An above knee prosthesis, or transfemoral prosthesis, is designed for individuals following amputation above the knee. This device replaces both the anatomical limb and the functional role of the knee, to assist in restoration of mobility, stability, and functional independence.
At Head to Foot Orthotics and Prosthetics, management is centred on individualised prosthetic prescription, precise socket design, and ongoing clinical review, supporting patients across Croydon, Alexandra, Ballarat, Berwick, and Dandenong.
Advances in prosthetic technology have significantly improved functional outcomes, allowing patients to return to ambulation, activities of daily living and vocational activities..
Transfemoral Amputation: Clinical Overview
A transfemoral amputation involves removal of the limb above the knee joint, necessitating integration of an artificial knee mechanism within the prosthetic system.
Common aetiologies include:
- Trauma
- Peripheral vascular disease and diabetes
- Infection
- Malignancy
- Congenital limb deficiency
Given the knee’s critical role in gait efficiency, stability, and energy conservation, prosthetic design must replicate controlled stance and swing phase mechanics.
Prosthetic Design and Biomechanics
A transfemoral prosthesis consists of multiple integrated components:
- Custom socket: Interfaces with the residual limb, distributes load and PROVIDES SUSPENSION FOR THE PROSTHESIS.
- Prosthetic knee unit: Controls stance stability and swing phase
- Foot-ankle system: Facilitates shock absorption and forward progression
Optimal alignment and component integration are essential to achieve efficient gait, minimise compensatory patterns, and reduce tissue stress.
Prosthetic Knee Technologies
Selection of a prosthetic knee is guided by the patient’s functional level, goals, and environment.
Mechanical Knees
Provide basic stability through single-axis OR POLYCENTRIC mechanisms. Suitable for ALL activity levels.
Hydraulic/Pneumatic Knees
Utilise fluid or air resistance to allow variable cadence (CHANGES IN SPEED) and smoother gait transitions.
Microprocessor-Controlled Knees
Incorporate sensor-based technology to dynamically adjust resistance in real time, improving stability, safety, and gait symmetry across varying terrains.
For a more detailed comparison of these technologies, see our guide to mechanical knees vs microprocessor prosthetic knees.
Prosthetic Prescription and Fitting
Successful outcomes depend on accurate clinical assessment and socket design.
Key considerations include:
- Residual limb morphology and tissue integrity
- Muscle strength and neuromuscular control
- Level of amputation
- Functional goals and activity level
The socket interface is critical in distributing load, maintaining skin integrity AND SUSPENDING THE PROSTHESIS.
Precise adjustment of the prosthesis ensures the foot, ankle, and knee work together effectively.
Rehabilitation and Functional Outcomes
Rehabilitation following transfemoral amputation requires a structured, multidisciplinary approach.
Focus areas include:
- MAXIMISING HIP RANGE OF MOVEMENT
- Hip and core strengthening
- Balance and proprioceptive training
- Gait re-education with prosthetic integration
- Endurance and functional conditioning
Due to the absence of the anatomical knee, patients must develop adaptive movement strategies to achieve safe and efficient ambulation.
With appropriate rehabilitation, many individuals regain independent mobility and functional participation.
Comparison: Above Knee vs Below Knee Prosthesis
The key distinction lies in preservation of the anatomical knee joint.
- Transtibial (below knee) amputations typically allow more efficient gait and lower energy expenditure
- Transfemoral (above knee) amputations require prosthetic substitution of knee function, increasing biomechanical complexity
Despite this, well-prescribed AND OPTIMALLY FITTING prosthetic systems can deliver high levels of function ACROSS ALL AMPUTATION LEVELS.
Long-Term Management
Ongoing prosthetic care is essential to maintain optimal outcomes.
Benefits of modern prosthetic systems include:
- Improved mobility and balance
- Enhanced independence
- Increased participation in daily and vocational activities
Regular clinical review ensures appropriate fit, alignment, and timely component adjustment as patient needs evolve.
Service Delivery
Head to Foot Orthotics and Prosthetics provides comprehensive prosthetic services across Victoria, including:
Croydon
Alexandra
Ballarat
Berwick
Dandenong
Patients have access to experienced prosthetists, advanced componentry, and individualised care pathways.
Frequently Asked Questions
What is a transfemoral prosthesis?
A prosthetic limb designed to replace function following amputation above the knee, incorporating a prosthetic knee joint.
Can functional ambulation be achieved?
Yes. With appropriate prescription and rehabilitation, many patients achieve safe, independent ambulation.
What is the expected lifespan?
Prosthetic components (foot and knee) typically last 2 – 5 years, with regular periodic reviews. The prosthetic socket, liners and suspension may require replacement during this time.
How long does rehabilitation take?
Initial prosthetic use may begin within months post-amputation, with functional outcomes improving progressively through rehabilitation.
