Bone-anchored prostheses represent a promising solution to numerous medical complications associated with conventional socket-suspended prostheses. The following technical overview was constructed for engineers and orthopedic surgeons interested in osseointegrated implants for transfemoral prosthesis-residuum interfacing. Existing osseointegrated implants comprise different biomaterial compositions (i.e., titanium alloy versus cobalt-chromium-molybdenum alloy) and mechanical designs (i.e., screw-fixated versus press-fixated devices). Perioperative systems of osseointegration surgery include preoperative assessments (i.e., alongside inclusion and exclusion criteria), intraoperative procedures, and postoperative rehabilitation (i.e., static loading and dynamic gait rehabilitation). The intraoperative procedures involve transecting and reorganizing the residual musculature, embedding the implant into the femoral intramedullary cavity, and coupling the osseointegrated implant to an external prosthesis. Postoperative clinical evaluations have demonstrated significant biomechanical, psychological, and physiological improvements in patients using bone-anchored prostheses compared to conventional socket-suspended prostheses. Nevertheless, bacterial infections surrounding the skin-implant bio-interface, often resulting from Staphylococcus aureus or other coagulase-negative staphylococci, remain a relatively frequent medical complication, which can culminate in periprosthetic osteomyelitis and/or implant extraction. The technical overview concludes with discussing the recent Food and Drug Administration humanitarian use device designations, financial analyses between bone-anchored prostheses and socket-suspended prostheses, and applications of vibrotactile osseoperception for augmenting walking and balance feedback control.
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Technical Overview of Osseointegrated Transfemoral Prostheses: Orthopedic Surgery and Implant Design Centered
Andrii Maryniak,
Andrii Maryniak
Center for Medical Education,
Poznan University of Medical Sciences,
Poznan 61-701, Poland
e-mail: andre.maryniak@mail.utoronto.ca
Poznan University of Medical Sciences,
Poznan 61-701, Poland
e-mail: andre.maryniak@mail.utoronto.ca
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Brock Laschowski,
Brock Laschowski
Institute of Biomaterials and
Biomedical Engineering,
University of Toronto,
Toronto, ON M5S 3G9, Canada
e-mail: brock.laschowski@mail.utoronto.ca
Biomedical Engineering,
University of Toronto,
Toronto, ON M5S 3G9, Canada
e-mail: brock.laschowski@mail.utoronto.ca
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Jan Andrysek
Jan Andrysek
Bloorview Research Institute,
Holland Bloorview Kids Rehabilitation Hospital,
Toronto, ON M4G 1R8, Canada
e-mail: jandrysek@hollandbloorview.ca
Holland Bloorview Kids Rehabilitation Hospital,
Toronto, ON M4G 1R8, Canada
e-mail: jandrysek@hollandbloorview.ca
Search for other works by this author on:
Andrii Maryniak
Center for Medical Education,
Poznan University of Medical Sciences,
Poznan 61-701, Poland
e-mail: andre.maryniak@mail.utoronto.ca
Poznan University of Medical Sciences,
Poznan 61-701, Poland
e-mail: andre.maryniak@mail.utoronto.ca
Brock Laschowski
Institute of Biomaterials and
Biomedical Engineering,
University of Toronto,
Toronto, ON M5S 3G9, Canada
e-mail: brock.laschowski@mail.utoronto.ca
Biomedical Engineering,
University of Toronto,
Toronto, ON M5S 3G9, Canada
e-mail: brock.laschowski@mail.utoronto.ca
Jan Andrysek
Bloorview Research Institute,
Holland Bloorview Kids Rehabilitation Hospital,
Toronto, ON M4G 1R8, Canada
e-mail: jandrysek@hollandbloorview.ca
Holland Bloorview Kids Rehabilitation Hospital,
Toronto, ON M4G 1R8, Canada
e-mail: jandrysek@hollandbloorview.ca
1Corresponding author.
Manuscript received November 12, 2017; final manuscript received January 16, 2018; published online February 27, 2018. Assoc. Editor: Peter McNair.
ASME J of Medical Diagnostics. May 2018, 1(2): 020801 (7 pages)
Published Online: February 27, 2018
Article history
Received:
November 12, 2017
Revised:
January 16, 2018
Citation
Maryniak, A., Laschowski, B., and Andrysek, J. (February 27, 2018). "Technical Overview of Osseointegrated Transfemoral Prostheses: Orthopedic Surgery and Implant Design Centered." ASME. ASME J of Medical Diagnostics. May 2018; 1(2): 020801. https://doi.org/10.1115/1.4039105
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