Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

Overview

Journal Ann Biomed Eng

Specialty Biomedical Engineering

Date 2018 Jan 13

PMID 29327257

Citations 32

Authors

Alexander Thesleff

Rickard Branemark

Bo Hakansson

Max Ortiz-Catalan

Affiliations

Soon will be listed here.

Abstract

Bone-anchored limb prostheses allow for the direct transfer of external loads from the prosthesis to the skeleton, eliminating the need for a socket and the associated problems of poor fit, discomfort, and limited range of movement. A percutaneous implant system for direct skeletal attachment of an external limb must provide a long-term, mechanically stable interface to the bone, along with an infection barrier to the external environment. In addition, the mechanical integrity of the implant system and bone must be preserved despite constant stresses induced by the limb prosthesis. Three different percutaneous implant systems for direct skeletal attachment of external limb prostheses are currently clinically available and a few others are under investigation in human subjects. These systems employ different strategies and have undergone design changes with a view to fulfilling the aforementioned requirements. This review summarises such strategies and design changes, providing an overview of the biomechanical characteristics of current percutaneous implant systems for direct skeletal attachment of amputation limb prostheses.

Citing Articles

A one-year follow-up case series on gait analysis and patient-reported outcomes for persons with unilateral and bilateral transfemoral amputations undergoing direct skeletal fixation.

Toderita D, McGuire T, Benton A, Handford C, Ramasamy A, Hindle P J Neuroeng Rehabil. 2024; 21(1):208.

PMID: 39614354 PMC: 11606069. DOI: 10.1186/s12984-024-01509-4.

Harmonic Vibration Analysis in a Simplified Model for Monitoring Transfemoral Implant Loosening.

Zhou Q, Rose L, Ebeling P, Russ M, Fitzgerald M, Chiu W Sensors (Basel). 2024; 24(19).

PMID: 39409493 PMC: 11479371. DOI: 10.3390/s24196453.

Bone mineral density in osseointegration implant surgery: A review of current studies (Review).

Carr J, Pedagandham S, Giugni A, Shen C, Kim A, Cribbin E Biomed Rep. 2024; 21(2):122.

PMID: 38978538 PMC: 11229397. DOI: 10.3892/br.2024.1809.

The Moment Criterion of Anthropomorphicity of Prosthetic Feet as a Potential Predictor of Their Functionality for Transtibial Amputees.

Pitkin M Biomimetics (Basel). 2023; 8(8).

PMID: 38132511 PMC: 10741750. DOI: 10.3390/biomimetics8080572.

and methods for the biomechanical assessment of osseointegrated transfemoral prostheses: a systematic review.

Galteri G, Cristofolini L Front Bioeng Biotechnol. 2023; 11:1237919.

PMID: 37662439 PMC: 10469938. DOI: 10.3389/fbioe.2023.1237919.

References

Eriksson E, Branemark P . Osseointegration from the perspective of the plastic surgeon. Plast Reconstr Surg. 1994; 93(3):626-37. View

Jeyapalina S, Beck J, Bachus K, Williams D, Bloebaum R . Efficacy of a porous-structured titanium subdermal barrier for preventing infection in percutaneous osseointegrated prostheses. J Orthop Res. 2012; 30(8):1304-11. DOI: 10.1002/jor.22081. View

Guirao L, Samitier C, Costea M, Camos J, Majo M, Pleguezuelos E . Improvement in walking abilities in transfemoral amputees with a distal weight bearing implant. Prosthet Orthot Int. 2016; 41(1):26-32. DOI: 10.1177/0309364616633920. View

Al Muderis M, Khemka A, Lord S, Van de Meent H, Frolke J . Safety of Osseointegrated Implants for Transfemoral Amputees: A Two-Center Prospective Cohort Study. J Bone Joint Surg Am. 2016; 98(11):900-9. DOI: 10.2106/JBJS.15.00808. View

