Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three casesJournal of Orthopaedic Surgery and Research (2016)
Background: Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a
transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced
muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with
osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an
osseointegrated implant for prosthetic attachment.
Methods: We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration
with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to
a THR with a modular revision stem and a stoma was created. Clinical outcomes were assessed at baseline and
1.5–2.5-year follow-up using standard measures of health-related quality of life, ambulation, and activity levels including
the Short Form-36 (SF-36), Questionnaire for Transfemoral Amputees (Q-TFA), Timed Up and Go test, and 6-min walk test.
Results: Patient age ranged from 35 to 65 years. There were no major adverse events, but there was one case of
superficial infection. All patients showed improved Q-TFA and SF-36 scores. Two patients who were wheelchair-bound
at baseline became community ambulators, and the third patient exhibited improved ambulation.
Conclusions: This study demonstrated the feasibility of combining a THR with an osseointegrated implant in
Citation InformationKhemka, A., FarajAllah, C., Lord, S., Bosley, B., and Al Muderis, M. (2016). Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases. Journal of Orthopaedic Surgery and Research, 11. DOI: 10.1186/s13018-016-0348-3