Osseointegration amputation prostheses on the upper limbs

Abstract

The two-stage osseointegration procedure has the potential to change the rehabilitation strategy for selected upper limb amputees. The method eliminates the need for a socket and the prosthesis will always fit. The stable prosthetic fixation and increased freedom of motion generates improved function. Specially designed components and rehabilitation procedures have been developed.

Mechanical design and performance specifications of anthropomorphic prosthetic hands: A review

“…Since the forces from the device are borne by the soft tissue instead of the skeleton, the perceived weight in the terminal device is increased. Although researchers are currently working to alleviate attachment problems through the use of customized socket design and osseointegrated attachment mechanisms [19], the weight of the prosthesis is a key contributor to interface discomforts and use fatigue. A recent Internet survey of myoelectric prosthetic users concluded that 79 percent considered their device "too heavy" [18].…”

Comparison of prosthetic costs and service between osseointegrated and conventional suspended transfemoral prostheses

“…14,15 For amputees, the OPRA treatment requires two surgery sessions, about 6 months apart, followed by a period of rehabilitation. 11,16,17 The artificial limb itself used after osseointegration treatment (OI-prosthesis) requires some specific components, which are not used for conventional socket-suspended prostheses (S-prosthesis), such as an attachment device to connect the prosthesis to the implant 16,17 ( Figure 1). …”

The evolution of functional hand replacement: From iron prostheses to hand transplantation

“…Osseointegration was developed in the 1950s by Swedish surgeon Per-Ingvar Brånemark, but it was his son Rickard Brånemark who pioneered its application to extremity prostheses (26). By providing stable fixation, osseointegrated prostheses eliminate socket-related problems, such as chafing and sweating, while increasing the amputee's range of motion (27). The intimate prosthesis-skeletal junction also allows users to experience improved pressure and vibratory sensation (28).…”

“…Between 1990 and 2010, Brånemark's team fitted 10 transradial and 16 transhumeral osseointegrated prostheses. Only three patients were later unable to use their prosthesis due to implant fracture, traumatic damage or incomplete integration (27). Infection and implant cost are major limitations to greater adoption of osseointegration in upper extremity amputees.…”