Osseointegration surgery is a groundbreaking procedure that offers a more effective and comfortable solution for attaching prosthetic limbs to the body. By inserting a bone-anchor into the residual limb, this surgery provides a secure and direct connection between the prosthesis and the skeleton. Here’s a detailed look at how this procedure works and what patients can expect.
The Osseointegration Procedure
In the past, osseointegration surgery was performed in two stages, with a gap of 4 to 6 months between each stage. However, advancements in medical techniques have shown that a single-stage procedure can lead to faster patient recovery and reduce the risk of complications, such as infections. Despite this some patients, especially those needing implants in the head, neck, or hand, may still require multiple, staged procedures.
The Surgery
The specifics of the surgery depend on where the bone-anchor is being placed. Here’s an overview of the general steps involved:
Anesthesia:
- Surgery is typically performed under general anesthesia. For lower limb patients, this may be combined with a spinal or epidural block. For upper limb patients, a brachial plexus nerve block may be used. In some cases, surgery might be done under regional anesthesia alone, with additional intravenous sedation.
Incision and Exposure:
- An incision is made at the end of the residual limb (stump) to expose the bone. The surgeon then removes any unwanted tissue and prepares the bone by clearing out bony spurs or abnormal bony areas that can occur after trauma (Heterotopic Ossification, HO).
Muscle and Soft Tissue Preparation:
- The muscles and soft tissue layers are reorganized and attached to the bone to enhance control over the residual limb. This helps create a stable interface between the soft tissues and the implant.
Bone Preparation:
- Special instruments are used to shape the bone canal into a cylindrical form, making it ready for the implant. If necessary, bone removed during this process can be used as a graft to ensure a better fit for the implant.
Implant Insertion:
- The bone-anchor implant is carefully inserted into the prepared bone canal.. The implants we use at Relimb are “press fit” which have been shown to have fewer complications, particularly in the lower limb.
Closure and Skin Flap:
- A skin flap is prepared by removing excess fat and then used to cover the muscles and implant. The flap is secured with sutures and staples, and a small opening (stoma) is created for the tip of the implant to protrude through the skin.
Attachment of Dualcone:
- A dualcone is attached to the end of the bone-anchor. This component will eventually connect to the prosthesis, which will be fitted by rehabilitation specialists after the patient is discharged. It is designed to minimize the wear and tear on the implant through normal daily activity. It will require regular maintenance and replacement, much like the components in the prosthesis, related to the intensity of activity.
Post-Surgery Rehabilitation
Recovery and rehabilitation are crucial parts of the process following osseointegration surgery. We rely on our rehabilitation partners at Dorset Orthopaedic who have the largest experience in the UK in this field. For detailed information on what to expect during the rehabilitation phase, patients are advised to refer to specific information sheets provided by their medical team.
Osseointegration surgery offers amputees a revolutionary way to improve their mobility and quality of life. By providing a secure and direct connection between the prosthetic limb and the body, this procedure helps eliminate many of the discomforts and limitations associated with traditional socket-mounted prostheses. If you are considering this surgery, contact us to find out more.
