What to expect from osseointegration (OI) / Every patient is unique to us, but here is a snapshot of the typical process.

Quick facts

  • Major limb osseointegration (OI) surgery is usually performed as a 1-stage procedure for faster rehabilitation and to reduce the risk of infection.
  • Multi-step procedures may be required for some forms of OI surgery, particularly in the head and neck region or in the hand.


Surgery for OI is usually performed under general anaesthesia. Our anaesthetist may also recommend a spinal or epidural block (for lower limb patients) or brachial plexus nerve block (for upper limb patients). In some cases, surgery may be performed under spinal or brachial plexus block alone, together with intravenous sedation.

Preparing the site for your implant

Your surgeon will start by making an incision at the end of your residual limb and opening your tissues in layers to expose the end of the residual bone. Using specialised instruments, they will prepare the end of your bone by removing any unwanted soft tissue, bony spurs or areas of excessive bone growth. To reduce your chances of experiencing ongoing pain, your surgeon will also identify and deal with any neuromas using TMR or RPNI surgery . Finally, the muscles in this area will be re-attached to help you have better control over your residual limb. Reattaching the muscles also helps to maintain the stability of your implant.

Inserting your implant

Your surgeon will now prepare your bone, creating a specially shaped cavity into which the implant will fit. Your surgeon will carefully push the implant into this space in your bone. Any bone that is removed during this process will be saved for potential use as a bone-graft. The graft can help to improve the fit of your implant.

Completing the procedure

To close the end of the stump, your surgeon will create a skin flap that covers the muscles surrounding your implant. A circular opening (stoma) is created in the skin flap, allowing the tip of the implant to come through the skin. They will then use surgical sutures and stainless-steel staples to hold the skin flap in place and close the skin.

A device called a dualcone is now inserted into the end of the implant. Our prosthetic partners, Dorset Orthopaedic, will then take over the rest of the process, including fitting of the connector components to the dualcone, after your discharge from the Royal Free Hospital.

What happens next?

For more details on the rehabilitation process after OI, click here

Want to find out more about OI?

Get in touch and learn more from our experienced team. Our dedicated enquiries team are available to answer your questions or book you in for a consultation. Contact us Monday – Friday from 8am – 6pm on 020 7317 7751 or