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Comparison of thicknesses of talar cartilage, tibialis anterior, and gastrocnemius muscles between high-activity patients with unilateral traumatic transtibial amputation and nonamputated individuals: A clinical and sonographic study

Background: The aim of this study was to compare the thicknesses of intact talar cartilage, tibialis anterior (TA), gastrocnemius medialis (GCM), and gastrocnemius lateralis (GCL) muscles of traumatic unilateral transtibial amputees with that of nonamputated individuals by ultrasound and to investigate the relationship between cartilage and muscle thickness measurements with clinical parameters. Methods: Thirty-six patients with unilateral traumatic transtibial amputation, and 36 age-matched, sex-matched, and body mass index–matched nonamputated controls were included in this cross-sectional study. Subjects’ talar cartilage, TA, GCM, and GCL muscle thickness measurements were performed using musculoskeletal ultrasound. Other outcome measures were 6-minute walking test, the Foot and Ankle Outcome Score, and Short Form-36. Results: TA and GCM muscles were thicker on the intact limbs of the patients than those of the controls (p = 0.015 and p = 0.014, respectively). There was no statistically significant difference in talar cartilage and GCL muscle thicknesses when patients were compared with control subjects. Talar cartilage thickness was positively correlated with body mass index, 6-minute walking test, and sport and recreation subscale score of the Foot and Ankle Outcome Score. TA and GCM muscle thicknesses were positively correlated with the duration of prosthesis use and role limitations because of the physical health subscale score of Short Form-36. Conclusions: TA and GCM muscles were found to be thickened on the intact sides of traumatic unilateral transtibial amputees. The correlations between lower leg muscle thicknesses and clinical parameters suggest that the observed thickness change is not necessarily pathological and has potential impact on function at least in our young cohort.