Hip Disarticulation and Hemipelvectomy Amputation

Hip Disarticulation and Hemipelvectomy Amputation

What does it mean to be a Hip Disarticulation or Hemipelvectomy amputee?

A Hip disarticulation means your entire leg has been amputated through your hip joint, leaving your pelvis intact. A Hemipelvectomy is the amputation of your entire leg as well as a portion of your pelvis. A hip disarticulation or hemipelvectomy are possibly the most difficult types of amputations to overcome, both physically and emotionally. It affects not only your body image but can also has an adverse impact on your bladder, bowel and sexual functions.  

There are a few more components needed than an above knee prosthesis so your main components that will be required are a comfortable socket, a suitable prosthetic hip and knee joint and a prosthetic foot.  

The need for a Hip disarticulation or Hemipelvectomy amputation may be as result of one of the following conditions: 

  • Peripheral vascular disease (poor circulation)
  • Diabetes
  • Infection
  • Ulcers
  • Trauma causing the lower leg to be crushed or severed
  • Tumours

What is a Hip disarticulation Amputation in medical terms?

This is a very complex surgery where the surgical team will need to ensure that the amputee is able to weight bear on the remaining skeletal surfaces during both sitting and standing. The entire leg is surgically removed and in the case of hemipelvectomy some organs on the area may also be affected. No two amputations are the same. 

Above Knee Amputation – the positives

While an amputation is never ideal, although not many there are some positives when it comes to a Hip Disarticulation amputee. 

  • Advances in prosthetic socket design ensures a better more core comfortable fit. 
  • Some users are able run with their prosthesis 

The Socket

As with all prosthetic sockets, the fit is extremely important. A Hip disarticulation socket is custom made according to the shape and size of the remaining pelvis. The prosthetists expertise come into the design and understanding of your unique needs. The prosthesis is suspended by various methods that will be discussed during your assessment. The socket design is unique to you. It is quite important that you discuss with your prosthetist any concerns or explain as best as you can where you are feeling pain or discomfort in your socket. You are the one wearing it and you need to be comfortable in it. 

The prosthesis is suspended by means of on encapsulating socket design to with suspend above the or below the iliac crests. Multiple socket fits will be required initially to ensure a comfortable fit. A BOA or strap system will be used to fasten the socket on to you. 

The Prosthetic Hip

The prosthetic allows you to be able to bend and straighten at the socket for sitting and standing, While there are not very many hip joint variations available on the market, they range from a simple lock design to the more complex Helix Hip from Ottobock. Your prosthetist will help you chose the correct hip joint. 

The Prosthetic Knee

The prosthetic knee joint allows both flexion (bending) and extension (straightening) and varies in function depending on your needs, weight and activity level. They vary in function as a result of these factors, from basic locking knees that stay straight when you are walking to high functioning hydraulic knees that are controlled by built in microprocessors. Your prosthetist will assist in selecting the knee that is right for you based on your needs. Ideally you will need a knee joint that will allow the knee centre of rotation to be as close to the sound limb as possible. This is not always possible, and function often supersedes cosmetic appearance. 

Our prosthetists are experienced in using a wide range of knee joints and we are manufacturer certified to fit high end components including, C-leg and VGK Knee joints. 

The Prosthetic Foot

As with the prosthetic knee, the prosthetic foot chosen will be based on your weight, activity level and specific needs. They vary in their capabilities depending on levels of activity. Some are activity specific such as running blades, they are designed specifically for walking and not for day to day walking due to their energy return capabilities. They are designed for you to put a lot of weight/energy into the foot for it to release energy to propel you forward, as you can imagine, not ideal for day to day walking. The same could be said for an entry level foot, its purpose is to facilitate a smooth roll over while walking and provide a broad base of stability. Trying to run with this type of foot will lead to it failing and causing pain or discomfort to your residual limb. 

The look of the prosthesis

This is determined by the shape and size of your residual limb as well as the intended use of the prosthesis. Some prosthetic users like to have the components of their prosthesis exposed, others a High Definition silicone cover to match their sound limb. The decision is yours and again this is something that needs to be discussed with your prosthesis so they can advise on what is possible and what isn’t. Setting expectations in this regard is extremely important. 

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