
9. Heitzmann DWW, Leboucher J, Block J, et al. The influence of hip muscle strength on gait in individuals with a unilateral transfemoral amputation. PLoS One. 2020;15(9):e0238093. doi:10.1371/journal.pone. 0238093
10. Long IA. Normal shape-normal alignment (NSNA) above-knee prosthesis. Clin Prosthet Orthot. 1985;9(4):9-14.
11. Sabolich J. Contoured Adducted Trochanteric-Controlled Alignment Method (CAT-CAM); introduction and basic princi ples. Clin Prosthet Orthot. 1985;9:15-26.
12. Hachisuka K, Umezu Y, Ogata H, Ohmine S, Shinkoda K, Arizono H. Subjective evaluations and objective measurements of the ischial-ramal containment prosthesis. J UOEH. 1999;21(2):107-118. doi:10.7888/juoeh. 21.107
13. Gailey RS, Lawrence D, Burditt C, Spyropoulos P, Newell C, Nash MS. The CAT-CAM socket and quadrilateral socket: a comparison of energy cost during ambulation. Prosthet Orthot Int. 1993;17(2):95-100. doi:10. 3109/03093649309164363
14. Flandry F, Beskin J, Chambers RB, Perry J, Waters RL, Chavez R. The effect of the CAT-CAM above-knee prosthesis on functional rehabilitation. Clin Orthop Relat Res (1976-2007). 1989;239:249-262.
15. Fairley M. MAS Socket: a transfemoral revolution. O&amp;P Edge. 2004.
16. Goujon-Pillet H, Sapin E, Fod&eacute; P, Lavaste F. Three-dimensional motions of trunk and pelvis during transfemoral amputee gait. Arch Phys Med Rehabil. 2008;89(1):87-94. doi:10.1016/j.apmr.2007.08.136
17. Sj&ouml;dahl C, Jarnlo GB, S&ouml;derberg B, Persson BM. Kinematic and kinetic gait analysis in the sagittal plane of trans-femoral amputees before and after special gait re-education. Prosthet Orthot Int. 2002;26(2):101-112. doi:10.1080/03093640208726632
18. Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T. Pelvic alignment changes during the perinatal period. PLoS One. 2019; 14(10):e0223776. doi:10.1371/journal.pone.0223776
19. Azevedo DC, Santos H, Carneiro RL, Andrade GT. Reliability of sagittal pelvic position assessments in standing, sitting and during hip flexion using palpation meter. J Bodyw Mov Ther. 2014;18(2):210-214. doi:10. 1016/j.jbmt.2013.05.017
20. Gottschalk F. The importance of soft tissue stabilization in trans-femoral amputation : English version. Orthopade. 2016;45(Suppl 1):S1-S4. doi:10.1007/s00132-015-3098-8
21. K&ouml;hler TM, Blumentritt S, Braatz F, Bellmann M. The impact of transfemoral socket adduction on pelvic and trunk stabilization during level walking-a biomechanical study. Gait Posture. 2021;89:169-177. doi: 10.1016/j.gaitpost.2021.06.024
22. Gaunaurd I, Gailey R, Hafner BJ, Gomez-Marin O, Kirk-Sanchez N. Postural asymmetries in transfemoral amputees. Prosthet Orthot Int. 2011;35(2):171-180. doi:10.1177/0309364611407676
23. Ezhumalai K, Padhi A, Mohanty RK, Pradhan R, Mohanty P. Influence of femur length on asymmetry of prosthetic gait biomechanics in transfemoral amputation. J Mech Med Biol. 2024;24(05):2350099. doi: 10.1142/S0219519423500999
24. Michaud SB, Gard SA, Childress DS. A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation. J Rehabil Res Dev. 2000;37(1):1-10.
25. Karimi MT, Kavyani M, Mehrvar A. Osseointegration: a new approach to improve functional performance of prostheses-a systematic review of the literature. Curr. Orthop. Pract. 2024;35(6):229-236. doi:10.1097/BCO.0000000000001275
26. Ravari R, Rehani M, Hebert JS. Biomechanical characteristics of transfemoral bone-anchored prostheses during gait: a review of literature. Prosthet Orthot Int. 2024;48(4):412-421. doi:10.1097/PXR. 0000000000000263
Article available in :
Volume 8, Issue 2, 2025
Page : 210-214
https://doi.org/10.32322/jhsm.1607601
Article Information
Received : 26 Ara 2024
Accepted : 28 Oca 2025
Published : 21 Mar 2025
Corresponding Author :

Kamil Yılmaz: Department of Orthotics and Prosthetics, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkiye

[email protected]
Citation : Yılmaz K. Analysis of static pelvic tilt variations in transfemoral prosthesis users: comparison of different socket designs with healthy controls. J Health Sci Med. 2025;8(2):210-214.

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