Two-Stage Osseointegrated Reconstruction of Post-traumatic Unilateral Transfemoral Amputees

Abstract

A new technique called osseointegration was introduced recently by intimately connecting the artificial limb prosthesis to the residual bone, eliminating the problematic socket-residuum interface. The objective here is to describe the two-stage strategy for the osseointegrated reconstruction of amputated limbs and discuss the clinical outcomes of the procedure. This is a prospective case series of 37 post-traumatic unilateral transfemoral amputees with a minimum 2-yr follow-up. Outcome measures included the Questionnaire for persons with a Transfemoral Amputation (Q-TFA), the Short Form Health Survey 36 (SF-36), the 6 Minute Walk Test (6MWT), and Timed Up and Go (TUG) tests. Adverse events including infection, revision surgery, fractures, and implant failures were reported. Clinical outcomes for all outcome measures were significantly improved at follow-up. Twelve participants were wheelchair bound pre-operatively; however, all 12 were able to ambulate after osseointegrated reconstruction. Sixteen patients experienced infection episodes but were managed successfully without the need for implant removal. One periprosthetic fracture occurred due to increased activity, which was revised successfully. These results confirm that the procedure is a suitable alternative for post-traumatic unilateral transfemoral amputees experiencing socket-related discomfort, with the potential to reduce recovery time compared with other treatment protocols.