title: Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up.
abstract: OBJECTIVE
  To report outcomes regarding general and specific physical health-related quality of life of treatment with percutaneous osseointegrated prostheses.
  
  
  METHODS
  Prospective 2-year case-control study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Individuals (N=39; mean age, 44 ± 12.4 y) with unilateral transfemoral amputation as a result of trauma (n=23), tumor (n=11), or other cause (n=5). At baseline, 33 of the 39 participants used socket-suspended prostheses.
  
  
  METHODS
  Osseointegrated prosthesis.
  
  
  METHODS
  Questionnaire for Persons with Transfemoral Amputation (Q-TFA), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) physical functioning (PF) and physical component summary (PCS), SF-6D, and Physiological Cost Index (PCI).
  
  
  RESULTS
  At 2 years postimplantation, 6 of 7 Q-TFA scores improved (P<.0001) compared with baseline (prosthetic use, mobility, problem, global, capability, walking habits). The walking aid subscore did not improve (P=.327). Of the 39 participants, increased prosthesis use was reported by 26, same amount of use by 11, and less use by 2. Improvement was reported in 16 of the 30 separate problem items (P<.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<.0001), 8.5 ± 9.7 (P<.0001), and .039 ± .11 (P=.007) points, respectively. Walking energy cost decreased (mean PCI at baseline, .749; mean PCI at follow-up, .61; P<.0001).
  
  
  CONCLUSIONS
  Two years after intervention, patients with a unilateral TFA treated with an 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 percutaneous osseointegrated prostheses are a relevant treatment option.
authors: Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: kerstin.hagberg@vgregion.se.
authors: Kerstin
authors: K
authors: Hagberg
authors: Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Elisabeth
authors: E
authors: Hansson
authors: Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Rickard
authors: R
authors: Brånemark
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001186:Artificial Limbs / Q000009:adverse effects; D016022:Case-Control Studies; D004734:Energy Metabolism; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology; D016348:Osseointegration; D010591:Phantom Limb / Q000534:rehabilitation; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology
keywords: Artificial limbs; Osseointegration; Quality of life; Rehabilitation