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Osseointegration 

Staff Writer


Osseointegration is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant, typically made of titanium. It is a property virtually unique to titanium, and has enhanced the science of medical bone, and joint replacement techniques. Retention of a craniofacial prosthesis such as an artificial ear (ear prosthesis), eye (orbital prosthesis), or nose (nose prosthesis) has been practiced for a number of years; however, osseointegration of a lower limb prosthesis is now on the horizon. Osseointegration in humans was discovered in 1952 during animal experiments and has been used for lower limb prostheses since the 1990s.

The first amputee to undergo this procedure was a very high level bilateral above knee amputee, who was not an ideal candidate for conventional prostheses. At accomplish this, titanium bolts, called “abutments” were attached to the distal ends of both femur bones. The prosthetic knee and foot components attach directly to these bolts. This procedure involves two major surgeries, the first to thread the device into the skeleton and the second to re-expose the fixture and attach the bolt. Both surgeries involve extended recoveries, with an estimated six month recovery for each surgery. Approximately 100 lower limb and 30 upper limb amputees have undergone this procedure.

The main advantages of osseointegration, over conventional prosthetic fittings, are:
· The prosthesis feel more like a natural extension of the human body, with no artificial interface
· Less components mean the prosthesis is lighter weight
· The user reports better control over the prosthesis

All problems associated with prosthetic sockets, including discomfort, sweating, volume change and skin breakdown, are eliminated as this design does not incorporate a prosthetic socket The procedure, however, is not without its faults:
· The user must undergo two surgeries, which both pose health risks
· Long surgery recovery
· Delay of prosthetic fitting, which is normally recommended soon after amputation, for the user’s emotional and physical health
· There is a high risk of infection as the bolt extending from the femur is essentially a permanently open wound
· Possibility of bone fracture due to excessive weight load
· The fixture can become unthreaded from the bone and detach from the user

The socket is often the most problematic component of a prosthesis, as it is in constant contact with the residual limb and is commonly the source of discomfort for an amputee. Osseointegration eliminates the socket, but also eliminates the most important function of a lower limb prosthetic socket. For lower limb amputees, particularly above knee amputees, an ischial containment socket locks onto the pelvis and ensures ultimate stability during ambulation. It provides greater distribution of pressure and stress throughout multiple areas of the body.

With osseointegration, 100% of the pressure and stress is focused at the distal end of the femur. The osseointegration fixture is designed to pull muscle away from the distal end of the bone, thereby limiting movement of skin around the bolt site. This makes it more difficult for bacteria to enter the site and grow. If bacteria do form, antibiotics are used. Serious infection could lead to revision surgery and even a higher level of amputation. Despite the huge risk factor involved in this procedure, it is no doubt the logical conclusion in prosthetic technological developments.


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Comments

mark lesek : re: Osseointegration commented on Friday, June 01, 2012 8:51:00 PM
I am The most difficult and shortest osseointegration patient ever done,but also the most sucessful.The USA get over the infection myth and get on with this.Your Wounded Warriors are waiting. See my new function on youtube. Type in my name or new old prosthetic.
mark lesek : re: Osseointegration commented on Friday, June 01, 2012 8:42:21 PM
. The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. . The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. . The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. . The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. . The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. . The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control. Osseointegration | Orthotic & Prosthetic Product Reviews, Blogs, Videos, News & Amputee Community |. www.360oandp.com I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks. Like · · Share. The tide has turned finally getting this treatment into the US. I am living proof that Osseointegration works. The myth of infection has been woken up to as misinformation to buy US corporations time to reinvent and make profit and be in control .. . .. . .. .
Max Ortiz C. : re: Osseointegration commented on Monday, January 09, 2012 9:20:23 AM
Dear Randy and Marc, the OPRA treatment (Osseointegrated prosthesis for the rehabilitation of amputees) from the Branemark group in Sweden is currently under FDA revision, however, it is available in Europe (UK, France, Spain, Belgium, Holland, etc), Australia and Chile. American patients have been treated in Sweden so you can always contact the Sahlgrenska Hospital for more information (http://www.sahlgrenskaic.com/osseointegration/osseointegration/).
Marc Rohner : re: Osseointegration commented on Tuesday, June 23, 2009 8:24:22 PM

I would like to know if the FDAhas approved this as well. Randy i would also check to see, it's likely your insurance at this point wouldn't cover this procedure yet. Also talk with your physician see what he thinks.

Good Luck

 

Randy Tiger : re: Osseointegration commented on Wednesday, March 18, 2009 10:49:04 AM

Need to know if osseointegration surgery for above knee amputee has been approved by FDA ? I am having my left leg amputated above the knee within the next few weeks and I want to have this procedure done . Thank you .

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