Osseointegrated Implants Minimal Infection Risk
Study finds minimal risk for serious infection with osseointegrated implants
A study recently published in the Journal of Bone and Joint Surgery found patients with osseointegrated implants had minimal risk for severe infection.
Osseointegrated Implants Minimal Infection Risk – According to a press release from the American Academy of Orthopaedic Surgeons, researchers used a new infection classification system developed by the Osseointegrated Group of Australia to track adverse events in 86 patients with 91 implants. The patients received a “press-fit” osseointegrated implant between 2009 and 2013 and were followed for a median of 31 months. Osseointegration included placement of a porous-coated implant in the femur bone and the creation of a stoma (an artificial opening) to attach the prosthesis.
For more than 600 years, patients with amputations above the knee received a prosthesis that fit over the skin and soft tissue of the amputation stump. However, approximately one-third of these patients experience problems, including discomfort and skin irritation, resulting in limited mobility and reduced quality of life. Over the past 20 years, osseointegrated implants—or implants that grow directly into the bone—have emerged, and while most patients do well with these implants, concerns persist about the risk for serious infection.
New Infection Classification System
Using a new infection classification system, researchers tracked adverse events in 86 patients (91 implants) who received a “press-fit” osseointegrated implant between 2009 and 2013. For each patient, the procedure was performed in two stages: first, a porous-coated implant was placed in the femur bone, and second, a stoma, or opening, was created to attach the prosthesis. The patients, ages 25 to 81, were followed for a median of 31 months.
Among the results:
- Thirty-one patients (36%) had no side effects or complications related to the osseointegration system.
- Twenty-nine (34%) patients developed a grade one or two infection, successfully managed with “simple measures.”
- Twenty-six patients (30%) had no infection, but reported other complications such as problems with the orthopaedic hardware, problems with skin and soft tissue, or fracture of the femur bone.
- No patients had a grade three or four infection.
Opportunity to function closer to an able-bodied person
“For amputees struggling with socket fit (Socket- the portion of the prosthesis that fits around and envelopes the residual limb and to which the prosthetic components are attached), the osseointegrated press-fit implant provides greater comfort, mobility and the opportunity to function closer to an able-bodied person,” Munjed Al Muderis, MB, ChB, FRACS, FAOrthA, an orthopedic surgeon at Macquarie University Hospital in Sydney and study author, said in the release. “We can confidently say that this type of prosthesis is a viable choice, and the new infection classification system [provides] an effective tool for use in patient selection, as well as infection management.”
The Sydney OGAP Team, led by Dr Munjed Al Mudeis, is the first to develop a single stage implant surgical technique utilizing a two piece implant system for upper extremity and lower extremity applications. With the addition of a weightless treadmill that was developed in the US by NASA. They offer an accelerated rehabilitation protocol that has most patients mobilizing ten days post op.