Quality of life in persons with partial foot or transtibial amputation: A systematic review

Study design: Systematic review.

Background: Common beliefs about quality of life in people with partial foot and transtibial amputation are often described as passing comments in the literature with seeming little research evidence. A clear understanding of the research evidence is important to inform decisions about amputation level from a quality of life perspective.

Objective: To systematically gather and appraise research evidence comparing quality of life between persons with partial foot and transtibial amputation.

Methods: A comprehensive suite of databases (e.g. Cochrane Library, MEDLINE and Web of Science) were searched using terms relating to amputation level and quality of life. Reference lists of articles that met the inclusion criteria were hand searched. Included studies reported quantitative data for persons with partial foot and transtibial amputation secondary to peripheral vascular disease and diabetes. Studies were appraised using the McMaster University Critical Review form.

Results: There is insufficient evidence comparing quality of life in people with partial foot and transtibial amputation. The available evidence suggests that quality of life may be very similar in people with partial foot and transtibial amputation and the small differences are not likely to be clinically meaningful.

Conclusion: Without adequate evidence comparing quality of life in people with partial foot and transtibial amputation, it is difficult to inform decisions about amputation level from a quality of life perspective.

Clinical relevance: There is insufficient evidence about differences in QoL between persons with PFA or TTA. Contrary to common belief, the available evidence suggests that QoL may be similar in persons with PFA and TTA. Further research is needed to inform decisions about amputation level from a QoL perspective.