Osseointegration implantation may improve outcomes for lower limb amputees
Osseointegration prosthesis implantation in the femur or tibia may improve overall and functional outcomes of patients with above-the-knee or below-the-knee amputations, according to published results.
Taylor J. Reif, MD, and colleagues performed a retrospective review of data for 31 consecutive patients who underwent implantation of a press-fit osseointegration implant of the femur (n=18) or tibia (n=13) with follow-up of at least 6 months. Researchers considered the patient-reported Questionnaire for Persons with a Transfemoral Amputation (Q-TFA), which was measured preoperatively and 6 to 12 months postoperatively, as the primary outcome. Researchers also recorded Patient-Reported Outcomes Measurement Information System (PROMIS) and Limb Deformity-Scoliosis Research Society scores, 2-minute and 6-minute walk tests, and complications.
Results showed significant improvement in all Q-TFA domains from preoperative to postoperative measures, including the global score, prosthetic use, prosthetic mobility and prosthetic problems. Researchers also found significant improvements in the overall and functional outcomes domains of the PROMIS and Limb Deformity-Scoliosis Research Society scores, as well as the 2-minute walk test and 6-minute walk test.
Patients had an overall implant retention of 93%, and researchers identified two periprosthetic hip fractures, one explantation for septic loosening and one explantation for aseptic loosening. Low-grade, soft tissue infection requiring oral antibiotics was the most common complication, according to results.
“Our results add to the growing body of literature that suggests this is the future of amputation reconstruction to optimize limb function and that most patients would be happier with an osseointegration prosthesis than a socket,” Reif, orthopedic surgeon at Hospital for Special Surgery, told Healio Orthopedics. “The primary question that needs to be addressed with future research is the longevity of these implants 20 or 30 years after implantation, because they are the ideal solution for young, active patients.”