Transfemoral Osseointegration-a self-case study and physiotherapy assessment

A patient (the first author) with a preexisting right side transfemoral amputation (20 years before) had osseointegration surgery. She was assigned a physiotherapist (the second author) and began a rehabilitation program. We provide a unique insight into the first 18 months of rehabilitation after insertion of an osseointegration bone anchor from a physiotherapist and patient perspective with the intention of informing practitioners, patients, and potential patients about the experience and identifying potential areas for improvements in the rehabilitation protocol. The experience was tracked by both the patient and the physiotherapist for 18 months post-surgery. The physiotherapist followed a specific protocol with the patient in the first part of the recovery stage. The patient kept records of subjective experiences over the same period. Loading and physiotherapy were completed in line with the protocol for the first 12-week phase including successful fitting of the prosthetic limb on day 12. Physiotherapy and other interventions evolved to meet the patient's needs over the 18-month period. The patient progressed through her rehabilitation, and new data about the patient's experience were gathered. Following the protocol enabled the patient to progress through her rehabilitation. Unforeseen setbacks (abscesses and inflammation/entheseopathies) slowed this process to some extent. Findings from these data can be used to help inform and improve future rehabilitations for patients with osseointegration: patients can be advised about possible setbacks and physiotherapy, and other interventions can be developed to treat should these problems arise.