title: Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.
abstract: The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program. The standard implant design of the OPRA system and surgical techniques are described as well as the special rehabilitation protocols based on surgical sites. The results of long-term follow-up for transradial, transhumeral, and thumb amputee operations are briefly reported including the prospective study of transfemoral amputees according to OPRA protocol. The importance of refinement on implant designs and surgical techniques based on the biomechanical analysis and early clinical trials is emphasized. Future aspects on osseointegration surgery are briefly described, including novel treatment options using implanted electrodes.
authors.affiliation: Center of Orthopedic Osseointegration (COO), Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Department of Orthopedics, Gothenburg University, Gothenburg, Sweden.|Division of Orthopedics and Biotechnology, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Center of Orthopedic Osseointegration (COO), Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Department of Orthopedics, Gothenburg University, Gothenburg, Sweden. rickard.branemark@orthop.gu.se.|Department of Orthopedics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. rickard.branemark@orthop.gu.se.|International Center for Osseointegration Research, Education and Surgery (iCORES), Department of Orthopedics, University of California, San Francis, USA. rickard.branemark@orthop.gu.se.
authors.forename: Rickard
authors.initials: R
authors.lastname: Brånemark
mesh_terms: D000671:Amputation, Surgical / Q000534:rehabilitation*; D000672:Amputation Stumps; D001186:Artificial Limbs; D019317:Evidence-Based Medicine; D000067190:Exoskeleton Device; D006801:Humans; D016348:Osseointegration; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D013548:Sweden; D016896:Treatment Outcome
keywords: Amputation; OPRA; Osseointegration Artificial limbs; Prostheses and implants; Prosthesis implantation