title: RADIOGRAPHIC ASSESSMENT OF EXTREMITY OSSEOINTEGRATION FOR THE AMPUTEE.
abstract: Osseointegration (OI) is a bone-anchoring procedure that allows the direct skeletal attachment of a prosthesis through the use of an implant. Transcutaneous OI implants are similar to subcutaneous intramedullary joint implants with some exceptions. Particularly, OI implants are inserted at the distal aspect of the femur, while intramedullary implants are inserted at the proximal aspect of the femur. In this report, an additional adaptation of the radiographic zonal analysis used for intramedullary implants, known as Gruen zones, is introduced to include OI implants of extremity prosthetics. Radiographic zonal analyses and interpretations are proposed. Gruen zones are used for intramedullary implants, which are generally inserted from the proximal aspect of the bone. OI extremity implants are inserted from the distal end of the bone. Therefore, the zonal analysis is inverted. A radiographic zonal analysis has been introduced by the Osseointegration Group of Australia (OGA). This analysis is needed specifically for the clinical evaluation of extremity OI, as significant changes to the bone and OI implant have been reported and need to be clinically described. A classification technique is necessary for establishing treatment guidelines for the extremity osseointegrated implant. The OGA Zonal analysis addresses this need by adapting a common reference standard to osseointegration of the extremity amputee.
authors.affiliation: The Australian School of Advanced Medicine, Macquarie University, Macquarie, Australia; School of Medicine, University of Notre Dame Australia, Auburn, Australia; Norwest Private Hospital, Bella Vista, Australia.
authors.forename: Munjed
authors.initials: M
authors.lastname: Al Muderis
authors.affiliation: Norwest Private Hospital, Bella Vista, Australia.
authors.forename: Belinda A
authors.initials: BA
authors.lastname: Bosley
authors.affiliation: BayCare Medical Group, Tampa, FL, USA.
authors.forename: Anthony V
authors.initials: AV
authors.lastname: Florschutz
authors.affiliation: BayCare Medical Group, Tampa, FL, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Lunseth
authors.affiliation: Prosthetics and Sensory Aids Service, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Tyler D
authors.initials: TD
authors.lastname: Klenow
authors.affiliation: School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA; Extremity Trauma & Amputation Center of Excellence (EACE), U.S. Department of Veterans Affairs, Tampa, FL, USA; 319 Minimal Care Detachment, U.S. Army Reserves, Pinellas Park, FL, USA.
authors.forename: M Jason
authors.initials: MJ
authors.lastname: Highsmith
authors.affiliation: OP Solutions, Tampa, FL, USA; Prosthetic Design + Research, Tampa, FL, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Kahle
keywords: Amputation surgery; Implant; Interface; Prosthesis; Socket; Transfemoral amputation