UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees

Matthews, Douglas J.; Arastu, Mateen; Uden, Maggie; Sulliván, John; Bolsakova, Kristina; Robinson, K. P.; Sooriakumaran, S.; Ward, David A.

doi:10.1177/0309364618791616

Cited by 27 publications

(50 citation statements)

References 25 publications

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“…A recently published study of persons with a screw-type osseointegration implant revealed also a variability in rehabilitation duration despite a predefined rehabilitation programme. 25 This study contains some limitations. First, the adverse events were extracted from the participants' Radboudumc medical file.…”

Section: Discussionmentioning

confidence: 93%

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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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Section: Discussionmentioning

confidence: 93%

“…A recently published study of persons with a screw-type osseointegration implant revealed also a variability in rehabilitation duration despite a predefined rehabilitation programme. 25 …”

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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“…9,199 Although serious, adverse events such as periprosthetic or overall fractures, implant loosening, osteomyelitis, revision surgery, or implant removal are rare, they pose a serious clinical concern. 9,10,199 Three long-term follow-up studies (5, >9, and 15 years) indicate that, although improvement in patientreported outcomes has been reported since OI was first introduced, there are still concerns with tissue infection 205,206 and the mechanical properties of the implant, 206,207 possibly related to higher activity. 207 In addition, loss of bone density is associated with implant removal.…”

Section: Additive Manufacturingmentioning

confidence: 99%

Lower limb prosthetic interfaces

Safari

2020

Prosthetics &Amp; Orthotics International

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The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.

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“…(1)(2)(3)(4)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) Indeed, surgical procedures are growing at an unprecedented pace worldwide. (18,27,28)…”

Section: Strong Demand For Bone-anchored Prosthesesmentioning

confidence: 99%

Development of a Government Continuous Quality Improvement Procedure for Assessing the Provision of Bone Anchored Limb Prosthesis: A Process Re-Design Descriptive Study

Frossard

Ferrada

Quincey

et al. 2018

Can. Prosthet. Orthot. J.

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BACKGROUND: Evidences of sustainable clinical benefits of bone-anchored prosthesis (BAP) using osseointegrated fixation over typical socket-suspended prostheses are becoming more probing. This influx of individuals to be fitted with BAP has pressed government organisations to adjust their policies. However, the appraisal of consumer’s experience for the provision of BAP founded by government organisation is yet to be developed. This descriptive study shares the experience gained by a government organisation, namely the Queensland Artificial Limb Service (QALS), while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure. OBJECTIVE(S): The primary objective was to present the methods and outcomes of key steps required to plan and create this CQI procedure. The secondary objective was to highlight key barriers and facilitators of the transition from a socket-focused to the proposed BAP-inclusive CQI procedure. METHODOLOGY: The re-design process of the CQI procedure for 65 current QALS’s consumers with BAP involved a two-step process for the planning (e.g., case-mix, stakeholder) and creation (e.g., diagnosis, technical options, cost). FINDINGS: Prosthetists labour toward CQI procedure represented 1.3 hrs out of 22 hrs and AUD$213 out of AUD$3,300 or 6% of the whole procedure for the provision of BAP. The time spent by a prosthetist, consumer and QALS staff represented 24%, 24% and 53% of the time of the CQI procedure, respectively. The cost of prosthetist and QALS staff labour represented 70% and 30% of the CQI procedure, respectively. CONCLUSIONS: This descriptive study shares the workings and methodology that government organisations, such as QALS, can use to re-design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/31326/24425 LAYMAN’S ABSTRACT There is evidence supporting the long term clinical benefits of bone-anchored prosthesis (BAP) using an osseointegrated fixation over typical socket-suspended prostheses. The increasing number of individuals treated with osseointegrated fixation has pressed government organisations to adjust their policies for fair and equitable provision of prosthetic care. However, the appraisal of consumer’s experience for the provision of BAP by government organisation is yet to be developed. This descriptive study has fulfilled this need by sharing the experience gained by a QALS while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure. This study revealed that government organisations can design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure. How to Cite: Frossard L, Ferrada L, Quincey T, Burkett B, Berg D. Development of a government continuous quality improvement procedure for assessing the provision of bone anchored limb prosthesis: a process re-design descriptive study. Canadian Prosthetics & Orthotics Journal, Volume 1, Issue 2, No 4, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.31326

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UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees

Cited by 27 publications

References 25 publications

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

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

Lower limb prosthetic interfaces

Development of a Government Continuous Quality Improvement Procedure for Assessing the Provision of Bone Anchored Limb Prosthesis: A Process Re-Design Descriptive Study

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