Treatment Osseointegration

Advantages and disadvantages Osseointegration

Advantages

An osseointegrated prosthesis offers many advantages to individuals with an arm or leg amputation compared with a socket prosthesis (which fits over the stump of the amputated leg or arm). The attachment of the osseointegrated prosthesis is much more stable and provides a full range of joint movement, making walking much easier. An osseointegrated prosthesis does not cause pain or skin breakdown when used. Because the prosthesis is directly attached to the bone, the wearer feels as though their prosthesis is part of their own body by a process known as “natural osseoperception” (i.e. it feels as though it is their own leg or arm). Since 2009, the Radboud University Medical Centre (Radboudumc) in Nijmegen, the Netherlands, has been offering this highly innovative technique which significantly improves the quality of life of individuals with an amputation.

In 2011, the Radboudumc carried out a study of the first 22 patients to be given an osseointegrated prosthesis at their centre. Aspects of walking and quality of life with the osseointegrated prosthesis were compared with a socket prosthesis. It was found that prosthesis use increased from 56 to 101 hours per week, walking speed increased by 32% and walking required 18% less energy with the osseointegrated prosthesis. Prosthesis-related quality of life improved from 39 to 62 on a scale of 0 to 100.

Advantages of an osseointegrated prosthesis

• Increased prosthetic use
• Longer walking distances
• Full range of joint movement
• Better sitting comfort
• No skin problems
• Stable and safer standing and sitting
• A sense of the artificial limb belonging to the body
• Easy and quick attachment and removal
• Improved quality of life.

Disadvantages

Osseointegration is a safe treatment, and inflammation of the bone is rare. A disadvantage is that the area where the implant enters the skin (called the “stoma”) has to be cleaned twice daily with soap and water. This is comparable with brushing the teeth. In some cases, the skin around the stoma may become irritated. In the first year after implantation, intense muscle pain may be felt. This muscle pain disappears as soon as the stump muscles become fitter and stronger.