Division of Orthopaedics and Biotechnology, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Theme Trauma and Reparative Medicine, Department of Orthopedics and Traumatology, Karolinska University Hospital, Stockholm, Sweden.
Division of Orthopaedics and Biotechnology, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Theme Trauma and Reparative Medicine, Department of Orthopedics and Traumatology, Karolinska University Hospital, Stockholm, Sweden.
Biomaterials. 2021 Jun;273:120836. doi: 10.1016/j.biomaterials.2021.120836. Epub 2021 Apr 19.
In the past 50 years, bone anchored prostheses have evolved from a concept for experimental treatment to a rapidly developing area in orthopedics and traumatology. Up to date, there are dozens of centers in the world providing osseointegration amputation reconstructions and more than a thousand patients using the bone anchored prostheses. Compared with conventional socket prostheses, the bone anchored prosthesis by osseointegration avoids the debilitating problems related with soft tissues. It also provides physiological weight bearing, improved range of motion, and sensory feedback, all of which contribute to the improvement on quality of life for amputees. The present article briefly reviews the historical development of osseointegration surgery for amputation reconstruction and the current challenges. The implant design characters and surgical techniques of the two types of implants; the screw-type implant (presented by the OPRA system), and the press-fit implants (presented by EEP and OPL systems) are described. The major complications, infections and mechanical failures, are discussed in detail based on the latest evidence. Future aspects and experimental trials aiming to overcome the current challenges are presented.
在过去的 50 年中，骨整合假体已从实验治疗的概念发展为矫形和创伤学领域的快速发展领域。迄今为止，全球已有数十个中心提供骨整合截肢重建，并有一千多名患者使用骨整合假体。与传统的插座假体相比，骨整合假体避免了与软组织相关的衰弱问题。它还提供生理承重、改善运动范围和感觉反馈，所有这些都有助于提高截肢者的生活质量。本文简要回顾了截肢重建的骨整合手术的历史发展和当前的挑战。描述了两种植入物的植入物设计特征和手术技术; 螺钉式植入物（由 OPRA 系统提供）和压配合植入物（由 EEP 和 OPL 系统提供）。根据最新证据，详细讨论了主要并发症、感染和机械故障。提出了旨在克服当前挑战的未来方面和实验性试验。
