Stable fixation of an osseointegated implant system for above-the-knee amputees
Identifieur interne : 002F70 ( Main/Curation ); précédent : 002F69; suivant : 002F71Stable fixation of an osseointegated implant system for above-the-knee amputees
Auteurs : Audrey Nebergall [États-Unis] ; Charles Bragdon [États-Unis] ; Anne Antonellis [États-Unis] ; Johan K Rrholm [Suède] ; Rickard Br Nemark [Suède] ; Henrik Malchau [États-Unis]Source :
- Acta Orthopaedica [ 1745-3674 ] ; 2012.
Abstract
Rehabilitation of patients with transfemoral amputations is particularly difficult due to problems in using standard socket prostheses. We wanted to assess long-term fixation of the osseointegrated implant system (OPRA) using radiostereometric analysis (RSA) and periprosthetic bone remodeling.
51 patients with transfemoral amputations (55 implants) were enrolled in an RSA study. RSA and plain radiographs were scheduled at 6 months and at 1, 2, 5, 7, and 10 years after surgery. RSA films were analyzed using UmRSA software. Plain radiographs were graded for bone resorption, cancellization, cortical thinning, and trabecular streaming or buttressing in specifically defined zones around the implant.
At 5 years, the median (SE) migration of the implant was –0.02 (0.06) mm distally. The rotational movement was 0.42 (0.32) degrees around the longitudinal axis. There was no statistically significant difference in median rotation or migration at any follow-up time. Cancellization of the cortex (plain radiographic grading) appeared in at least 1 zone in over half of the patients at 2 years. However, the prevalence of cancellization had decreased by the 5-year follow-up.
The RSA analysis for the OPRA system indicated stable fixation of the implant. The periprosthetic bone remodeling showed similarities with changes seen around uncemented hip stems. The OPRA system is a new and promising approach for addressing the challenges faced by patients with transfemoral amputations.
Url:
DOI: 10.3109/17453674.2012.678799
PubMed: 22489885
PubMed Central: 3339524
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PMC:3339524Le document en format XML
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<series><title level="j">Acta Orthopaedica</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background and purpose</title>
<p> Rehabilitation of patients with transfemoral amputations is particularly difficult due to problems in using standard socket prostheses. We wanted to assess long-term fixation of the osseointegrated implant system (OPRA) using radiostereometric analysis (RSA) and periprosthetic bone remodeling.</p>
</sec>
<sec><title>Methods</title>
<p> 51 patients with transfemoral amputations (55 implants) were enrolled in an RSA study. RSA and plain radiographs were scheduled at 6 months and at 1, 2, 5, 7, and 10 years after surgery. RSA films were analyzed using UmRSA software. Plain radiographs were graded for bone resorption, cancellization, cortical thinning, and trabecular streaming or buttressing in specifically defined zones around the implant.</p>
</sec>
<sec><title>Results</title>
<p> At 5 years, the median (SE) migration of the implant was –0.02 (0.06) mm distally. The rotational movement was 0.42 (0.32) degrees around the longitudinal axis. There was no statistically significant difference in median rotation or migration at any follow-up time. Cancellization of the cortex (plain radiographic grading) appeared in at least 1 zone in over half of the patients at 2 years. However, the prevalence of cancellization had decreased by the 5-year follow-up.</p>
</sec>
<sec><title>Interpretation</title>
<p> The RSA analysis for the OPRA system indicated stable fixation of the implant. The periprosthetic bone remodeling showed similarities with changes seen around uncemented hip stems. The OPRA system is a new and promising approach for addressing the challenges faced by patients with transfemoral amputations.</p>
</sec>
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