Christopher Gerzina1, Eric Potter2, Amgad M Haleem3,4, Sherif Dabash5,6. 1. Department of Orthopaedic Surgery and Rehabilitation, Texas Tech Health Sciences Center, 3601 4th St, 4th floor, Lubbock, Texas, 79430, USA. 2. Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso. Medical Education Building, 2200 5001 El Paso Drive, El Paso, Texas, 79905, USA. 3. Department of Orthopaedic Surgery, Oklahoma University Health Sciences Center, 825 NE 10th Street, OU Physicians, 1C, Oklahoma City, OK, 73104, USA. 4. Department of Orthopedic Surgery, College of Medicine, Cairo University, Cairo, Egypt. 5. Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, 535 East 70 Street, New York, NY, 10021, USA. 6. Department of Orthopedic Surgery, College of Medicine, Ain Shams University, Cairo, Egypt.
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.
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.
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