Kramer M, Tanner B, Horvai A, ODonnell R . Compressive osseointegration promotes viable bone at the endoprosthetic interface: retrieval study of Compress implants. Int Orthop. 2007; 32(5):567-71. PMC: 2551719. DOI: 10.1007/s00264-007-0392-z. View

Hall C . Developing a permanently attached artificial limb. Bull Prosthet Res. 1974; :144-57. View

Branemark R, Emanuelsson L, Palmquist A, Thomsen P . Bone response to laser-induced micro- and nano-size titanium surface features. Nanomedicine. 2010; 7(2):220-7. DOI: 10.1016/j.nano.2010.10.006. View

Branemark R, Ohrnell L, Nilsson P, Thomsen P . Biomechanical characterization of osseointegration during healing: an experimental in vivo study in the rat. Biomaterials. 1997; 18(14):969-78. DOI: 10.1016/s0142-9612(97)00018-5. View

Pendegrass C, Goodship A, Price J, Blunn G . Nature's answer to breaching the skin barrier: an innovative development for amputees. J Anat. 2006; 209(1):59-67. PMC: 2100310. DOI: 10.1111/j.1469-7580.2006.00595.x. View

10.

Holt B, Bachus K, Beck J, Bloebaum R, Jeyapalina S . Immediate post-implantation skin immobilization decreases skin regression around percutaneous osseointegrated prosthetic implant systems. J Biomed Mater Res A. 2013; 101(7):2075-82. DOI: 10.1002/jbm.a.34510. View

11.

Jonsson S, Caine-Winterberger K, Branemark R . Osseointegration amputation prostheses on the upper limbs: methods, prosthetics and rehabilitation. Prosthet Orthot Int. 2011; 35(2):190-200. DOI: 10.1177/0309364611409003. View

12.

Hall C, Cox P, Mallow W . Skeletal extension development: criteria for future designs. Bull Prosthet Res. 1976; (10-25):69-96. View

13.

Jeyapalina S, Beck J, Bachus K, Chalayon O, Bloebaum R . Radiographic evaluation of bone adaptation adjacent to percutaneous osseointegrated prostheses in a sheep model. Clin Orthop Relat Res. 2014; 472(10):2966-77. PMC: 4160482. DOI: 10.1007/s11999-014-3523-z. View

14.

Pitkin M . Design features of implants for direct skeletal attachment of limb prostheses. J Biomed Mater Res A. 2013; 101(11):3339-48. PMC: 3758435. DOI: 10.1002/jbm.a.34606. View

15.

Hall C, Mallow W, Cox P . Developing a supraperiosteal endoprosthesis. Trans Am Soc Artif Intern Organs. 1977; 23:358-62. DOI: 10.1097/00002480-197700230-00091. View

16.

Hall C . A future prosthetic limb device. J Rehabil Res Dev. 1985; 22(3):99-102. DOI: 10.1682/jrrd.1985.07.0099. View

17.

Haggstrom E, Hagberg K, Rydevik B, Branemark R . Vibrotactile evaluation: osseointegrated versus socket-suspended transfemoral prostheses. J Rehabil Res Dev. 2014; 50(10):1423-34. DOI: 10.1682/JRRD.2012.08.0135. View

18.

Haggstrom E, Hansson E, Hagberg K . Comparison of prosthetic costs and service between osseointegrated and conventional suspended transfemoral prostheses. Prosthet Orthot Int. 2012; 37(2):152-60. DOI: 10.1177/0309364612454160. View

19.

Al Muderis M, Lu W, Li J . Osseointegrated Prosthetic Limb for the treatment of lower limb amputations : Experience and outcomes. Unfallchirurg. 2017; 120(4):306-311. DOI: 10.1007/s00113-016-0296-8. View

20.

Tranberg R, Zugner R, Karrholm J . Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses. Gait Posture. 2010; 33(2):165-8. DOI: 10.1016/j.gaitpost.2010.11.004. View