People with above or below knee amputation seek to return to a mobile lifestyle. Conventional rehabilitation uses a socket prosthesis, which is fixed to the soft tissue of the remaining residual limb using suction or vacuum. The artificial knee joint and/ or lower leg prosthesis is then attached to the socket. This enables the patient to walk without aids, but there are several challenges in the use of suction prosthesis.
One important factor is the length of the remaining limbs as it determines the lever arm and the force, which has to be applied for conducting, guiding and controlling prosthesis. If socket does not fit properly it can create skin irritation of the soft tissue which may lead to sore, ulcers and chronic inflammations with abscesses and pain. Moreover, the stump length correlates with the energy expenditure during walking. On average the amputee uses 70% more energy than musculoskeletal system.
This often leads amputee to utilize walking aids or even wheelchair. For many amputees it’s difficult to find a way back into an active lifestyle or to the working force. Often, they cannot perform activities or sports and have to rely on the help of others during everyday life.
Time for innovation!
Osseo integration (OI) is a procedure that has been used over the last several decades; it was first used in animal models in the 1940`s and 50`s, and then utilized in dental implants in the 1960`s. More recently, Osseo integration has also become an option for attachment of the prosthetics in extremity amputation. As the name suggests, this procedure involves the integration of the titanium implant directly into a long bone. The bone cells attach and grow around the titanium implant, which allows for the incorporation of the implant with normal bone growth.
In the instance amputation, the titanium implant is fit into the residual bone left over the amputation, and the prosthetic can be directly fitted onto the implant. The direct integration of the implant with the bone provides a secure fixation for the prosthetic for the anchorage and the titanium composition of the implant prevents rejection from occurring.
Though Osseointegration is used for extremity amputation has gained approval and acceptance in several counties, it is still a relatively novel procedure in many areas. Indeed, while nations such as Australia, the United Kingdom, and the other European countries have been on the forefront the utilizing Osseo integration and have performed many of these operations, other western countries have been slower to adopt this procedure, as the number world- wide are still relatively small and persons who have undergone OI are spread-out.
In India, Dr. Aditya Khemka has started Osseo integration (OI) Surgery, an indigenously designed implant called Osseo integration Limb System (OLS).
Innovative is the fact that the Osseo integrated limb system is an Endo- Exo system – the endo prosthesis is implanted directly into the bone and hence, molded on the anatomy of the human body. Once integrated it allows for a simple quick and safe connection between the residual limb and the lower exo-prosthesis.
The prosthesis takes the load back directly to the bone and associated muscles. The patient is able to control and guide the exo-prosthesis very precisely. Clinical experience shows that the bone growth is encouraged. The improved femur position finally leads to almost physiological gait. No longer is the prosthesis merely attached to the person via socket, but it becomes the part of the person`s bone structure allowing to return to the maximum level of comfort, mobility and physical activity.