• Robin Atallah, Jiao Jiao Li, William Lu, Ruud Leijendekkers, Jan Paul Frölke, and Al Muderis Munjed M.
• 1Department of Surgery (R.A.), Physical Therapy, Department of Orthopaedics (R.L.), and Osseointegration, Department of Surgery (P.F.), Radboud University Medical Center, Nijmegen, the Netherlands 2Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, New South Wales, Australia 3Australian School of Advanced Medicine, Macquarie University, North Ryde, New South Wales, Australia 4School of Medicine, The University of Notre Dame Australia, Auburn, New South Wales, Australia 5Norwest Private Hospital, Bella Vista, New South Wales, Australia.
• J Bone Joint Surg Am. 2017 Sep 20; 99 (18): 1516-1523.

BackgroundOsseointegration 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.MethodsFive patients with transtibial amputation and a history of peripheral vascular disease who received an osseointegration implant from 2014 to 2015 were followed for 12 months. Clinical and functional outcomes were assessed, including pain, the amount of time the patient wore the prosthesis, mobility, walking ability, and quality of life. Adverse events, including infection, fracture, implant failure, revision surgery, additional amputation, and death, were monitored and recorded.ResultsFive transtibial amputees (56 to 84 years of age) followed for 1 year after osseointegration surgery were included in this case series. The mobility of all patients was improved at the time of follow-up. Three patients were wheelchair-bound prior to the surgery but all 5 were able to walk and perform daily activities at the time of follow-up. Four of the 5 patients were pain-free at 12 months postoperatively, and all 5 were using the osseointegrated prosthesis. Two patients had a single episode of superficial soft-tissue infection.ConclusionsAn osseointegrated implant may be considered a feasible alternative to the conventional socket prosthesis for patients with peripheral vascular disease.Level Of EvidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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