Tereshenko Vlad, Giorgino Riccardo, Eberlin Kyle R, Valerio Ian L, Souza Jason M, Alessandri-Bonetti Mario, Peretti Giuseppe M, Aszmann Oskar C
From Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Plast Reconstr Surg Glob Open. 2024 May 28;12(5):e5850. doi: 10.1097/GOX.0000000000005850. eCollection 2024 May.
Upper extremity limb loss profoundly impacts a patient's quality of life and well-being and carries a significant societal cost. Although osseointegration allows the attachment of the prosthesis directly to the bone, it is a relatively recent development as an alternative to conventional socket prostheses. The objective of this review was to identify reports on osseointegrated prosthetic embodiment for transhumeral amputations and assess the implant systems used, postoperative outcomes, and complications.
A systematic review following PRISMA and AMSTAR guidelines assessed functional outcomes, implant longevity and retention, activities of daily living, and complications associated with osseointegrated prostheses in transhumeral amputees.
The literature search yielded 794 articles, with eight of these articles (retrospective analyses and case series) meeting the inclusion criteria. Myoelectric systems equipped with Osseointegrated Prostheses for the Rehabilitation of Amputees implants have been commonly used as transhumeral osseointegration systems. The transhumeral osseointegrated prostheses offered considerable improvements in functional outcomes, with participants demonstrating enhanced range of motion and improved performance of activities compared with traditional socket-based prostheses. One study demonstrated the advantage of an osseointegrated implant as a bidirectional gateway for signal transmission, enabling intuitive control of a bionic hand.
Osseointegrated prostheses hold the potential to significantly improve the quality of life for individuals with transhumeral amputations. Continued research and clinical expansion are expected to lead to the realization of enhanced efficacy and safety in this technique, accompanied by cost reductions over time as a result of improved efficiencies and advancements in device design.
上肢缺失会严重影响患者的生活质量和幸福感,并带来巨大的社会成本。尽管骨整合允许将假肢直接附着在骨头上,但作为传统套筒式假肢的替代方案,它是一项相对较新的发展。本综述的目的是识别关于经肱骨截肢的骨整合假肢实施方案的报告,并评估所使用的植入系统、术后结果和并发症。
按照PRISMA和AMSTAR指南进行的系统综述评估了经肱骨截肢者中与骨整合假肢相关的功能结果、植入物寿命和保留情况、日常生活活动以及并发症。
文献检索产生了794篇文章,其中八篇文章(回顾性分析和病例系列)符合纳入标准。配备用于截肢者康复的骨整合假肢植入物的肌电系统已普遍用作经肱骨骨整合系统。与传统的基于套筒的假肢相比,经肱骨骨整合假肢在功能结果方面有显著改善,参与者表现出更大的活动范围和更好的活动表现。一项研究证明了骨整合植入物作为信号传输双向通道的优势,能够直观控制仿生手。
骨整合假肢有可能显著改善经肱骨截肢者的生活质量。持续的研究和临床扩展有望实现该技术更高的疗效和安全性,随着时间的推移,由于效率提高和设备设计进步,成本也会降低。