Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases

Aditya Khemka; Laurent Frossard; Sarah J Lord; Belinda Bosley; Munjed Al Muderis

doi:10.3109/17453674.2015.1068635

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Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases

Journal article

Open access

Peer reviewed

Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases

Aditya Khemka, Laurent Frossard, Sarah J Lord, Belinda Bosley and Munjed Al Muderis

Acta Orthopaedica, Vol.86(6), pp.740-744

2015

DOI: https://doi.org/10.3109/17453674.2015.1068635

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Abstract

osseointegrated implants

knee replacement

lower limb prosthesis

Background and purpose - Osseointegrated implants are an alternative for prosthetic attachment in individuals with amputation who are unable to wear a socket. However, the load transmitted through the osseointegrated fixation to the residual tibia and knee joint can be unbearable for those with transtibial amputation and knee arthritis. We report on the feasibility of combining total knee replacement (TKR) with an osseointegrated implant for prosthetic attachment. Patients and methods - We retrospectively reviewed all 4 cases (aged 38-77 years) of transtibial amputations managed with osseointegration and TKR in 2012-2014. The below-the-knee prosthesis was connected to the tibial base plate of a TKR, enabling the tibial residuum and knee joint to act as weight-sharing structures. A 2-stage procedure involved connecting a standard hinged TKR to custom-made implants and creation of a skin-implant interface. Clinical outcomes were assessed at baseline and after 1-3 years of follow-up using standard measures of health-related quality of life, ambulation, and activity level including the questionnaire for transfemoral amputees (Q-TFA) and the 6-minute walk test. Results - There were no major complications, and there was 1 case of superficial infection. All patients showed improved clinical outcomes, with a Q-TFA improvement range of 29-52 and a 6-minute walk test improvement range of 37-84 meters. Interpretation - It is possible to combine TKR with osseointegrated implants.

Details

Title: Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases
Authors: Aditya Khemka (Author) - University of Notre Dame Australia
Laurent Frossard (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and Engineering
Sarah J Lord (Author) - University of Notre Dame Australia
Belinda Bosley (Author) - Norwest Private Hospital
Munjed Al Muderis (Author) - Macquarie University
Publication details: Acta Orthopaedica, Vol.86(6), pp.740-744
Publisher: Informa Healthcare
Date published: 2015
DOI: 10.3109/17453674.2015.1068635
ISSN: 1745-3674
Copyright note: Copyright © 2015 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0)
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99449175802621
Output Type: Journal article

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