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Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up.

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Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up.

Arch Phys Med Rehabil. 2014 Jul 23;

Authors: Hagberg K, Hansson E, Brånemark R

Abstract
OBJECTIVE: To report outcome regarding general and specific physical health-related quality of life of treatment with percutaneous osseointegrated prostheses.
DESIGN: Prospective two-year case-control study.
SETTING: University hospital.
PARTICIPANTS: 39 individuals (mean age 44±12.4) with unilateral transfemoral amputation due to trauma (n=23), tumor (n=11) or other cause (n=5). At baseline, 33/39 used socket-suspended prostheses.
INTERVENTION: osseointegrated prosthesis.
MAIN OUTCOME MEASURES: Questionnaire for Individuals with Transfemoral Amputation (Q-TFA), SF-36 Physical Function (PF) and Physical Component Scores (PCS), SF-6D and the Physiological Cost Index (PCI).
RESULTS: At two years post implantation, six of seven Q-TFA scores improved (p<0.0001) compared with baseline (Prosthetic Use, Mobility, Problem, Global, Capability and Walking Habits). The Walking Aid sub-score did not improve (p=0.327). Increased prosthesis use was reported by 26/39, the same amount of use by 11/39, and less use by 2/39 subjects. Improvement was reported in 16/30 separate Problem items (p<0.05). Unchanged items included problems regarding phantom limb pain and pain from the back, shoulders and contralateral limb. The PF, PCS and SF-6D improved a mean of 24.1±21.4 (p<0.0001), 8.5±9.7 (p<0.0001) and 0.039±0.11 (p=0.007) points, respectively. Walking energy cost decreased (mean PCI: baseline 0.749, follow-up 0.610 (p<0.0001)).
CONCLUSIONS: Two years after intervention, patients with a unilateral TFA treated with OPRA implant showed important improvements in prosthetic function and physical quality of life. However, walking aids used and the presence of phantom limb pain and pain in other extremities were unchanged. This information is valuable when considering whether a percutaneous osseointegrated prosthesis is a relevant treatment option.

PMID: 25064778 [PubMed – as supplied by publisher]

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