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Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases
Aditya Khemka1,2, Laurent Frossard3,4, Sarah J Lord1,5
1a 1 School of Medicine, University of Notre Dame Australia , Auburn.
Acta Orthopaedica
|July 7, 2015
Summary
Combining osseointegrated implants with total knee replacement (TKR) offers a feasible solution for transtibial amputees with knee arthritis, improving prosthetic attachment and weight-bearing capabilities.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Rehabilitation medicine
Background:
- Osseointegrated implants provide prosthetic attachment for amputees unable to use sockets.
- Transtibial amputees with knee arthritis experience significant load on the residual limb and knee joint with osseointegration alone.
- Combining total knee replacement (TKR) with osseointegration is explored for improved load distribution.
Observation:
- A retrospective review of 4 transtibial amputees (aged 38-77) who underwent combined osseointegration and TKR between 2012-2014.
- A two-stage procedure involved connecting a standard hinged TKR to custom implants and a skin interface.
- Prostheses were attached to the TKR tibial base plate, allowing the knee and residual limb to share weight.
Findings:
- No major complications were reported; one superficial infection occurred.
- All patients demonstrated enhanced clinical outcomes.
- Significant improvements were observed in the Questionnaire for Transfemoral Amputees (Q-TFA) (29-52 points) and the 6-minute walk test (37-84 meters).
Implications:
- Combining TKR with osseointegrated implants is a viable treatment option.
- This combined approach can improve quality of life, ambulation, and activity levels for specific amputee populations.
- Further research may validate this technique for broader clinical application in managing complex lower-limb amputations.
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