There is a minimal risk for severe infection with osseointegrated implants, a newer prosthetic system, press-fitted directly into the femur bone, that enables bone growth over a metal, robotic prosthetic limb in patients with above knee amputations, according to a study published in the Journal of Bone and Joint Surgery.
For more than 600 years, patients with amputations above the knee received a prosthesis that fit over the skin and soft tissue of the amputation stump. However, approximately one-third of these patients experience problems, including discomfort and skin irritation, resulting in limited mobility and reduced quality of life. Over the past 20 years, osseointegrated implants--or implants that grow directly into the bone--have emerged, and while most patients do well with these implants, concerns persist about the risk for serious infection.
‘Osseointegrated implants, a newer prosthetic system, pose minimal infection risk among patients with amputations above the knee.’
AdvertisementUsing a new infection classification system, researchers tracked adverse events in 86 patients (91 implants) who received a "press-fit" osseointegrated implant between 2009 and 2013. For each patient, the procedure was performed in two stages: first, a porous-coated implant was placed in the femur bone, and second, a stoma, or opening, was created to attach the prosthesis. The patients, ages 25 to 81, were followed for a median of 31 months.
Among the results:
- Thirty-one patients had no side effects or complications related to the osseointegration system.
- Twenty-nine patients developed a grade one or two infection, successfully managed with "simple measures."
- Twenty-six patients had no infection, but reported other complications such as problems with the orthopaedic hardware, problems with skin and soft tissue, or fracture of the femur bone.
- No patients had a grade three or four infection.
"We can confidently say that this type of prosthesis is a viable choice and the new infection classification system, developed by the Osseointegrated Group of Australia, provides an effective tool for the use in patient selection as well as infection management."
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