Anschlussadapter zur Ankopplung der Exoprothese an den Endostiel

Abstract

Bone anchored prostheses influence the skeleton and joints in a more direct way. This fact requires specific prosthetic measures concerning the connection between the endo-implant and the exoprosthesis. Therefore, specially matched adaptors and the prosthetic alignment are the focus of interest. Prostheses connected to an osseointegrated implant have many biomechanical advantages compared to socket-guided prostheses. Because the quality of rehabilitation is clearly affected by the prosthetic alignment, it has to be carried out extremely carefully and precisely if the prosthesis is connected to an osseointegrated implant. According to the survey, none of the prosthesis wearers wanted to return to a socket-guided prosthesis.

Rehabilitation of Patients with Osseointegrated Prosthesis after Transfemoral Amputation – Literature-based Recommendation for Postoperative Rehabilitative Procedure

“…Zwischen den Brückenmodulen wird eine Silikonkappe zum Schutz der Austrittsstelle eingesetzt [14]. Grundsätzlich ist eine Anpassung der weiteren Prothesenbauteile an die geänderte Biomechanik aufgrund der direkten Kraftübertragung erforderlich [15]. Das Muskelverhältnis verlagert sich nach transfemoraler Amputation mit jeder Kürzung zugunsten der Flexoren des Hüftgelenks, was häufig in einer Hüftbeugekontraktur resultiert [16].…”

“…Erfolgt ein Verfahrenswechsel auf osseointegrierte Prothesen, kann eine vorher durch eine Schaftanpassung suffizient kompensierte Kontraktur der anstehenden Gangschulung im Wege stehen. Hierfür stehen verschiedene Anschlussadapter zur Verfügung, mit denen die exakte Positionierung der Längsachse und des Drehpunktes erreicht werden kann [15]. Ebenfalls sind das prothetische Kniegelenk sowie der Prothesenfuß an die Dynamik der direkten Kraftübertragung anzupassen.…”

“…They consist of the implant, which is attached to the connection adapter by two bridge modules, allowing precise alignment [14]. A silicone cap is inserted between the bridge modules to protect the emergence site [14] In principle, adaptation of the other prosthesis components to the changed biomechanics is necessary due to the direct force transmission [15]. Following transfemoral amputation, the muscle ratio shifts in favour of the flexors of the hip joint with each shortening, often resulting in a hip flexion contracture [16].…”

“…If the procedure for implantation of osseointegrated prostheses is altered, a contracture that was previously compensated adequately by socket adaptation can obstruct the upcoming gait training. Different connection adapters are available for this purpose, with which the exact positioning of the longitudinal axis and pivot point can be achieved 15 . Similarly, the prosthetic knee joint and prosthetic foot must be adapted to the dynamics of direct power transmission.…”