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J Orthop Surg Res. 2016 Jan 19;11:13. doi: 10.1186/s13018-016-0348-3.

Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases.

Author information

1
School of Medicine, University of Notre Dame Australia, Sydney, Australia. adk_sun@hotmail.com.
2
Norwest Private Hospital, Sydney, Australia. adk_sun@hotmail.com.
3
Rural Clinical School, University of Notre Dame Australia, Sydney, Australia. adk_sun@hotmail.com.
4
The Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. dr_chalak@yahoo.com.
5
School of Medicine, University of Notre Dame Australia, Sydney, Australia. sally.lord@nd.edu.au.
6
Rural Clinical School, University of Notre Dame Australia, Sydney, Australia. sally.lord@nd.edu.au.
7
National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, Australia. sally.lord@nd.edu.au.
8
Norwest Private Hospital, Sydney, Australia. belindabosley@gmail.com.
9
School of Medicine, University of Notre Dame Australia, Sydney, Australia. munjed@me.com.
10
Norwest Private Hospital, Sydney, Australia. munjed@me.com.
11
The Australian School of Advanced Medicine, Macquarie University, Sydney, Australia. munjed@me.com.

Abstract

BACKGROUND:

Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an osseointegrated implant for prosthetic attachment.

METHODS:

We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to a THR with a modular revision stem and a stoma was created. Clinical outcomes were assessed at baseline and 1.5-2.5-year follow-up using standard measures of health-related quality of life, ambulation, and activity levels including the Short Form-36 (SF-36), Questionnaire for Transfemoral Amputees (Q-TFA), Timed Up and Go test, and 6-min walk test.

RESULTS:

Patient age ranged from 35 to 65 years. There were no major adverse events, but there was one case of superficial infection. All patients showed improved Q-TFA and SF-36 scores. Two patients who were wheelchair-bound at baseline became community ambulators, and the third patient exhibited improved ambulation.

CONCLUSIONS:

This study demonstrated the feasibility of combining a THR with an osseointegrated implant in transfemoral amputees.

PMID:
26781501
PMCID:
PMC4717552
DOI:
10.1186/s13018-016-0348-3
[Indexed for MEDLINE]
Free PMC Article

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