Das Endo-Exo-Prothesen-Versorgungskonzept

Hoffmeister, T.; Schwarze, Frederik; Aschoff, Horst‐Heinrich

doi:10.1007/s00113-017-0350-1

Cited by 19 publications

(6 citation statements)

References 9 publications

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“…The ILP implant system was designed for transfemoral amputees, but tibial and humeral implantation has also been reported. 10 , 11 , 40 The implant has a cast stem of cobalt-chrome-molybdenum alloy and the implant stem is 140–180 mm long and slightly curved to prevent rotation in the intramedullary cavity and to fit to the normal curvature of the femur. Since its introduction, the system has gone through several design changes.…”

Section: Resultsmentioning

confidence: 99%

Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

et al. 2018

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Bone-anchored limb prostheses allow for the direct transfer of external loads from the prosthesis to the skeleton, eliminating the need for a socket and the associated problems of poor fit, discomfort, and limited range of movement. A percutaneous implant system for direct skeletal attachment of an external limb must provide a long-term, mechanically stable interface to the bone, along with an infection barrier to the external environment. In addition, the mechanical integrity of the implant system and bone must be preserved despite constant stresses induced by the limb prosthesis. Three different percutaneous implant systems for direct skeletal attachment of external limb prostheses are currently clinically available and a few others are under investigation in human subjects. These systems employ different strategies and have undergone design changes with a view to fulfilling the aforementioned requirements. This review summarises such strategies and design changes, providing an overview of the biomechanical characteristics of current percutaneous implant systems for direct skeletal attachment of amputation limb prostheses.

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Section: Resultsmentioning

confidence: 99%

Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

et al. 2018

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“…In 2015, Khemka et al 44 reported on 4 patients with TTOI connected to a total knee replacement who were followed for 12 to 32 months; all patients reported no pain and further procedures were not needed. Writing about the same 9 patients who were followed for an unspecified time, Juhnke and Aschoff 46 , Aschoff and Juhnke 47 , and Hoffmeister et al 48 reported that 3 implants were removed: 2 for infection and 1 for aseptic loosening. In 2019, Leijendekkers et al 49 reported that, at 1 year, 9 patients with TTOI reported improved pain, and at least 1 patient had explantation for infection.…”

Section: Discussionmentioning

confidence: 99%

Transtibial Osseointegration for Patients with Peripheral Vascular Disease

et al. 2021

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Background: The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI). Methods: Six patients (aged 36 to 84 years) with transtibial amputation and preexisting PVD underwent osseointegration between 2014 and 2016 and were followed for 3 to 5 years. Pre- and postoperative clinical and functional outcomes (pain, prosthesis wear time, mobility, walking ability, and quality of life) and adverse events (infection, fracture, implant failure, revision surgery, additional amputation, and death) were prospectively recorded. Results: All patients’ mobility improved following osseointegration. Three patients initially had required the use of a wheelchair, precluding baseline walking tests; the other 3 were classified as K level 1 or 2, with mean baseline Timed Up and Go (TUG) test = 14.0 ± 2.2 s and 6-Minute Walk Test (6MWT) = 262 ± 75 m. At the time of the latest follow-up, all patients were K level 2 or 3; mean TUG = 12.7 ± 7.2 s and 6MWT = 353 ± 148 m. Four patients wore their prosthesis ≥16 hours daily. Three patients had superficial soft-tissue infections. One other patient experienced recurrent infections 2.8 years after osseointegration requiring debridements and transfemoral amputation; the patient died 2 days following surgery from myocardial infarction caused by coronary atherosclerosis. Conclusions: All 6 patients who underwent PVD-TTOI in this case series survived through 2 years. Patients who initially had used a wheelchair achieved and maintained independent, unaided ambulation until PVD-related impairments in the contralateral leg occurred in 1 patient. Patients previously using a traditional socket prosthesis reported improvement in mobility and quality of life. One patient’s death underscores the importance of careful patient selection. However, marked improvement in the other 5 patients suggests cautious optimism that PVD-TTA is not an absolute osseointegration contraindication. Conscientious further investigation seems appropriate. Level of Evidence: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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“…The level of satisfaction was high in our cohort which is similar as found in another cohort of transfemoral bone-anchored prosthesis users. 23…”

Section: Discussionmentioning

confidence: 99%

Functional performance and safety of bone-anchored prostheses in persons with a transfemoral or transtibial amputation: a prospective one-year follow-up cohort study

et al. 2018

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Objectives:(1) To compare level of function, activity, health-related quality of life (HRQoL) and satisfaction in persons with a lower extremity amputation before surgery and 6- and 12-months after implantation of an osseointegration implant and (2) to report adverse events.Design:Prospective cohort study.Setting:University medical centre.Subjects:A total of 40 consecutive persons (median age: 56 years) who received a transfemoral (31) or transtibial (9) osseointegration implant, between April 2014 and March 2016.Intervention:Osseointegration implant surgery followed by a predefined rehabilitation programme.Main measures:Hip abductor strength, prosthetic use, back pain frequency, postoperative pain, mobility level (Timed-Up and Go (TUG) and wheelchair-boundedness), walking ability (6 minute walking test (6MWT) and walking distance in daily life), HRQoL, satisfaction regarding the prosthesis, and adverse events.Results:Strength, prosthetic use, walking distance, HRQoL, and satisfaction level increased significantly at 6- and 12-month follow-up compared to baseline (P ⩽ 0.002). The TUG showed no change at 6-month follow-up (P = 0.420) but improved significantly at 12-month follow-up compared to baseline (P = 0.005). Wheelchair-boundedness decreased from 12/40 participants at baseline to 0 at follow-ups. The 6MWT (P ⩾ 0.038) and back pain (P ⩾ 0.437) did not change over time. Stump pain was present in 28/39 and 22/40 of the participants at 6-and 12-month follow-up, respectively. The major adverse events were managed successfully and included three dual-cone breakages and four bone fractures. An uneventful course was completed by 19/31 transfemoral and 4/9 transtibial bone-anchored prostheses users.Conclusion:Bone-anchored prostheses lead to improved performance and appear to be safe, so they might be considered for persons with socket-related problems.

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Das Endo-Exo-Prothesen-Versorgungskonzept

Cited by 19 publications

References 9 publications

Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

Transtibial Osseointegration for Patients with Peripheral Vascular Disease

Functional performance and safety of bone-anchored prostheses in persons with a transfemoral or transtibial amputation: a prospective one-year follow-up cohort study

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