Stable fixation of an osseointegated implant system for above-the-knee amputees
Identifieur interne : 002800 ( Pmc/Curation ); précédent : 002799; suivant : 002801Stable 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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<author><name sortKey="Antonellis, Anne" sort="Antonellis, Anne" uniqKey="Antonellis A" first="Anne" last="Antonellis">Anne Antonellis</name>
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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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<front><journal-meta><journal-id journal-id-type="nlm-ta">Acta Orthop</journal-id>
<journal-id journal-id-type="iso-abbrev">Acta Orthop</journal-id>
<journal-id journal-id-type="publisher-id">ORT</journal-id>
<journal-title-group><journal-title>Acta Orthopaedica</journal-title>
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<issn pub-type="ppub">1745-3674</issn>
<issn pub-type="epub">1745-3682</issn>
<publisher><publisher-name>Informa Healthcare</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22489885</article-id>
<article-id pub-id-type="pmc">3339524</article-id>
<article-id pub-id-type="doi">10.3109/17453674.2012.678799</article-id>
<article-id pub-id-type="publisher-id">ORT_A_678799_O</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Papers</subject>
</subj-group>
</article-categories>
<title-group><article-title>Stable fixation of an osseointegated implant system for above-the-knee amputees</article-title>
<subtitle>Titel RSA and radiographic evaluation of migration and bone remodeling in 55 cases</subtitle>
</title-group>
<contrib-group><contrib id="a1" contrib-type="author" corresp="no"><name><surname>Nebergall</surname>
<given-names>Audrey</given-names>
</name>
<xref ref-type="aff" rid="AF0001"><sup>1</sup>
</xref>
</contrib>
<contrib id="a2" contrib-type="author" corresp="no"><name><surname>Bragdon</surname>
<given-names>Charles</given-names>
</name>
<xref ref-type="aff" rid="AF0001"><sup>1</sup>
</xref>
</contrib>
<contrib id="a3" contrib-type="author" corresp="no"><name><surname>Antonellis</surname>
<given-names>Anne</given-names>
</name>
<xref ref-type="aff" rid="AF0001"><sup>1</sup>
</xref>
</contrib>
<contrib id="a4" contrib-type="author" corresp="no"><name><surname>Kärrholm</surname>
<given-names>Johan</given-names>
</name>
<xref ref-type="aff" rid="AF0002"><sup>2</sup>
</xref>
</contrib>
<contrib id="a5" contrib-type="author" corresp="no"><name><surname>Brånemark</surname>
<given-names>Rickard</given-names>
</name>
<xref ref-type="aff" rid="AF0002"><sup>2</sup>
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<contrib id="a6" contrib-type="author" corresp="yes"><name><surname>Malchau</surname>
<given-names>Henrik</given-names>
</name>
<xref ref-type="aff" rid="AF0001"><sup>1</sup>
</xref>
</contrib>
<aff id="AF0001"><sup>1</sup>
<addr-line>Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA</addr-line>
,<country>USA</country>
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<aff id="AF0002"><sup>2</sup>
<addr-line>Sahlgrenska University Hospital, Göteborg</addr-line>
,<country>Sweden</country>
.</aff>
</contrib-group>
<author-notes><corresp id="c1">Correspondence: <email xlink:href="hmalchau@partners.org">hmalchau@partners.org</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>4</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>24</day>
<month>4</month>
<year>2012</year>
</pub-date>
<volume>83</volume>
<issue>2</issue>
<fpage>121</fpage>
<lpage>128</lpage>
<history><date date-type="received"><day>24</day>
<month>6</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>04</day>
<month>2</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Copyright: © Nordic Orthopaedic Federation</copyright-statement>
<copyright-year>2002</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.5/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.</license-p>
</license>
</permissions>
<abstract><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>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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