Osseointegration is a revolutionary procedure for amputees that utilizes a titanium rod implanted in the bone of the residual limb to attach the prosthetic appliance instead of a traditional socket.
Did you know… A Step Ahead Prosthetics has been on the forefront of osseointegration support for years! In 2008, Erik Schaffer, C.P. traveled to Sweden to meet with Dr. Rickard Brånemark of Integrum, a pioneer in osseointegration surgery. There he learned how to design prosthetic systems to compliment and enhance the outcomes of the procedure. Even though it had not yet been approved in the USA, Erik saw the enormous potential of osseointegration for A Step Ahead’s patients and began collaborating with some of the world’s top orthopedic hospitals and surgeons to further the cause of osseointegration.
OSSEOINTEGRATION AND PROSTHETIC APPLICATIONS
WHAT IS OSSEOINTEGRATION?
Osseointegration is a revolutionary procedure for amputees that utilizes a titanium rod implanted in the bone of the residual limb to attach the prosthetic appliance instead of a traditional socket. Over time, the existing bone and the titanium fuse together, creating a single structure that offers a number of advantages over a prosthetic socket including:
- Fast and easy donning/doffing
- No more fit issues due to weight gain/loss
- No problems with perspiration since no liners are required
- No pressure sores or skin irritation
- Better outcomes for hard-to-fit patients, such as those with very short residual limbs
In short, osseointegration can allow amputees to wear a prosthetic for longer periods of time with greater comfort than a typical socket prosthesis, which in turn provides better quality of life!
Nearly anyone with a prosthesis can be a candidate for osseointegration, as it is currently offered for above and below knee amputees and above and below elbow amputees. In addition, osseointegration can be used to affix maxillofacial prosthetics and finger or toe prosthetics.
SURGERY AND REHABILITATION
Because each individual is different, osseointegration surgeries are modified to suit each individuals’ needs, therefore it is very important to consult with your doctor and prosthetist before following any of the steps below. These general guidelines should help you prevent infections, maintain your residual limb, prepare for weight-bearing and ultimately regain your mobility.
After discharge from the hospital
You do not need any dressing covering the remaining wound and staples, exposing the wound to sunshine is the best management.
Excess debris can be removed with a soft shaving brush or toothbrush. This should be done weekly on an ongoing basis. Any brushes used to clean the metal abutment should be replaced at least once per month if not more frequently.
Gauze dressing only need to be used on an ongoing basis if there are continued secretions from the residual limb site. This is best wrapped around the gold dual cone and secured with tape. That way the wounds say uncovered and when you are upright any secretions will drain down into the gauze.
In the case of trans tibial amputees, it is not uncommon to have some nerve pain from time to time in the distal tip of the stump. Appropriate pain management is vital during this time. After 12 months this pain in most cases does settle.
This is a surgical intervention and will require a period of approximately 12 months for bone and wounds to heal.
What rehabilitation is required after surgery?
Rehabilitation can start 1 or 2 days after your surgery, unless otherwise indicated by your surgical team. This is done in two phases, followed by physiotherapy and a set of guidelines for long-term maintenance and care. This is determined by your doctor, physiotherapist or prosthetist and depends upon your body weight, health and physical aptitude.
Phase 1 – Static Loading
Loading on the abutment (metal part protruding from the skin) can usually be started at around 10 lbs, depending on your surgical team’s instructions, and quickly increase to the target load. This is accomplished by resting the metal abutment (with protective rubber) onto a scale and applying pressure according to an individual prescribed loading protocol and timescale.
Phase 2 – Training prosthesis
At the end of Phase 1 you will be fitted by our prosthetist and commence assisted walking.
For the first 6 weeks after completing the weight-bearing phase, walking is unlimited with two crutches and guided by pain levels. Please rest if needed as this maybe counterproductive to your ongoing rehabilitation regime.
Strengthening, stretching and balance exercises are ongoing as prescribed by your physiotherapist. Hip Abductors are likely to require strengthening. Many patients do suffer with hip pain after osseointegration as these muscles have not been used for some time.
At any time if you do feel sore in your hip or knee please reduce your activity levels until the discomfort subsides then slowly build up again.