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.


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.


The two most popular systems are the ORPA and the OPL. A Step Ahead Prosthetics has vast experience and deep connection to both. Ultimately the system you choose will depend on your anatomy, needs, goals, insurance coverage and other factors which should be considered by you and your doctor. The following content will try to better illustrate the differences between the systems without bias.


The OPRA™ Implant System is a bone-anchored prostheses system. The system consists of three parts; an anchoring element (the Fixture) and a skin penetrating connection (the Abutment), secured with a screw (the Abutment Screw). The unique design ensures protection of the patient by avoiding bone fractures from accidental loads. The system has been used by hundreds of amputees since the world’s first surgery in 1990, and has been proven in several clinical studies.

The OPRA™ fixture is coated with a new surface technology, BioHelix™. The surface will promote faster, stronger attachment to the bone, thereby increasing the strength of the bone-to-implant interface. The prosthesis is connected to the system using a load controlling device. Integrum has developed specific components each customized for different indications levels, including both upper and lower limb.

In the United States the OPRA™ Implant System components are implanted over two surgeries (stages), about 6 months apart.


Created by A/Prof. Munjed Al Muderis and The Osseointegration Group of Australia, the OGAP-OPL system provides above and below knee amputees with an implant which is designed to be as close to the human anatomy as possible. The surgery involves an implant being inserted into an amputee’s femur which, when integrated with the bone allows for a simple, quick, safe connection between the stump and the lower prosthesis.

Donning and doffing your prosthesis involves one single screw and can be completed in seconds and with its accelerated surgical and rehabilitation program, the OPL system reduces the overall recovery time to 4-6 weeks.

Since 2014 A/Prof Al Muderis modified the surgical technique and developed a new implant design which facilitated the ability to perform single-stage surgery without compromising outcomes. This has resulted in eliminating the need for a second operation and the associated risks, improved soft tissue management, faster rehabilitation, earlier return to work and lower overall costs.