Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases.

Abstract

BACKGROUND:

Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an osseointegrated implant for prosthetic attachment.

METHODS:

We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to a THR with a modular revision stem and a stoma was created. Clinical outcomes were assessed at baseline and 1.5-2.5-year follow-up using standard measures of health-related quality of life, ambulation, and activity levels including the Short Form-36 (SF-36), Questionnaire for Transfemoral Amputees (Q-TFA), Timed Up and Go test, and 6-min walk test.

RESULTS:

Patient age ranged from 35 to 65 years. There were no major adverse events, but there was one case of superficial infection. All patients showed improved Q-TFA and SF-36 scores. Two patients who were wheelchair-bound at baseline became community ambulators, and the third patient exhibited improved ambulation.

CONCLUSIONS:

This study demonstrated the feasibility of combining a THR with an osseointegrated implant in transfemoral amputees.

• Authors: Aditya Khemka, Chalak I FarajAllah, Sarah J Lord, Belinda Bosley, Munjed Al Muderis
• Journal: Journal of orthopaedic surgery and research (J Orthop Surg Res) Vol. 11 Pg. 13 (Jan 19 2016) ISSN: 1749-799X [Electronic] England
• PMID: 26781501 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Aged
• Amputees
• Arthroplasty, Replacement, Hip (methods, rehabilitation)
• Artificial Limbs
• Bone-Implant Interface (physiopathology)
• Feasibility Studies
• Female
• Femur (diagnostic imaging, surgery)
• Humans
• Male
• Middle Aged
• Osseointegration
• Postoperative Care (methods)
• Prosthesis Design
• Recovery of Function
• Retrospective Studies
• Treatment Outcome