Der Unfallchirurg
-
Historical Article
[On the history of cementless implants in extremity surgery].
The aim of implantation of cementless hip prostheses is vital ingrowth of bone into the structured metal surface of the implant. Since the 1960s several implants with surfaces made of cobalt-based alloys have been produced for this purpose. In the 1980s a novel hip endoprosthesis with a spongiosa-metal surface was introduced. ⋯ These implants made of cobalt-based alloys can also be used in endo-exo prostheses. Titanium implants with a microstructured surface have also been used and very good osseintegration of the surface was also demonstrated by histomorphology. The optimization of the surface and design of the prostheses plays an increasingly more important role in the field of revision endoprostheses.
-
Review Case Reports
The Compress® transcutaneous implant for rehabilitation following limb amputation.
Amputation is an unfortunate outcome of a variety of orthopedic conditions. Many amputees can be functionally fitted with conventional suspension sockets. A substantial subset, however, fails this conventional treatment and is unable to function. ⋯ We have recently adopted this device for transcutaneous use. These procedures have been performed in the United States on a custom regulatory basis. Results of this have been encouraging, and we are planning to begin a regulatory trial in the near future.
-
Review
Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.
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 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.
-
Intramedullary, bone-anchored (osseointegrated), transcutaneous docking of artificial limbs has been in clinical use for more than 25 years. This system of prosthetic limb attachment is a valuable treatment option in the rehabilitation of patients after limb amputation. ⋯ There are also reservations among institutions responsible for exoprosthetic treatment. Ultimately, the advantages and disadvantages of this treatment procedure must be explained in detail to the patients themselves in order to reduce fears and concerns and to be able to bring the overstretched expectations back to reality.