Abstract
Electronically controlled prosthetic knee joints have been introduced to meet ambulation demands of leg amputees. This study assessed whether microprocessor-controlled knee joints or non-electronically controlled knee joints are to be preferred regarding costs and functional health.
Thirteen participants with a unilateral knee/hip disarticulation or transfemoral amputation wore a prosthesis featuring a microprocessor-driven knee joint (C-group). Thirteen similar upper-leg amputees used a non-electronic knee joint (N-group).
Direct and indirect costs were established using a cost questionnaire, the PRODISQ, and database records of the Hoensbroeck Rehabilitation Centre. Intervention costs, health care costs, patients/family costs, productivity costs and total costs were calculated. Functional health was measured using the SF-36 (SF-6D).
Total costs averaged from € 39,350 (C-group) to € 46,086 (N-group). In the C-group intervention costs were 28.2% higher (p = 0.043) as were prosthetics costs (p = 0.000). Patients/family costs amounted to € 7,094 (C-group) and € 12,992 (N-group) (p = 0.053). In the N-group housekeeping assistance cost € 4,058 more (p = 0.007), and productivity loss was higher (p = 0.051). SF-6D scores and SF-36 sub-scores were higher in the C-group (p-values between 0.001 and 0.071).
Higher purchasing costs for prostheses with a microprocessor-controlled knee joint seem to be counterbalanced by lower costs in other domains. Functional health was clearly higher in the C-group.