title: Osseointegrated Prosthetic Limb for the treatment of lower limb amputations : Experience and outcomes.
abstract: BACKGROUND
  Osseointegration has emerged over the past two decades as a dramatically different approach for the treatment of lower limb amputations, which involves direct attachment of the prosthesis to the skeletal residuum. This approach can address many of the socket-interface issues associated with socket prostheses which represent the current standard of care for amputees. The Osseointegrated Prosthetic Limb (OPL) is an osseointegration implant with a new design and improved features compared to other available implant systems.
  
  
  OBJECTIVE
  To report on the experience and outcomes of using the OPL for osseointegrated reconstruction of lower limb amputations.
  
  
  METHODS
  This is a retrospective study of 22 patients who received the OPL implant between December 2013 and November 2014. Clinical outcomes were obtained pre- and post-operatively, with results reported at the 1‑year follow-up. Outcome measures included the Questionnaire for persons with a Trans-Femoral Amputation (Q-TFA), Short Form Health Survey 36 (SF-36), Six-Minute Walk Test (6MWT), and Timed Up and Go (TUG). Adverse events were also recorded.
  
  
  RESULTS
  Compared to the mean pre-operative values obtained while patients were using socket prostheses or were wheelchair-bound, the mean post-operative values for all four validated outcome measures were significantly improved. There were 15 episodes of minor infections in 12 patients, all of which responded to antibiotics. Soft tissue refashioning was performed electively on 6 patients. No other adverse events were recorded.
  
  
  CONCLUSIONS
  The results demonstrate that osseointegration surgery using the OPL is a relatively safe and effective procedure for the reconstruction and rehabilitation of lower limb amputees.
authors.affiliation: The Australian School of Advanced Medicine, Macquarie University, 2109, North Ryde, NSW, Australia.|School of Medicine, University of Notre Dame, 2144, Auburn, NSW, Australia.|Norwest Private Hospital, 2153, Bella Vista, NSW, Australia.
authors.forename: Munjed
authors.initials: M
authors.lastname: Al Muderis
authors.affiliation: Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, 2006, Sydney, NSW, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Lu
authors.affiliation: Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, 2006, Sydney, NSW, Australia. jiaojiao.li@sydney.edu.au.
authors.forename: Jiao Jiao
authors.initials: JJ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000672:Amputation Stumps; D001186:Artificial Limbs; D019317:Evidence-Based Medicine; D000067190:Exoskeleton Device; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Implant; Leg prosthesis; Osseointegration; Quality of life; Trans-femoral amputation