Following a transfemoral (TF) amputation, the ability to walk with a prosthesis is the main objective of rehabilitation. The achieved speed of walking is considered a determining factor in the amputee's perception of quality of life.

This experimental before-after study evaluates the walking abilities and improvement of important parameters such as gait, walking speed, pain and hours of prosthesis use in transfemoral amputees after placing a novel femoral implant that permits distal weight bearing of the residuum within a socket, adapted for distal load bearing.

Thirty TF amputees with an amputee history of more than 12 months received an all-inside femoral implant, comprised of a femoral stem and a polyethylene spacer that allows distal load of the residuum within an adapted socket. The post-intervention follow-up period was 14 months.

The applied rehabilitation schedule was our standard one, and no hardware changes were allowed during the follow-up period of 14 months, except for the adapted socket. Functionality was evaluated using the standard 2-minute walk test (2MWT) and the physiological cost index (PCI).

To date 19 patients (8 trauma, 8 vascular and 3 tumour patients) have finished the follow-up period.

Prior to the implant placement the mean 2MWT covered distance was 103.16m (SD=33.03), and at 14 months was 124.95m (SD=39.22), (P=0.00); an increase of 21.1%.

The initial mean Visual Analogue Pain (VAS) score was 2.26 (SD=2.76) and at 14 months 0.42 (SD=0.77), (P<0.005), a reduction of 81.4%. The PCI reduction (D heart rate/walking speed) was not statistically significant (P<0.596). The observed increase of oxygen consumption in the vascular group (+20.15%) also indicates an additional beneficial general health improvement for this type of patients.

The results of the present study show significant improvements in walking speed, pain reduction, hours of prosthesis use and general health status at 14 months after having received a femoral distal load implant in patients of different ethiology.