Undergoing osseointegration surgery is a significant step toward improving mobility and quality of life for amputees. This blog post outlines what you can expect during the osseointegration rehabilitation process and provides a comprehensive guide to help you through your recovery journey.
What is Osseointegration Rehabilitation?
Osseointegration rehabilitation occurs in several phases. It begins before surgery . For the first month after surgery we allow your wound to heal and stabilise and do not begin any formal physiotherapy. This involves carefully increasing the weight and stress on the bone-anchor that was inserted during your surgery to ensure it fuses with the bone. . Rehabilitation varies depending on whether you have an upper or lower limb bone-anchor, and it typically involves three phases. Below, we describe a general rehabilitation protocol. Your specific program will be personalized to fit your needs and provided by our rehabilitation partner, Dorset Orthopaedic.
Upper Limb Rehabilitation
Phase 1 – Starting at Week 6
At six weeks post-surgery, you will start the loading protocol. This involves gradually increasing the weight applied to the bone-anchor. Here’s a general outline of this phase:
- Loading and Distraction: Begin by loading the bone-anchor with 1kg for 20 minutes, twice daily. Increase the weight by 0.5kg every three days until reaching the weight of your prosthesis (around 5-6 kg). Distraction involves attaching weights to the end of the implant and holding the limb still for 10 minutes, twice daily. Once 4kg is achieved, distraction loading can become dynamic, meaning you’ll walk with the weighted adaptor to mimic natural arm movement.
- Effusion Management: This involves applying cold compresses or soft tissue massages to manage swelling. Your clinician will monitor your temperature, pain levels, and stump circumference during this time.
- Muscle Exercises: Start exercises to improve muscle activation and tone, possibly using electrical stimulation. Pain should stay below 3/10 to continue loading safely.
Phase 2 – Home Loading
After returning home, you will continue loading until you can comfortably bear the weight of your prosthesis without bone pain. This phase usually lasts about four weeks and involves a mix of compression and dynamic loading. Regular check-ups with your therapist will ensure you are progressing well.
Phase 3 – Fitting the Prosthesis
Once you can handle the necessary weights without pain, your definitive prosthesis will be fitted. You will then learn to move and use it effectively, with ongoing support from your rehabilitation therapist.
Lower Limb Rehabilitation
Phase 1 – Initial Loading
For lower limb patients, loading often begins a few days post-surgery. The initial phase involves standing on a bathroom scale using a loading device attached to the bone-anchor. Starting with up to 20kg, you gradually increase the load by 5kg per day until reaching 80-90% of your body weight.
Phase 2 – Gait Training
Above-knee amputees will be fitted with a light prosthetic leg for gait training. You will start walking with the help of parallel bars, progressing to crutches as you gain confidence and stability.
Phase 3 – Full Prosthesis Use
Once your definitive prosthesis is fitted, you’ll begin walking with crutches for six weeks, then with one crutch for another six weeks, and eventually unaided. It’s crucial to avoid high-impact activities and falls during this period to prevent bone fractures.
Ongoing Aftercare
Most patients complete initial rehabilitation and walk without assistive devices within 3-4 months post-surgery. However, full recovery can take 12-18 months. Regular visits to your prosthetist and physiotherapist will help you continue improving your gait and balance.
Daily Care Tips:
- Cleaning: Shower daily, gently washing the stump with soap and water. Avoid soaking in bathtubs or swimming in public pools for at least a year post-surgery.
- Monitoring: Keep an eye on your stoma for any signs of infection (pain, redness, fever) and contact your healthcare team immediately if you notice any issues.
Osseointegration post-surgery requires dedication to a structured rehabilitation process to ensure the best outcomes. With patience and consistent effort, you will regain mobility and improve your quality of life.
