Limb Osseointegration-How Important Is the Role of Nutrition in the Process?

Osseointegration (OI) surgery of the appendicular skeleton for repair in amputees is a treatment in which a metal implant is directly fixed to the residual bone and subsequently connected to a prosthetic limb via a transcutaneous connector through a small incision in the skin. Current treatment does not consider nutritional advice for patients undergoing the OI procedure. However, since the group of patients is very heterogeneous, the results may not be always satisfactory for patients and clinicians. Furthermore, in some individuals, incorrect nutrition and diet habits may lead to complications and rejection of the implant.

We created an extensive narrative evaluation by conducting a methodical search. A comprehensive search was conducted across three major databases: PubMed, Embase, and Scopus. The search was carried out in October 2024 with no time limit specified. The approach involved using specific, pre-defined search terms, which were first applied in PubMed, followed by Embase and Scopus to ensure a broad and diverse range of articles was captured. The search process was refined by considering studies published in high-impact journals, as identified based on impact factors and subject relevance. To ensure consistency and rigor, the selection criteria were applied uniformly across all databases, and irrelevant or incomplete articles were excluded.

Based on the specific nature of the OI procedure, it is crucial to adapt patients' diets and nutrition after the process. To translate the findings from the reviewed literature into practical clinical guidance for osseointegration (OI) procedures, we developed dietary recommendations for both patients and clinicians, presented as proposed dietary plans and summarized in tables. These recommendations were informed by evidence from various studies, highlighting findings that were supported by randomized controlled trials (RCTs) as well as areas where the evidence remains inconclusive or unsupported by RCTs. Major vitamins and micro- and macroelements were distinguished and presented as guidelines for clinicians.

OI is currently the most promising therapeutic options for amputees. To promote efficient tissue healing and provide energy for rehabilitation, it is recommended to follow a healthy, well-balanced diet that contains all the essential micronutrients, macronutrients, vitamins, and minerals. We also provide suggestions for future studies.