Transkutane osseointegrierte Prothesensysteme (TOPS) nach Majoramputation der unteren Extremität

Örgel, Marcus; Ranker, Alexander; Harb, Afif; Krettek, Christian; Aschoff, Horst‐Heinrich

doi:10.1007/s00132-020-04031-2

Cited by 11 publications

(11 citation statements)

References 46 publications

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“…adapter befestigt wird, womit eine genaue Ausrichtung möglich ist [14]. Zwischen den Brückenmodulen wird eine Silikonkappe zum Schutz der Austrittsstelle eingesetzt [14].…”

Section: Bedeutung Und Anpassung Des Prothesenaufbausunclassified

“…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].…”

Section: Significance and Fitting Of The Prosthesis/abutmentmentioning

confidence: 99%

“…Similarly, the prosthetic knee joint and prosthetic foot must be adapted to the dynamics of direct power transmission. To achieve the best possible gait pattern in the long term, prosthetic alignment must be assessed regularly with regards to the changed biomechanics [14].…”

Section: Significance and Fitting Of The Prosthesis/abutmentmentioning

confidence: 99%

“…Models for multi-level longterm care have not been described in the literature so far. adapter befestigt wird, womit eine genaue Ausrichtung möglich ist [14]. Zwischen den Brückenmodulen wird eine Silikonkappe zum Schutz der Austrittsstelle eingesetzt [14].…”

Section: Bedeutung Und Anpassung Des Prothesenaufbausunclassified

“…Ebenfalls sind das prothetische Kniegelenk sowie der Prothesenfuß an die Dynamik der direkten Kraftübertragung anzupassen. Um langfristig ein bestmögliches Gangbild zu erreichen, ist der Prothesenaufbau regelmäßig hinsichtlich der veränderten Biomechanik zu prüfen [14].…”

Section: Bedeutung Und Anpassung Des Prothesenaufbausunclassified

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

2021

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Background Osseointegrative implantation after amputation of the lower extremity is a special treatment option. Physiotherapeutic treatment is important for the functional outcome. This study systematically evaluated existing follow-up treatment protocols to establish a literature-based recommendation for postoperative rehabilitation procedures. Methodology A PubMed literature search was conducted on December 10, 2020, using the following search terms: (osseo-integrat* OR endo-exo OR boneanchored OR bone anchored) AND (prosthe*) AND (leg OR lower limb* OR lower extremit* OR transfem* OR transtib*) AND (rehabilitation). 113 publications were found in this context. 10 of them met inclusion criteria. The Cochrane risk of bias tool was used to determine the publicationsʼ quality. Results Three systematic rehabilitation protocols have been described: Osseointegrated Prostheses for the Rehabilitation of Amputees protocol, Osseointegration Group of Australia Accelerated protocol and Radboud Amputation: rehabilitation protocol for endo-exo femoral prosthesis. There are clear differences in the duration of the rehabilitation protocols. The quality of published studies is limited due to the high risk of bias and low evidence levels (mainly III – V). A concept for long-term rehabilitation has not been described yet. Conclusions There are various protocols for rehabilitation after treatment with osseointegrative prosthesis. Gradually increasing axial weight bearing started shortly after surgery; step-by-step gait training, adaptation of the prosthesis to the new biomechanics and critical patient selection and pre-operative training have been proven useful for successful rehabilitation. Controlled comparative studies, standardised outcome measurements or comparative studies between different protocols are not available. Models for multi-level long-term care have not been described in the literature so far.

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“…adapter befestigt wird, womit eine genaue Ausrichtung möglich ist [14]. Zwischen den Brückenmodulen wird eine Silikonkappe zum Schutz der Austrittsstelle eingesetzt [14].…”

Section: Bedeutung Und Anpassung Des Prothesenaufbausunclassified

Section: Significance and Fitting Of The Prosthesis/abutmentmentioning

confidence: 99%

Section: Significance and Fitting Of The Prosthesis/abutmentmentioning

confidence: 99%

Section: Bedeutung Und Anpassung Des Prothesenaufbausunclassified

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

2021

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Biomimetic Connection of Transcutaneous Implants with Skin

Weigel,

Christ,

Dembski

et al. 2023

Adv Healthcare Materials

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Bacterial infection is a crucial complication in implant restoration, in particular in permanent skin‐penetrating implants. Therein, the resulting gap between transcutaneous implant and skin represents a permanent infection risk, limiting the field of application and the duration of application. To overcome this limitation, a tight physiological connection is required to achieve a biological and mechanical welding for a long‐term stable closure including self‐healing probabilities. This study describes a new approach, wherein the implant is connected covalently to a highly porous electrospun fleece featuring physiological dermal integration potential. The integrative potential of the scaffold is shown in vitro and confirmed in vivo, further demonstrating tissue integration by neovascularization, extracellular matrix formation, and prevention of encapsulation. To achieve a covalent connection between fleece and implant surface, self‐initiated photografting and photopolymerization of hydroxyethylmethacrylate is combined with a new crosslinker (methacrylic acid coordinated titanium‐oxo clusters) on proton‐abstractable implant surfaces. For implant modification, the attached fleece is directed perpendicular from the implant surface into the surrounding dermal tissue. First in vitro skin implantations demonstrate the implants' dermal integration capability as well as wound closure potential on top of the fleece by epithelialization, establishing a bacteria‐proof and self‐healing connection of skin and transcutaneous implant.

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Comparison of functional outcome and patient satisfaction between patients with socket prosthesis and patients treated with transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation

Örgel

Schwarze

Graulich

et al. 2022

Eur J Trauma Emerg Surg

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Purpose The aim of this retrospective analysis was to investigate and evaluate differences in functional outcome and satisfaction of patients treated with a TOPS and patients using socket prosthesis after transfemoral amputation. Methods This retrospective comprehensive analysis included patients from a single hospital, and was conducted between February 2017 and December 2018. Overall n = 139 patients with prosthesis were included and divided into two comparable groups (socket- and TOPS group). Incomplete data sets were excluded. This led to n = 36 participants for the socket- and n = 33 for the TOPS group. Functional outcome and satisfaction were evaluated by Patient Reported Outcome Measures (PROMs). The used PROMs were: Questionnaire for Persons with a Transfemoral Amputation (Q-TFA), EQ5D-5L, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Prosthesis Mobility Questionnaire (PMQ 2.0) and Functional Independence Measure (FIM). Results Significant results in favor of TOPS patients were identified for the EQ-5D 5L (p = 0.004), Q-TFA (p = 0.000), SAT-PRO (p = 0.000) and PMQ 2.0 (p = 0.000). For FIM, no statistical significance was found (p = 0.318). Conclusion In this study, transfemoral amputees treated with an osseointegrated prosthetic attachment (TOPS) showed significantly higher scores for mobility and satisfaction. This demonstrates the high potential of TOPS in the prosthetic treatment of patients with transfemoral amputation with regard to their functional abilities in daily life.

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Transkutane osseointegrierte Prothesensysteme (TOPS) nach Majoramputation der unteren Extremität

Cited by 11 publications

References 46 publications

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

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

Biomimetic Connection of Transcutaneous Implants with Skin

Comparison of functional outcome and patient satisfaction between patients with socket prosthesis and patients treated with transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation

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