Better quality of life with a prosthesis attached directly to the femur
Patients with normal prosthetic limbs often develop sores from chafing on the amputation stump and experience discomfort because the prosthesis is uncomfortable. A prosthesis attached directly to the bone with titanium screws gives better mobility and fewer problems, as a thesis from Sahlgrenska Academy shows.
More than 2,000 leg amputations are performed in Sweden every year. Most patients are elderly and suffer from diabetes or poor circulation, but amputations are also performed on younger people. The study comprised only patients who had had their femurs amputated as a consequence of serious accidents or diseases other than diabetes. Almost 100 people answered questions about how they experienced their life with a prosthesis.
- Very many of them have considerable problems that diminish their quality of life. It is important to understand what it means to have a normal prosthetic limb in order to understand the gains that are achieved with this new type, says physical therapist Kerstin Hagberg.
Normal prosthetic limbs are attached using a socket that is placed over the amputation stump. The study shows that two thirds of the patients suffer from heat and perspiration in the socket, and sores from chafing on the amputation stump cause them severe discomfort.
- Even if many people use their prosthetic legs extensively, few walk any longish distance at any one time, says Kerstin Hagberg.
Many of the patients also say that it is uncomfortable to sit when they are wearing their prosthetic limb.
Researchers in Göteborg have developed a new, unique method of attaching prosthetic legs that mean that patients no longer need to use a socket. The prosthesis is quite simply screwed to a titanium implant that has been anchored to the bone and that protrudes from the stump. A hundred amputees have so far been treated using the new method. The implant has been developed out of the tooth implants that Per-Ingvar Brånemark developed in the 1960s.
18 patients who have been given osseointegrated prosthetic femurs were asked to answer questions about their quality of life two years after their operation. For one of them, the treatment was a failure. The remaining 17 said that they wore their prosthetic limb more, that they were more mobile and that generally their quality of life had improved.
- The new prosthesis is very easy to put on and take off. Patients feel that they can rely on the prosthesis to remain in place and that it always fits. The prosthesis does not wear holes in clothes, patients can walk more without chafing and they can sit comfortably in an armchair, says Kerstin Hagberg.
Extensive studies are under way to further evaluate the use of osseointegrated prosthetic femurs.
