653 Evaluating the Effectiveness of Osseointegration for Traumatic Lower Limb Amputations: A Narrative Review

Abstract

Abstract Aim Major trauma to the limbs often results in amputation and can have a debilitating effect on an individual’s physical and psychological health. Currently, the conventional management to remediate the consequences of limb amputation is a Traditional Socket-mounted Prosthesis (TSP) for the affected limbs. However, its use is associated with various complications, such as skin ulcers, increased fracture risk, nerve pain, and heterotopic ossification. To address this, a novel approach known as osseointegration; a procedure in which an artificial implant is surgically integrated and anchored into residual bone, has been developed. This narrative review aims to primarily evaluate the efficacy and functional outcomes of lower limb osseointegration compared to TSP. Method A literature review was performed to identify and analyse studies addressing the efficacy, functional outcomes, and complications of lower limb osseointegration prosthesis compared to TSP. Studies were summarised according to type of osseointegration prosthesis, number of surgeries required, and amputation location. Data on efficacy, functional outcomes, and complications of patients with osseointegrated prosthesis was extracted. Results Six studies were chosen for critical analysis of the primary and secondary aims. All studies reported osseointegration conferred significant improvements in mobility, walking capability, walking speed, quality of life, prosthesis comfortability, prosthetic control, and prosthetic use. Complications reported were mild infection, phantom limb pain and periprosthetic fractures although incidences were rare. Conclusions Osseointegration has been shown to increase prosthetic use, improve confidence, walking ability, and mobility. Complications are mild and easily treated. Overall, there is sufficient evidence to suggest osseointegration could become standard management for lower-limb amputations.