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. 2020 Feb;11(Suppl 1):S142-S148.
doi: 10.1016/j.jcot.2019.05.025. Epub 2019 May 31.

The future of the amputees with osseointegration: A systematic review of literature

Christopher Gerzina  1 , Eric Potter  2 , Amgad M Haleem  3   4 , Sherif Dabash  5   6
Affiliations

The future of the amputees with osseointegration: A systematic review of literature

Christopher Gerzina et al. J Clin Orthop Trauma. 2020 Feb.

Abstract

Objective: Socket prosthesis attachment is the current gold standard for limb amputees. Osseointegrated implantation is a novel technique that has many proposed advantages over the current gold standard. Clear advantages for its use over socket prosthetic attachment has been well established in literature. It decreases socket problems as pinching, pressure points, chronic skin problems and frequent socket change due to atrophy of muscles.

Methods: We reviewed primary research articles documenting complication rates and outcome measures in patients with osseointegrated prosthesis implantation after limb amputation.

Results: Nine studies were identified with a total of 211-242 patients. Clinical, radiographic, and functional outcomes, as well as complications were considered. The mean duration of follow-up was greater than 12 months in all studies.

Conclusions: Osseointegration is an effective alternative to socket prosthesis in transfemoral amputees. Transtibial and upper extremity implants are underreported in the literature and clear indication for their effectiveness over socket prosthesis does not exist. Minor complications are most common, such as soft tissue infections, and may be mitigated in the future by improvements in surgical technique and implant design.The level of evidence is 3.

Keywords: Amputation; Osseointegration; Transfemoral; Transtibial.

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Figures

Fig. 1
Fig. 1
The Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA) Implant System. It includes three main parts: an implanted fixture, an abutment, and an abutment screw. The first operation implants the fixture into the residual bone. The percutaneous parts (the abutment and the sbutment screw) are installed into the fixture six months later in a second operation. Replacements to these latter two components can be made if needed. A percutaneous area where the implant protrudes from the residual limb is created during the second operation. This figure is reproduced with permission from Brånemark R, Berlin O, Hagberg K et al. A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: A prospective study of 51 patients. Bone Joint J 2014; 96-B:106–113.
Fig. 2
Fig. 2
Flow diagram depicting study selection algorithm (created using PRISMA 2009 Flow diagram, version 2.1.3).
See this image and copyright information in PMC

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