DOS Kongressen 2014 ·
159
Osseointegrated prosthesis for the trans-femoral
amputees.
Peter Holmberg Jørgensen, Klaus Kjær Petersen, Jens Ulrik Petersen, Rene
Lessmann Hansen
Orthopedic Surgery, University Hospital of Aarhus; Videncenter for Sårheling,
Bispebjerg Hospital
Background:
Osseointegrated (OI) prosthesis for trans-femoral amputees is
as a new treatment option in Denmark. The OI- prostheses can often be used
when socket prosthesis is not an option e.g. in very short residual bone length.
Purpose / Aim of Study:
To evaluate the results of the first 20 patients oper-
ated with an OI-prosthesis.
Materials and Methods:
20 trans-femoral amputees, mean age 48 (range
30-66), were operated through a two stage procedure (S1 ,S2). At S1, a titani-
um implant (fixture) was inserted into the distal part of femur. At S2, 6 months
later, a rod (abutment) was inserted into the fixture exiting through the skin at
the other end to be connected to an external prosthesis. The patients were re-
habilitated for six months with increasing load on the OI implant until full weight
bearing. Evaluation: Walking ability, Q-TFA questionnaire, complications.
Findings / Results:
15 patients report increased walking ability, osseoper-
ception, increased sitting comfort and easier change of external prosthesis. 13
patients are using the external prosthesis all day, 2 use it regularly. 5 patients
don’t use the prosthesis: one developed severe pain and sensory disturbances of
the operated femur after a fall accident, one developed reflex dystrophia which
disappeared after removing the abutment, one implant was removed due to
loosening and two were removed due to deep infection. One patient developed
a soft tissue infection after two years which responded to antibiotic treatment.
3 patients had a soft tissue correction made due to overhang at the prosthetic
knee.
Conclusions:
Osseointegrated prosthesis for trans- femoral amputees is an al-
ternative to a socket prosthesis, and for some patients it is the only option to
be ambulatory. Deep infection is a severe complication which aims for further
studies on prophylactic procedures.
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