There is a lack of objective data on acceptable transection levels for transfemoral amputation. We retrospectively correlated the residual limb length of 13 young, athletic transfemoral and knee disarticulation amputees with temporal-spatial, kinematic, and kinetic outcomes after gait analysis. It was hypothesised that shorter residual limb lengths would correlate with greater gait deviations. Patients' residual femoral lengths ranged from 57% to 100% of their intact femoral length. With the exception of one patient, pelvic tilt excursion was inversely related to residual limb length. Limb length did not significantly correlate with any other temporal-spatial, kinematic, or kinetic parameter investigated. Consequently, these results suggest that if the femur is at least 57% of the length of the contralateral femur, length does not dramatically alter gait. This implies that surgeons may have more flexibility to amputate at a higher level to preserve soft tissue quality and improve prosthetic fitting without sacrificing gait function.
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