Press-Fit Bone-Anchored Prosthesis for Patients with Short Transfemoral Amputation.

Background: This video article describes the use of a bone-anchored prosthesis in patients with high above-the-knee amputations resulting in short residual limbs, most typically from trauma, cancer, infections, or dysvascular disease. The use of a socket prosthesis is usually unsuccessful in patients with a high transfemoral amputation because such prostheses have an unstable connection and often require additional waist belts for better attachment to the short residual limb. In most cases, a bone-anchored prosthesis results in substantial improvements in wear time, mobility, and quality of life in these patients.

Surgical technique of a transcutaneous osseointegration prosthesis system (TOPS) for transtibial amputees.

Transcutaneous osseointegration prosthetic systems (TOPS) are intended to provide stable skeletal attachment for artificial limbs after extremity amputation and is an alternative for socket attachment. TOPS for individuals with limb amputation using osseointegration implants (OI) has proven to consistently and significantly improve quality of life and mobility for the vast majority of amputees, previously using a socket prosthesis also experiencing socket-related problems. As with any implant, complications such as infection, aseptic loosening, or implant fracture can occur, which may necessitate hardware removal.

Surgical technique of minor revision of a transcutaneous osseointegration prosthetic system (TOPS) with implant retention.

Objective: Transcutaneous osseointegration prosthetic systems (TOPS) offer a stable skeletal attachment for artificial limbs post-extremity amputation, serving as an alternative to socket attachment. Press-fit osseointegration implants (OI) utilized in TOPS consistently enhance quality of life and mobility for amputees, particularly those experiencing socket-related issues. Despite notable benefits, late complications such as infection and implant loosening pose challenges unique to TOPS due to their percutaneous nature.

Revision of Press-Fit Bone-Anchored Prosthesis After Implant Failure.

Background: The present video article describes the revision of a bone-anchored prosthesis in patients who received an osseointegration implant after transfemoral amputation. Clinical follow-up studies have shown that approximately 5% of all patients who receive press-fit cobalt-chromium alloy femoral implants experience failure of the intramedullary stem component as a result of septic loosening or stem breakage. For stem breakage, stem diameter and the occurrence of infectious events were identified as risk factors.

What Are the Risk Factors for Mechanical Failure and Loosening of a Transfemoral Osseointegrated Implant System in Patients with a Lower-limb Amputation?

Background: Septic loosening and stem breakage due to metal fatigue is a rare but well-known cause of orthopaedic implant failure. This may also affect the components of the osseointegrated implant system for individuals with transfemoral amputation who subsequently undergo revision. Identifying risk factors is important to minimize the frequency of revision surgery after implant breakage.

Treatment of Distal Radius Fracture: Does Early Activity Postinjury Lead to a Lower Incidence of Complex Regional Pain Syndrome?

The optimal treatment for a distal radius fracture (DRF) remains an ongoing discussion. This study observed whether early activity postinjury can lead to the prevention of type 1 complex regional pain syndrome (CRPS-1). Patients who underwent nonoperative treatment for a DRF were invited to participate in this study.

Prevention of Complex Regional Pain Syndrome type 1 after conservative reatment of a distal radius fracture with a home exercise program: A proof-of-concept study.

Prevention of CRPS-1, a post-traumatic pain syndrome, after a distal radius fracture is important as this syndrome might lead to chronic pain and serious disabilities. In several studies, it was shown that CRPS-1 can be cured with exercise and graded activities. In a prospective cohort study, a home exercise program with progressive loading exercises was applied immediately after cast removal in patients with a distal radius fracture.

Functional performance and safety of bone-anchored prostheses in persons with a transfemoral or transtibial amputation: a prospective one-year follow-up cohort study.

Objectives:: (1) To compare level of function, activity, health-related quality of life (HRQoL) and satisfaction in persons with a lower extremity amputation before surgery and 6- and 12-months after implantation of an osseointegration implant and (2) to report adverse events.

