Osseointegration is a surgical procedure to create a direct structural connection between living bone and the surface of a load-carrying implant in generally above knee amputation or where there are significant problems with sockets.Sockets can be a problem for amputees for a variety of reasons. For example, amputees who live in hot countries can experience excessive sweating. Female amputees who change shape on a daily or monthly basis may experience socket problems. Other reasons may be due to a short residuum or issues such as skin grafts, scars, flaps, bone spurs and hypersensitive neuromas.Many amputees tolerate socket problems, but Osseointegration can offer a solution for those who lead a more active life style or simply cannot continue to tolerate socket problems any longer.Osseointegration is popular in transfemoral (above knee) and transhumeral (above elbow) amputees, but there are an increasing number of transtibial (below knee) amputees.There are contraindications to Osseointegration for example if a patient has peripheral vascular disease, diabetes or is a smoker.Claire Roantree, Partner in Boyes Turner’s Personal Injury team says, “I have spoken to a number of amputees who have had OI and now lead much more active and fulfilling lives as a consequence. However, it is still a relatively new and emerging surgical procedure and the long term risk benefit analysis is not clear, therefore anyone considering this procedure should consider the following:Take advice from one or more specialist Orthopaedic surgeons who perform this surgical procedure on a regular basis.Seek peer to peer support from others who have undergone the procedure. (Speak to your prosthetist or charitable organisation, such as Limbless, Limb Care and Reach, who can introduce you to other amputees or peer support services)Ideally you should have pre and post operation care from a Pain Psychologist, Pain specialists and Prosthetist.There should be a multi-disciplinary team approach, to provide prosthetic fitting and rehabilitation with an occupational therapist, a physiotherapist, and a personal trainer where necessary.
