Article
Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases
Acta Orthopaedica
(2015)
Abstract
Background and purpose — Osseointegrated implants are an
alternative for prosthetic attachment in individuals with amputation
who are unable to wear a socket. However, the load transmitted
through the osseointegrated fixation to the residual tibia and
knee joint can be unbearable for those with transtibial amputation
and knee arthritis. We report on the feasibility of combining
total knee replacement (TKR) with an osseointegrated implant
for prosthetic attachment.
Patients and methods — We retrospectively reviewed all 4 cases
(aged 38–77 years) of transtibial amputations managed with osseointegration
and TKR in 2012–2014. The below-the-knee prosthesis
was connected to the tibial base plate of a TKR, enabling the
tibial residuum and knee joint to act as weight-sharing structures.
A 2-stage procedure involved connecting a standard hinged TKR
to custom-made implants and creation of a skin-implant interface.
Clinical outcomes were assessed at baseline and after 1–3 years
of follow-up using standard measures of health-related quality of
life, ambulation, and activity level including the questionnaire for
transfemoral amputees (Q-TFA) and the 6-minute walk test.
Results — There were no major complications, and there was
1 case of superficial infection. All patients showed improved clinical
outcomes, with a Q-TFA improvement range of 29–52 and a
6-minute walk test improvement range of 37–84 meters.
Interpretation — It is possible to combine TKR with osseointegrated
implants.
Disciplines
Publication Date
2015
DOI
10.3109/17453674.2015.1068635
Citation Information
Khemka, A., Frossard, L., Lord, S., Bosley, B., and Al Muderis, M. (2015). Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases. Acta Orthopaedica, 86(6), 740-744. DOI: 10.3109/17453674.2015.1068635