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用于治疗下肢截肢的骨整合假肢:经验与结果。

Osseointegrated Prosthetic Limb for the treatment of lower limb amputations : Experience and outcomes.

作者信息

Al Muderis Munjed, Lu William, Li Jiao Jiao

机构信息

The Australian School of Advanced Medicine, Macquarie University, 2109, North Ryde, NSW, Australia.

School of Medicine, University of Notre Dame, 2144, Auburn, NSW, Australia.

出版信息

Unfallchirurg. 2017 Apr;120(4):306-311. doi: 10.1007/s00113-016-0296-8.

Abstract

BACKGROUND

Osseointegration has emerged over the past two decades as a dramatically different approach for the treatment of lower limb amputations, which involves direct attachment of the prosthesis to the skeletal residuum. This approach can address many of the socket-interface issues associated with socket prostheses which represent the current standard of care for amputees. The Osseointegrated Prosthetic Limb (OPL) is an osseointegration implant with a new design and improved features compared to other available implant systems.

OBJECTIVES

To report on the experience and outcomes of using the OPL for osseointegrated reconstruction of lower limb amputations.

MATERIALS AND METHODS

This is a retrospective study of 22 patients who received the OPL implant between December 2013 and November 2014. Clinical outcomes were obtained pre- and post-operatively, with results reported at the 1‑year follow-up. Outcome measures included the Questionnaire for persons with a Trans-Femoral Amputation (Q-TFA), Short Form Health Survey 36 (SF-36), Six-Minute Walk Test (6MWT), and Timed Up and Go (TUG). Adverse events were also recorded.

RESULTS

Compared to the mean pre-operative values obtained while patients were using socket prostheses or were wheelchair-bound, the mean post-operative values for all four validated outcome measures were significantly improved. There were 15 episodes of minor infections in 12 patients, all of which responded to antibiotics. Soft tissue refashioning was performed electively on 6 patients. No other adverse events were recorded.

CONCLUSIONS

The results demonstrate that osseointegration surgery using the OPL is a relatively safe and effective procedure for the reconstruction and rehabilitation of lower limb amputees.

摘要

背景

在过去二十年中,骨整合已成为一种截然不同的下肢截肢治疗方法,该方法涉及将假体直接附着于骨骼残端。这种方法可以解决许多与接受腔假体相关的接受腔界面问题,而接受腔假体是目前截肢者的标准护理方式。与其他现有植入系统相比,骨整合假肢(OPL)是一种具有新设计和改进功能的骨整合植入物。

目的

报告使用OPL进行下肢截肢骨整合重建的经验和结果。

材料与方法

这是一项对22例患者的回顾性研究,这些患者在2013年12月至2014年11月期间接受了OPL植入。在术前和术后获得临床结果,并在1年随访时报告结果。结果测量包括经股骨截肢者问卷(Q-TFA)、简短健康调查36项(SF-36)、六分钟步行测试(6MWT)和计时起立行走测试(TUG)。还记录了不良事件。

结果

与患者使用接受腔假体或依赖轮椅时获得的术前平均数值相比,所有四项经过验证的结果测量指标的术后平均数值均有显著改善。12例患者发生了15次轻微感染,所有感染对抗生素均有反应。6例患者接受了软组织重塑手术。未记录其他不良事件。

结论

结果表明,使用OPL进行骨整合手术是一种相对安全有效的下肢截肢者重建和康复手术。

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