Clinical application progress of percutaneous osseointegration prostheses
10.3760/cma.j.cn121113-20250303-00219
- VernacularTitle:经皮骨整合式假肢的临床研究进展
- Author:
Bowen SHI
1
;
Hengsheng SHU
1
Author Information
1. 天津大学天津医院创伤骨科，天津 300211
- Publication Type:Journal Article
- Keywords:
Amputation;
Osseointegration;
Artificial limbs;
Rehabilitation
- From:
Chinese Journal of Orthopaedics
2025;45(19):1283-1290
- CountryChina
- Language:Chinese
-
Abstract:
The percutaneous osseointegrated prosthesis anchors the prosthetic limb directly to the residual skeleton, obviating the requirement for soft tissues dependent load transmission, suspension or prosthetic control. This permitting external loads to be conveyed directly from the prosthesis to the skeletal system. Thus, osseointegrated prostheses can circumvent many of the limitations associated with conventional socket prostheses, such as skin breakdown and poor socket fit—problems that are particularly prevalent among patients with major limb amputations. To date, over ten percutaneous osseointegration implant systems have progressed to various stages of clinical trials. Among those, three systems—OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees), ILP (Integral Leg Prosthesis), and OPL (Osseointegrated Prosthetic Limb)—have advanced to standardized clinical implementation and have generated substantial longitudinal patient data for scientific evaluation. Candidates for osseointegration surgery are typically required to meet several criteria: documented intolerance or complications attributable to traditional socket prostheses; skeletally maturity with adequate bone volume in the residual limb; capacity for adhere to postoperative rehabilitation protocols strictly; and overall satisfactory systemic health. Nevertheless, universally accepted clinical indications and contraindications for osseointegration remain lacking. The procedure is generally performed as a single stage operation; however, in cases with compromised preoperative systemic health or suboptimal local soft tissue conditions, a two-stage strategy may be adopted. The inter-stage interval typically ranges from 6 weeks to 6 months, providing sufficient time for soft tissue healing and robust osseointegration establishment. Evidence indicates that following successful osseointegration, patients exhibit improvements in prosthetic wearing frequency, mobility, systemic health status, and pain scores. Although complications, including infection, periprosthetic fracture, and mechanical failure, can still be recognized, the overall complication rate remains comparatively low. Percutaneous osseointegrated prosthetic systems are in an early phase of clinical adoption and mandate multidisciplinary collaboration throughout the treatment continuum. Osseointegrated prostheses demonstrate significant promise and may ultimately evolve into a standard of care intervention, enabling amputees to achieve superior functional outcomes.