Design:: Prospective cohort study.

Setting:: University medical centre.

Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review.

Background: This study aimed to provide an overview of device-related complications occurring in individuals with an upper or lower extremity amputation treated with a screw, press-fit or other type of bone-anchored implant as well as interventions related to these complications.

Method: A systematic literature search was conducted in the MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science databases. The included studies reported on device-related complications and interventions occurring in individuals with bone-anchored prostheses.

Magnetic-resonance-imaging-based three-dimensional muscle reconstruction of hip abductor muscle volume in a person with a transfemoral bone-anchored prosthesis: A feasibility study.

Background: Persons with transfemoral amputation typically have severe muscle atrophy of the residual limb. The effect of bone-anchored prosthesis use on existing muscle atrophy is unknown. A potentially feasible method to evaluate this is magnetic resonance imaging (MRI)-based three-dimensional (3D) muscle reconstruction.

Osseointegrated Transtibial Implants in Patients with Peripheral Vascular Disease: A Multicenter Case Series of 5 Patients with 1-Year Follow-up.

Background: Osseointegration is an alternative treatment for amputees who are unable to wear or have difficulty wearing a socket prosthesis. Although the majority of limb amputations are due to vascular disease, such amputations have been perceived as a contraindication to osseointegration surgery. We report the outcomes of osseointegrated reconstruction in a series of 5 patients with limb amputation due to peripheral vascular disease.

Timing of definitive fixation of major long bone fractures: Can fat embolism syndrome be prevented?

Fat embolism is common in patients with major fractures, but leads to devastating consequences, named fat embolism syndrome (FES) in some. Despite advances in treatment strategies regarding the timing of definitive fixation of major fractures, FES still occurs in patients. In this overview, current literature is reviewed and optimal treatment strategies for patients with multiple traumatic injuries, including major fractures, are discussed.

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol.

Background: Patients with lower extremity amputation frequently suffer from socket-related problems. This seriously limits prosthesis use, level of activity and health-related quality of life (HRQoL). An additional problem in patients with lower extremity amputation are asymmetries in gait kinematics possibly accounting for back pain.

Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review.

Purpose: This study aimed to provide an overview of a) the used measurement instruments in studies evaluating effects on quality of life (QoL), function, activity and participation level in patients with a lower extremity amputation using bone-anchored prostheses compared to socket prostheses and b) the effects themselves.

Method: A systematic literature search was conducted in MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science. Included studies compared QoL, function, activity and/or participation level in patients with bone-anchored or socket prostheses.

The Effect of Implant Failure After Symphyseal Plating on Functional Outcome and General Health.

Objectives: To relate the incidence of implant failure after internal anterior fixation of the pelvic ring to functional outcome and the health-related quality of life in patients.

Design: Retrospective chart and radiographic review.

Setting: Level I Trauma center.

Correct Positioning of Percutaneous Iliosacral Screws With Computer-Navigated Versus Fluoroscopically Guided Surgery in Traumatic Pelvic Ring Fractures.

Objectives: To assess the correct positioning of iliosacral screw in patients with unstable traumatic pelvic ring injury by comparing fluoroscopically guided computer-navigated surgery (CNS) with conventional fluoroscopy (CF) through reviewing postoperative computed tomography (CT) and clinical indicators.

Design: A comparative multicenter cohort study.

Setting: Two level I Trauma Centers in the Netherlands.

Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses.

Objective: To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses.

Design: Prospective case-control study.

Setting: University medical center.

Safety of "pain exposure" physical therapy in patients with complex regional pain syndrome type 1.

"Pain exposure" physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of pain-avoidance behavior without the use of specific CRPS-1 medication or analgesics. The aim of this study was to investigate primarily whether PEPT could be applied safely in patients with CRPS-1. Twenty patients with CRPS-1 were consecutively enrolled in the study after giving informed consent.