From the Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Department of Orthopaedics, Institute for Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden (Dr. Brånemark, Dr. Hagberg, Mrs. Kulbacka-Ortiz, and Dr. Berlin), International Centre for Osseointegration Research, Education and Surgery (iCORES), Department of Orthopaedics, University of California, San Francisco, CA (Dr. Brånemark), and the Sahlgrenska University Hospital, Department of Orthopaedics, Institute for Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden (Dr. Rydevik).
J Am Acad Orthop Surg. 2019 Aug 15;27(16):e743-e751. doi: 10.5435/JAAOS-D-17-00621.
Direct skeletal attachment of prostheses has previously been shown to improve patient-reported outcome (PRO) measures of individuals with transfemoral amputation (TFA) at 2-year follow-up. This prospective study reports the outcomes at 5-year follow-up.
A total of 51 patients (55 legs) with TFA were included in a prospective study. Complications, success rate, and PRO measures were followed for 5 years.
The cumulative fixture survival rate at 5 years was 92%, and the revision-free survival rate was 45%. Thirty-four patients had 70 superficial infections. Eleven patients had 14 deep infections. Fifteen patients had mechanical complications. Four fixtures were removed (ie, one deep infection and three loosening). PRO measures showed significant improvements including more use of the prosthesis, better mobility, fewer issues, and improved physical health-related quality of life (all P < 0.0001) compared with baseline.
Individuals with TFA at 5-year follow-up had significant improvement in PRO measures, but increases in deep infections and mechanical complications are concerning.
直接将假体附着于骨骼，可改善股骨截肢患者的患者报告结局（PRO）测量值，此前的研究在随访 2 年后已证实了这一点。本前瞻性研究报告了随访 5 年的结果。
共纳入 51 例（55 条腿）股骨截肢患者进行前瞻性研究。随访 5 年，记录并发症、成功率和 PRO 测量值。
5 年时累计固定器存活率为 92%，无翻修存活率为 45%。34 例患者发生 70 例浅表感染。11 例患者发生 14 例深部感染。15 例患者发生机械并发症。有 4 个固定器被取出（即 1 例深部感染和 3 例松动）。与基线相比，PRO 测量值显著改善，包括更多地使用假体、更好的移动能力、更少的问题和提高的与身体相关的健康质量（均 P < 0.0001）。
随访 5 年的股骨截肢患者的 PRO 测量值显著改善，但深部感染和机械并发症的增加令人担忧。
