Mayo Clinic researchers found the type of prosthetic knee used in patients has dramatically different effects on medical costs associated with falls, according to a study published in Prosthetics and Orthotics International.

Every year, 185,000 patients undergo a transfemoral amputation, where the leg is removed above the knee, but only 25 to 30 percent of them received a prosthetic leg and knee. Additionally, those who receive a prothesis are regulated by what type they receive from their insurance. In most cases, only active patients are eligible for a knee with microprocessor technology. In this study, researchers evaluated how the type of prosthetic a patient receive affects the medical cost of an accidental fall.

“Understanding the costs is part of basic health economics,” said Kenton Kaufman, PhD, the study’s senior author, a biomedical engineer and orthopedics researcher at Mayo Clinic. “This study quantifies the cost of falls that require medical attention—providing evidence that it may not be economical to withhold microprocessor knees from patients with moderate ambulatory capabilities.”

The study evaluated the records of 77 transfemoral amputation patients between 2000 and 2014, 46 of which received a prosthetic knee. Overall, 22 patients experienced 31 falls that resulted in a visit to the emergency department or hospitalization. Results showed that six months after a fall, the cost for individuals requiring a visit to the emergency department was $18,000 while the cost for hospitalized patients was $25,000.

“Falls are expensive in adults with transfemoral amputations. The six-month costs of falls resulting in hospitalization are similar to those reported in the elderly population who are also at an increased risk of falling,” wrote Kaufman. “Clinical relevance estimates of fall costs in adults with transfemoral amputations can provide policy makers with additional insight when determining whether or not to cover a prescription for microprocessor-controlled prosthetic knees.”