Percutaneous Osseointegrated Prostheses for Transfemoral Amputations

Li, Yan; Lindeque, Bennie

doi:10.3928/01477447-20180227-03

Cited by 6 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Osseointegrated prostheses avoid the problem of socket suspension and have been extensively incorporated into practice in Europe, primarily in Sweden [41][42][43][44] . Early studies have shown a cumulative success rate of 92% at a 2year follow-up and an exponential improvement in the quality of life for patients who had undergone transfemoral amputation 45 .…”

Section: Osseointegrated Prosthesesmentioning

confidence: 99%

New Innovations in Targeted Muscle Reinnervation

Carlsen

2019

JBJS Rev

View full text Add to dashboard Cite

Targeted muscle reinnervation allows for the creation of additional electromyographic signals for a myoelectrically controlled prosthesis in patients who have undergone an upper-extremity amputation. » Targeted muscle reinnervation shows promise in addressing neuroma pain in both the upper and lower extremities. » Areas of further research include targeted sensory reinnervation as well as use in pediatric patients. » Osseointegration remains a challenge in need of further research given the high risk of infection. Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A452).

show abstract

Section: Osseointegrated Prosthesesmentioning

confidence: 99%

New Innovations in Targeted Muscle Reinnervation

Carlsen

2019

JBJS Rev

View full text Add to dashboard Cite

show abstract

“…Instead, the ends of the residual muscle are usually sutured directly into the periosteum of the residual bone to create a “muscle platform” (Figure 3). This part of the surgical technique is similar regardless of the type of bone-anchor used, including OPL implants (used for all the cases reported in this series) 5 and OPRA implants (Osseointegrated Prostheses for the Rehabilitation of Amputees) 8 . The creation of a muscle platform helps to stabilize the skin-implant interface and is a critical surgical step for ensuring the long-term success of the osseointegration procedure.…”

Section: Discussionmentioning

confidence: 95%

“…This part of the surgical technique is similar regardless of the type of bone-anchor used, including OPL implants (used for all the cases reported in this series) 5 and OPRA implants (Osseointegrated Prostheses for the Rehabilitation of Amputees). 8 The creation of a muscle platform helps to stabilize the skin-implant interface and is a critical surgical step for ensuring the long-term success of the osseointegration procedure. Therefore, it is not a surgical step that can be easily abandoned.…”

Section: Discussionmentioning

confidence: 99%

Enthesopathy, a Cause for Persistent Peristomal Pain after Treatment with an Osseointegrated Bone-Anchor: A Retrospective Case Series

et al. 2022

View full text Add to dashboard Cite

Introduction: After limb loss, many patients undergo treatment with an osseointegrated implant. Unfortunately, some develop persistent peristomal pain after surgery. This can be sufficiently severe to reduce the speed of their rehabilitation or may halt the process altogether. The pain may be due to an enthesopathy of the residual muscles. We describe the phenomenon and outcomes of treatment in a series of patients who underwent treatment with an osseointegrated prosthetic limb, bone-anchor. Materials and Methods: Over 36 months, we followed 14 patients with symptoms consistent with enthesopathy. Thirteen had undergone treatment with a transfemoral bone-anchor and one underwent treatment with a transhumeral bone-anchor. One patient had a bilateral transfemoral amputation. Analysis of the patients' ages, heights, weight at the time of surgery, length of residual femur, or preoperative dual-energy x-ray absorptiometry scans showed no correlation with the development of enthesopathy pain. Thirteen patients received steroid injections. Most received at least one injection of Adcortyl™ and bupivacaine. Patients were then encouraged to follow a program of physiotherapy to stretch out their enthesis, after injection. Results: All patients experienced relief from their symptoms, but only two were rendered completely pain free. The remaining 11 patients gained sufficient control of their symptoms to allow them to continue daily use of their prosthesis with less difficulty or, where rehabilitation had been delayed or halted completely, to resume this process. Conclusion: Enthesopathy seems to be a common phenomenon after bone-anchor surgery in individuals with transfemoral amputation. Steroid injections can help to relieve pain, allowing physiotherapy to be carried out. Patients undergoing treatment with a bone-anchor should be advised of the possibility of enthesopathy pain but can be reassured that there is a solution that works well in most cases. Clinical Relevance: This article may be of benefit to clinicians who are struggling to manage patients with persistent peristomal pain after insertion of a bone-anchor. It may also encourage further research into measures for securing the soft tissues around the stoma for patients undergoing bone-anchor surgery.

show abstract

“…It was kept constant for each thread depth, regardless the value of root radius in order to discern the effect of this parameter. Two cortical thicknesses were evaluated, a small cortical thickness of 2 mm which correspond to the minimum requirement after implantation according to the OPRA surgical protocol [38], and a larger cortical thickness of 5 mm.…”

Section: Methodsmentioning

confidence: 99%

The effect of cortical thickness and thread profile dimensions on stress and strain in bone-anchored implants for amputation prostheses

Thesleff¹,

Ortiz-Catalán²,

Brånemark³

2021

Preprint

View full text Add to dashboard Cite

<p>Skeletal attachment of limb prostheses ensures load transfer between the prosthetic leg and the skeleton. For individuals with lower limb amputation, these loads may be of substantial magnitude. To optimize the design of such systems, knowledge about the structural interplay between implant design features, dimensional changes, and material properties of the implant and the surrounding bone is needed. Here, we present the results from a parametric finite element investigation on a generic bone-anchored implant system of screw design, exposed to external loads corresponding to average and high ambulatory loading. Of the investigated parameters, cortical thickness had the largest effect on the stress and strain in the bone-anchored implant and in the cortical bone. 36 % – 44 % reductions in maximum longitudinal stress in the bone-anchored implant was observed as a result of increased cortical thickness from 2 mm to 5 mm. Changes in thread depth had larger effect on the maximum stresses in the fixture and the bone than changes in thread root radius within the evaluated parameter space. Stress reductions in the percutaneous abutment were obtained by autologous transplantation of bone tissue distal to the fixture. Results from this investigation may guide structural design optimization for bone-anchored implant systems for attachment of limb prostheses.</p>

show abstract

Percutaneous Osseointegrated Prostheses for Transfemoral Amputations

Cited by 6 publications

References 23 publications

New Innovations in Targeted Muscle Reinnervation

New Innovations in Targeted Muscle Reinnervation

Enthesopathy, a Cause for Persistent Peristomal Pain after Treatment with an Osseointegrated Bone-Anchor: A Retrospective Case Series

The effect of cortical thickness and thread profile dimensions on stress and strain in bone-anchored implants for amputation prostheses

Contact Info

Product

Resources

About