Rehabilitation after leg amputation with transcutaneous osseointegrated prostheses
|Traditional prostheses after limb amputations allow only a part of the affected persons to achieve the desired and desired autonomous mobility. In analogy to dental implants, systems have been developed that allow the coupling of an exoprosthesis to a force carrier integrated in the bone and transmitted through the skin.|
|Almost all of the problems associated with prosthetic limb replacement are due less to the functionality of the artificial joints and more to the prosthesis fixation systems that surround the residual limb. Therefore, starting in the 1990s, a concept analogous to dental implants was developed for limb replacement: A load bearing device permanently fixed in the bone and transmitted transcutaneously serves to couple the prosthesis.Such transcutaneous osseointegrated prosthesis systems (TOPS) represent a paradigm shift in care after limb amputation. They have become an indispensable part of the rehabilitation options, both in view of the high mobility gain and the significantly improved patient satisfaction.
After initially proceeding in two stages and applying the stoma 4-6 weeks after insertion of the force carrier, the one-stage procedure has now proven successful.
Between January 2003 and December 2021, the authors treated 244 patients (151 m/71 w) with a median age of 47.6 years (17-95 years), some bilaterally; long-term outcome data are available from 232 patients.
|Aschoff HH, Saß M, Mittlmeier Th, Fischer D-C||Dtsch Arztebl 2023; 120(38): A-1518 / B-1304 (german original)|
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