Do Amputation Characteristics Predict Outcomes Measures and Infections After Osseointegration Surgery?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Transfemoral osseointegration surgery offers a potential alternative to traditional prosthetic management for individuals with limb loss.
• Patient-centered outcomes and complication rates are critical metrics for evaluating the success of osseointegration procedures.
• Identifying factors associated with postoperative outcomes is essential for optimizing patient care and surgical planning.

Purpose of the Study:

• To investigate the association between baseline patient characteristics and patient-reported outcomes (PROs) and infection outcomes following transfemoral osseointegration.
• To identify specific patient factors that predict improvements in PROs and reduce infection incidence at 2-year follow-up.

Main Methods:

• A retrospective, single-center study was conducted involving 54 patients who underwent unilateral or bilateral transfemoral osseointegration and completed 2-year follow-up.
• Baseline characteristics, including limb-loss-adjusted body mass index (BMI), were analyzed as predictors for changes in PROs (Q-TFA, PROMIS) and infection events.
• Generalized linear models with backward elimination were used to identify significant predictors, adjusting for amputation laterality.

Main Results:

• Lower limb-loss-adjusted BMI was significantly associated with improved patient-reported outcomes, including Q-TFA Global and Problem scores, and PROMIS Pain Interference and Pain Behavior scores.
• Adjusted BMI also predicted improvements in Q-TFA Prosthetic Use, PROMIS Physical Function, and prosthesis use duration.
• The strongest predictor for the number of infection events was also found to be adjusted BMI.

Conclusions:

• Lower adjusted BMI is a key factor associated with superior patient-reported outcomes and a reduced risk of infections after transfemoral osseointegration.
• The findings suggest that BMI management may be an important consideration for patients undergoing this procedure.
• Differences observed between unilateral and bilateral amputees indicate that amputation laterality may play a role in modifying postoperative outcomes.