Bone-Anchored Leg Prostheses Improve Quality Of Life

Prosthetic limbs anchored to titanium implants in patients with above-the-knee amputations improve function and quality of life (QOL) in 9 out of 10 patients, according to a new study.

Researchers at the Sahlgrenska Academy (Gothenburg, Sweden) and Sahlgrenska University Hospital (Mölndal, Sweden) reported on the results of 51 patients who had been amputated above the knee, under the Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA) prosthesis treatment protocol. The patients were aged between 20 and 65 (55% male), and were reviewed for a two-year follow-up period. The results of the follow-up showed that 90% of the patients had improved function and QOL. The study was presented at the International Society of Orthopaedic Surgery and Traumatology (SICOT) annual international conference, held during September 2010 in Gothenburg (Sweden).


"Attaching prostheses directly to the bone with an implant has long been an unattainable vision, and this has been in development for more than 20 years. But we are now seeing the international breakthrough for this revolutionary treatment,” said study presenter and coauthor orthopedic surgeon Rickard Brånemark, M.D., Ph.D. "The treatment improves both function and quality of life in more than 9 out of 10 patients. It's important to point out that this treatment is intended for younger amputees and is not suitable for patients who have had amputations as a result of vascular disease.”

The OPRA implant is made of titanium, and consists of a fixture, an abutment, and an abutment screw. At the first surgery, the fixture is carefully inserted intramedullary into the residual femur, and the skin is closed. At second surgery, which is performed 6 months after the first, the prosthesis is inserted into the distal end of the fixture and protrudes from the residual-limb skin; in addition to abutment insertion, major soft-tissue surgery is also performed. The patient is immobilized for the first 10 to 12 days to achieve critical healing of the skin penetration area and soft tissues.

Osseointegration is a way of attaching prostheses directly to the bone, developed in the 1960s by Prof. Per-Ingvar Brånemark. He discovered that titanium is not rejected by the body, but instead fuses with the surrounding bone tissue. It was originally used to replace lost teeth using titanium dental implants, a treatment method that has spread worldwide and improved the quality of life of millions of people.

Related Links:
Sahlgrenska Academy
Sahlgrenska University Hospital