What Functional Outcomes Can Be Expected With Osseointegrated Prostheses in Transfemoral Amputations?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Transfemoral amputees often face challenges with conventional socket prostheses.
• Osseointegration offers a potential alternative, but evidence on its benefits is limited.
• Prospective studies are needed to evaluate outcomes and quantify advantages of osseointegration.

Purpose of the Study:

• To assess improvements in patient-reported outcome measures (PROMs) 2 years post-osseointegration surgery in transfemoral amputees.
• To determine the frequency and severity of early complications associated with osseointegration procedures.
• To establish the minimum clinically important difference (MCID) for a global PROMs in this patient population.

Main Methods:

• A prospective, observational trial involving 41 participants undergoing transfemoral osseointegration surgery.
• Participants completed validated questionnaires (Q-TFA, PROMIS) pre-operatively and at 3, 6, 12, and 24 months post-surgery.
• Complications were tabulated, and an anchored-based MCID for the Q-TFA global score was calculated.

Main Results:

• Significant improvements were observed in Q-TFA and PROMIS scores across multiple domains, including prosthetic use, mobility, and physical function (p < 0.05).
• Superficial infections occurred in 29% of cases (all resolved with antibiotics); deep infections were rare (7% overall, 1.4% bone/implant).
• The calculated anchored-based MCID for the Q-TFA global score was 17 out of 100.

Conclusions:

• Osseointegration surgery demonstrates promise for improving functional outcomes in transfemoral amputees with poor prosthesis function.
• Complication rates, particularly deep infections, appear lower than reported in previous osseointegration studies.
• The established MCID provides a benchmark for evaluating clinical significance in future osseointegration research.