Lower extremity osseointegration — a review of the current experiences and expectations

Abstract

Transcutaneous osseointegration for amputees (TOFA), an alternative approach to limb-loss rehabilitation, offers an enhanced quality of life and mobility, overcoming some challenges associated with amputation. This review presents evolution, surgical techniques, patient selection principles, and outcomes associated with TOFA. Notable points include the recognition that press-fit osseointegration techniques and implants achieve the quality of life and mobility improvements with a single surgical episode. Infection remains the most common adverse event, but uncommonly requires additional surgery, and rarely requires implant removal. Press-fit osseointegration has proven suitable for rehabilitating a broad range of patients with pelvic, transfemoral, or transtibial amputation performed to manage trauma, cancer, infection, chronic pain, and deformity. This technigue is safe for patients with vascular disease, diabetes mellitus, short residual bones, and osteoporotic residual bones. This article serves as a central resource for understanding the principles and techniques of osseointegration.

Keywords

• transcutaneous osseointegration
• press-fit osseointegration
• amputation
• limb-loss rehabilitation