Hi list,
Some advice please.
I have a knee disarticulation patient who is 18 months since traumatic
amputation. He successfully wears a distal end bearing socket with a
suction fit, microprocessor knee and carbon foot. He wears his
prosthesis all day, every day, walks unaided and functions at a high K3
level, working 5 days a week.
He has been referred by his orthopaedic surgeon privately (he is
insurance funded of course) for assessment for osseointegration. I do
not understand why.
From a prosthetic point of view these are my concerns:
– There is not going to be any functional gain.
– There is a history of infection (as initially he was
initially a transtibial level but had to be revised).
– Surgery is complicated by an IM nail for midshaft femur
fracture.
– The prosthetic knee centre will then have to be set more
distal (resulting in a larger discrepancy between the anatomical and
prosthetic knee centre).
– There is potential for his stump level to be revised which
would see him loose capacity to fully end bear.
Does anyone know if osseointegration has been performed on a knee
disarticulation patient successfully? I could not find any case study of
this in my literature search.
Or has anyone had a patient functioning at such a high level undergo
osseointegration before at a transfemoral level? In my limited
experience with osseointegration I have only observed it to be
prescribed for patients where a socket was not able to be successfully
worn so offered large functional gains.
Thanks in advance,
Katherine Hudson
Prosthetist Orthotist
Melbourne, Australia
