Page 46 - inmotion-21-05-web

This is a SEO version of inmotion-21-05-web. Click here to view full version

« Previous Page Table of Contents Next Page »

46 in Motion Volume 21, Issue 5 September/October 2011

by Carole St.-Jean, CP(c), and Natalie Fish, BSc (PT)

What is osseointegration?

Osseointegration is derived from the Greek word osteon , which means bone, and the Latin integrare , to make whole.

In fact, osseointegration is an alternative method of attaching a prosthetic limb to an amputee’s body.

Whenwas this attempted?

The frst attempts at osseointegration were begun in Sweden in the late 1950s by Dr. P.I. Brånemark with dental applications. The technique was then applied to facial pros-theses such as ears, noses and hearing aids, and subsequently for joint replacements in the hand and silicone prosthetic attachments for thumbs and fngers.

In the 1990s, Professor Rickard Brånemark’s team applied this technology to transfemoral amputees as well as upper-limb patients. Since that time, the Swedish team from the Sahlgrenska University Hospital and Integrum AB in Gothenburg have ftted approximately 200 amputees worldwide. Osseointegration is also

performed in other parts of the world, including England, Germany and Australia.

Howdoes itwork?

Osseointegration consists of a two-stage surgical procedure. This is the most commonly used technique (OPRA: Osseointegrated Prosthesis for Rehabilitation of Amputees), which was originally devel-oped by Brånemark.

In the frst stage, a threaded titanium implant is inserted into the marrow space of the bone of the residual limb. The implant is called a “fxture.” This fxture will become integrated into the bone over time; in other words, it will become part of the bone. In the second stage, which takes place 6

months later, a titanium exten-sion known as an “abutment” is attached to the fx-ture and brought out through the soft tissues and skin. The pros-thesis can then be directly attached to the abutment. With both stages of surgery a very strict rehabilita-tion program is required. Professor Brånemark’s team

has defned a regimented protocol to ensure a successful outcome. Part of this protocol includes a very gradual and progressive weight-bearing on the prosthesis. This begins with technical aids and aims for complete integration of the prosthesis into daily activity over a 6-month period. A safety component called a “failsafe” is integrated as a prosthetic component and will release itself to prevent fracture of the bone or excessive forces on the implant if a fall occurs.

What are the advantages?

• No socket – therefore, no sweating or skin irritations caused by the socket • No pain, pressure or discomfort caused by the socket

• Easy to don and doff the prosthesis • Excellent suspension • No restriction of hip movement • Comfort in the sitting position

Page 46 - inmotion-21-05-web

This is a SEO version of inmotion-21-05-web. Click here to view full version

« Previous Page Table of Contents Next Page »