Intraosseous Transcutaneous Amputation Prosthesis (<scp>ITAP</scp>) for Limb Salvage in 4 Dogs

Fitzpatrick, Noel; Smith, Thomas J.; Pendegrass, CJ; Yeadon, Russell; Ring, Michael E.; Goodship, Allen E.; Blunn, Gordon

doi:10.1111/j.1532-950x.2011.00891.x

Cited by 70 publications

(78 citation statements)

References 52 publications

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“…The ITAP system: http://www.itap-prosthetics.com/ was designed for a one‐step implantation procedure (see Table ) . It was reported to be applied to one transhumeral amputee, to the human thumb and index finger in one human patient and to four dogs. The approach for the system design is rooted in analysis of special biological structures such as horns, hair, feathers, fingernails, hooves, teeth, and antlers as examples where nature has solved the problems of “percutaneous devices.” As a result, the ITAP system emulates antlers: a flange caps the residuum, and is perforated by twenty‐four 0.7 mm holes are bored immediately below the epithelium to increase dermal attachment …”

Section: Methodsmentioning

confidence: 99%

Design features of implants for direct skeletal attachment of limb prostheses

Pitkin

2013

J Biomedical Materials Res

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In direct skeletal attachment (DSA) of limb prostheses, a construct is implanted into an amputee’s residuum bone and protrudes out of the residuum’s skin. This technology represents an alternative to traditional suspension of prostheses via various socket systems, with clear indications when the sockets cannot be properly fitted. Contemporary DSA was invented in the 1990s, and several implant systems have been introduced since then. The current review is intended to compare the design features of implants for DSA whose use in humans or in animal studies has been reported in the literature.

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Section: Methodsmentioning

confidence: 99%

Design features of implants for direct skeletal attachment of limb prostheses

Pitkin

2013

J Biomedical Materials Res

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“…The implants used here were coated with hydroxyapatite to reduce the risk of implant loosening and to facilitate both osseous and soft‐tissue integration to implants, as previously described in veterinary patients . At 1 year postsurgery, no lucency around the hemipelvic or femoral implants were noted on radiography and CT, consistent with a robust osseointegration of implants.…”

Section: Discussionmentioning

confidence: 97%

Hemipelvic and proximal femoral limb salvage endoprosthesis with tendon ongrowth in a dog

Fitzpatrick¹,

Guthrie²

2018

Veterinary Surgery

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Objective To report the clinical application of a hemipelvic and proximal femoral endoprosthesis for limb salvage. Study design Retrospective case report. Animal One 5‐year‐old, neutered female, flat coated retriever with a malignant neoplasia of the left coxofemoral joint. Methods An invasive soft tissue mass (histiocytic sarcoma) with bone lysis of the femoral head and acetabulum was noted on radiographs, computed tomography (CT), and MRI. Custom‐designed hemipelvic and proximal femoral endoprostheses were produced from CT images and manufactured with hydroxyapatite coated surfaces to allow tissue integration. The proximal femoral implant allowed tendon ongrowth and muscle attachment. The pelvic implant was anchored to the ilium and ischium with screws, and the femoral implant was cemented. Chemotherapy consisted of lomustine (CCNU). Results No evidence of implant loosening or local/thoracic metastases was noted on radiographs or CT at 6 weeks and at 3, 6, 9, and 12 months after surgery. A neurapraxia resolved 14 weeks postoperatively. Intensive rehabilitation was performed. At 12 months, activity was unrestricted with minimal residual lameness. The dog was euthanized at 14 months for metastatic disease. Conclusion Limb salvage with a hemipelvic and proximal femoral endoprosthesis resulted in limb function and survival for 14 months. Clinical significance Neoplasia involving the bones of the coxofemoral joint traditionally requires hemipelvic resection and pelvic limb amputation. This report provides evidence that limb salvage can result in satisfactory levels of activity.

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“…For example, ongoing animal studies on transcutaneous porous titanium bone implants (Farrell et al, 2014a,b; Fitzpatrick et al, 2011; Pitkin et al, 2009; Shelton et al, 2011) have aimed to reduce skin infection in individuals with bone-anchored lower limb prostheses (Branemark et al, 2014; Drygas et al, 2008; Tillander et al, 2010; Tsikandylakis et al, 2014), and ultimately to improve biomechanics of prosthetic locomotion. It is much less common, however, to translate successful developments in human biomechanics, orthopedic and prosthetic research to veterinary medicine to treat animals with limb loss.…”

Section: Introductionmentioning

confidence: 99%

“…Although few case report studies have suggested that quadrupedal animals might utilize a unilateral distal bone-anchored prosthesis for walking (Farrell et al, 2014a; Fitzpatrick et al, 2011), no studies have been published that rigorously document whether quadrupedal animals systematically utilize unilateral transtibial prostheses during locomotion and how prosthetic locomotion is performed. The use of the prosthetic limb during quadrupedal locomotion might depend on which limb is missing (forelimb versus hindlimb) and on loading demands on the prosthetic limb.…”

Section: Introductionmentioning

confidence: 99%

Kinetics of individual limbs during level and slope walking with a unilateral transtibial bone-anchored prosthesis in the cat

Jarrell

Farrell

Kistenberg

et al. 2018

Journal of Biomechanics

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Ongoing animal preclinical studies on transcutaneous bone-anchored prostheses have aimed to improve biomechanics of prosthetic locomotion in people with limb loss. It is much less common to translate successful developments in human biomechanics and prosthetic research to veterinary medicine to treat animals with limb loss. Current standard of care in veterinary medicine is amputation of the whole limb if a distal segment cannot be salvaged. Bone-anchored transcutaneous prostheses, developed for people with limb loss, could be beneficial for veterinary practice. The aim of this study was to examined if and how cats utilize the limb with a bone-anchored passive transtibial prosthesis during level and slope walking. Four cats were implanted with a porous titanium implant into the right distal tibia. Ground reaction forces and full-body kinematics were recorded during level and slope (±50%) walking before and 4–6 months after implantation and prosthesis attachment. The duty factor of the prosthetic limb exceeded zero in all cats and slope conditions (p < 0.05) and was in the range of 45.0–60.6%. Thus, cats utilized the prosthetic leg for locomotion instead of walking on three legs. Ground reaction forces, power and work of the prosthetic limb were reduced compared to intact locomotion, whereas those of the contralateral hind- and forelimbs increased (p < 0.05). This asymmetry was likely caused by insufficient energy generation for propulsion by the prosthetic leg, as no signs of pain or discomfort were observed in the animals. We concluded that cats could utilize a unilateral bone-anchored transtibial prosthesis for quadrupedal level and slope locomotion.

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Intraosseous Transcutaneous Amputation Prosthesis (ITAP) for Limb Salvage in 4 Dogs

Abstract: Implantation of ITAP to the distal limb of dogs is feasible and can result in favorable functional outcomes. Biological integration of osseous and dermal tissues with ITAP is reliable and robust.

Cited by 70 publications

References 52 publications

Design features of implants for direct skeletal attachment of limb prostheses

Design features of implants for direct skeletal attachment of limb prostheses

Hemipelvic and proximal femoral limb salvage endoprosthesis with tendon ongrowth in a dog

Kinetics of individual limbs during level and slope walking with a unilateral transtibial bone-anchored prosthesis in the cat

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