Perceptions and Acceptance of Osseointegration Among Individuals With Lower Limb Amputations: A Prospective Survey Study

Webster, Joseph B.; Chou, Teri G. Rosenbaum; Kenly, M; English, Michael; Roberts, Toni L.; Bloebaum, Roy D.

doi:10.1097/jpo.0b013e3181bfafba

Cited by 21 publications

(12 citation statements)

References 22 publications

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“…The absence of a prosthetic socket can alleviate the skin problems and residual limb pain. This technique has contributed to a significant improvement in the quality of life of transfemoral amputees [7,8].…”

Section: Osseointegrated Fixation: Solution For Transfemoral Amputationmentioning

confidence: 99%

Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: A proof-of-concept study

Frossard

Gow

Hagberg³

et al. 2010

Gait & Posture

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The purpose of this proof-of-concept study was to determine the relevance of direct measurements to monitor the load applied on the osseointegrated fixation of transfemoral amputees during static load bearing exercises. The objectives were (A) to introduce an apparatus using a three-dimensional load transducer, (B) to present a range of derived information relevant to clinicians, (C) to report on the outcomes of a pilot study and (D) to compare the measurements from the transducer with those from the current method using a weighing scale. One transfemoral amputee fitted with an osseointegrated implant was asked to apply 10 kg, 20 kg, 40 kg and 80 kg on the fixation, using self-monitoring with the weighing scale. The loading was directly measured with a portable kinetic system including a six-channel transducer, external interface circuitry and a laptop. As the load prescribed increased from 10 kg to 80 kg, the forces and moments applied on and around the antero-posterior axis increased by four-fold anteriorly and 14-fold medially, respectively. The forces and moments applied on and around the medio-lateral axis increased by nine-fold laterally and 16-fold from anterior to posterior, respectively. The long axis of the fixation was overloaded and underloaded in 17% and 83% of the trials, respectively, by up to + or - 10%. This proof-of-concept study presents an apparatus that can be used by clinicians facing the challenge of improving basic knowledge on osseointegration, for the design of equipment for load bearing exercises and for rehabilitation programs.

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Section: Osseointegrated Fixation: Solution For Transfemoral Amputationmentioning

confidence: 99%

Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: A proof-of-concept study

Frossard

Gow

Hagberg³

et al. 2010

Gait & Posture

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“…Amputees who use conventional sockets are aware of both the advantages and disadvantages of DSA, and are influenced by them. In a survey, 33% of respondents with above knee amputation stated that they would consider undergoing the osseointegration procedure for prosthetic attachment. Forty‐two percent of the participants responded that they would not consider having the procedure due to potential infection, implant failure, long rehabilitation course, and risk of a broken bone in the residual limb.…”

Section: Introductionmentioning

confidence: 99%

Design features of implants for direct skeletal attachment of limb prostheses

Pitkin

2013

J Biomedical Materials Res

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In direct skeletal attachment (DSA) of limb prostheses, a construct is implanted into an amputee’s residuum bone and protrudes out of the residuum’s skin. This technology represents an alternative to traditional suspension of prostheses via various socket systems, with clear indications when the sockets cannot be properly fitted. Contemporary DSA was invented in the 1990s, and several implant systems have been introduced since then. The current review is intended to compare the design features of implants for DSA whose use in humans or in animal studies has been reported in the literature.

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“…These POP devices, also known in the literature as osseointegrated (Albrektsson et al 1981; Branemark 1983; Hagert et al 1986; Branemark 2003; Brånemark et al 2005; Webster et al 2009; Chou et al 2010; Isaacson et al 2010; Jeyapalina et al 2011; Shelton et al 2011) and endo-exoprosthesis (Aschoff 2009; Aschoff et al 2009), represent a relatively new technology that is presently being investigated worldwide in an attempt to obviate the multiple shortcomings of socket technology by providing direct attachment in order to secure the exoprosthetic limb. Currently, there are three primary groups working with selected human amputee volunteers with this technology – Branemark and co-workers in Sweden, Aschoff and colleagues in Germany, and Blunn and Pendergrass in England).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous osseointegrated prostheses for amputees: Limb compensation in a 12-month ovine model

Shelton¹,

Beck²,

Bloebaum³

et al. 2011

Journal of Biomechanics

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Percutaneous osseointegrated prostheses are being investigated as an alternative strategy to attach prosthetic limbs to patients. Although the use of these implants has shown to be promising in clinical trials; the ability to maintain a skin seal around an osseointegrated implant interface is a major challenge to prevent superficial and deep periprosthetic infections. The specific aim of this study was to establish a translational load-bearing ovine model to assess postoperative limb compensation and gait symmetry following a percutaneous integrated implant. We tested the following hypotheses: (1) the animals would return to pre-amputation limb loads within 12-months; (2) the animals would return to a symmetrical gait pattern (stride length and time in stance) within 12-months. The results demonstrated that one month following surgery, the sheep loaded their amputated limb to a mean value of nearly 80% of their pre-amputation loading condition; by 12-months, this mean had dropped to approximately 74%. There were no statistical differences between the symmetry of the amputated forelimb and the contralateral forelimb at any time point for the animals stride length or the time spent in the stance phase of their gait cycle. Thus, the data showed that while the animals maintained symmetric gait patterns, they did not return to full weight-bearing after 12-months. The results of this study showed that a large animal load-bearing model had a symmetric gait and was weight bearing for up to 12 months. While the current investigation utilizes an ovine model, there data show that osseointegrated implant technology with postoperative follow-up can help our human patients return to symmetric gait and maintain an active lifestyle, leading to an improvement in their quality of life following amputation.

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Perceptions and Acceptance of Osseointegration Among Individuals With Lower Limb Amputations: A Prospective Survey Study

Cited by 21 publications

References 22 publications

Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: A proof-of-concept study

Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: A proof-of-concept study

Design features of implants for direct skeletal attachment of limb prostheses

Percutaneous osseointegrated prostheses for amputees: Limb compensation in a 12-month ovine model

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