Percutaneous Osseointegration Prostheses: A New Solution for Transfemoral Amputees

Under advisement of Kathy Dieruf, PT, PhD, NCS (physical therapy faculty member).Backround/Purpose: the aim of this paper is to explore percutaneous osseointegrated prostheses as a viable option to compete with the standard of care socket prosthesis as it relates to pain, comfort, and function. A case study is presented to show the effectiveness of the procedure as well a review of ten articles from the literature. Case Description: a 47 year old male who sustained a right above the knee amputation in addition to several other injuries from a motor vehicle accident in 1985. He had great difficulty and pain associated with a socket prosthesis, so in April 2013 he underwent an osseointegration surgery in Sydney, Australia and reports increased levels of function with the new system. Outcomes: four databases (PubMed, Cinahl, Cochrane, and PEDro) were searched, and ten articles were selected for analysis based on the patient population and demographics. Most of the literature reports for patients experiencing pain and discomfort with a socket prosthesis, they can benefit with increased endurance, range of motion, aerobic efficiency, and agility when using osseointegration. However, others experienced failure with infections or implant loosening being the most common reasons to remove the implant. Discussion: osseointegration is a surgical procedure that began in 1990 in Sweden. Now it is being practiced all around the world. The United States is currently in the process of performing clinical trials to move towards approving the procedure. Until then, American citizens must travel out of the country and pay for the procedure out of pocket with little to no help from insurance companies. Research is ongoing, but the current research is very promising for the population that does not benefit from the conventional standard of practice care