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Osseointegration

What is it, who is a candidate, and what does it involve?


Before (left): Patient’s residual limb from above-the-knee amputation fitted with socket-based prosthesis. After (right): Same patient with an osseointegrated leg implant and connected prosthesis showing improved alignment. Images provided by Hospital for Special Surgery.

What is it?

Osseointegration is a prosthetic option for patients with upper and/or lower limb loss. It is designed to address common limitations associated with conventional socket-based prostheses such as pain, discomfort, skin irregularity, slowed walking, and more. Osseointegration involves “anchoring” an implant into the bone of the residual limb.


A direct connection between human bone and artificial implant immediately forms and improves over time. In due course, the “outside” end of the implant is attached to a prosthetic.


Osseointegration and implant-based prosthetics have been in development since the 1990s, beginning in Sweden and expanding to Germany, Australia, and the United States in most recent times. In the United States, osseointegration is selectively available through the Humanitarian Device Exemption or the Custom Device Exemption pathways regulated by the FDA.


Above: Photo of the OPRA Implant System attached to the femur. This device is FDA-approved under the Humanitarian Device Exemption. Image provided by Integrum.

Who is a candidate?

Osseointegration targets patients with limb loss who are unable to wear socket-based prostheses. According to HSS, use of a socket is particularly difficult for patients with short, wide, scarred, or painful residual limbs. These patients are at risk of long-term pain and lower quality of life as a result of not being able to use a prosthetic.


What does osseointegration involve?

Osseointegration calls for an interdisciplinary team of healthcare practitioners (e.g. surgeons, orthotists, physical therapists), a surgery, and a post-operative healing plan. Nerve and soft tissue issues or interferences are usually addressed in the same surgery.


In terms of timeline:

  • A few days: The average hospital stay is 3 or 4 days during which the surgery occurs.

  • A few weeks: Patients are instructed to gradually put weight (or “load”) the implant in the weeks following surgery. This prepares the residual limb for the prosthetic to be attached in 3-10 weeks.

  • A few months: About 3 months following the surgery, the bone has grown into the implant; most patients are able to walk without crutches at this time.


Osseoperception is one of the most remarkable reported outcomes of osseointegration in which sensations (e.g. touch vibrations, ground impact) are transferred from the implant to the patient’s natural bone. This improves walking, stability, and strength of the unit according to HSS.


If you think you may benefit from osseointegration, consult with a healthcare provider to explore this prosthetic option.

 

About Writer: Pranita Muralidhar


Pranita Muralidhar is passionate about health sciences, entrepreneurship, and connecting people with products that benefit them the most. By contributing to the blog, Pranita hopes to help raise broad exposure and awareness of TheraV ELIX. 


Learn more about Pranita at pranitamuralidhar.com

1 Comment


sicnarf1
Apr 14, 2020

I am 81 with a BK left leg amputation due to an infection in 2015. I am still having much nerve ending discomfort at the point of termination. Is there a procedure to deaden the nerve endings permanently since all other methods have failed such as TENS, Vibration, massaging, and gabapentin. I wear the prosthetic each day for 12-14 hrs. and walk with ease. I am very active and just want to get rid of the sensation of feeling like someone is constantly poking my leg with lots of needles. I do not want to undergo Osseointegration. Can someone please advise me on the above?

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