A surgical procedure called osseointegration has the potential to provide people with lower-limb amputations with dramatically restored mobility as it reduces discomfort and potential tissue breakdown associated with socket-suspended prosthetic limbs.
The procedure involves surgically implanting a metal bar—typically in the thigh femoral bone for above knee amputees. The metal bar extends outside the body, connecting to a snap-on prosthetic device.
According to Ohio State orthopedic oncology surgeon Dr. Joel Mayerson, the osseointegration system offers patients who experience persistent skin wounds and discomfort from their socket-suspended prosthetic limbs a long-term option for reducing pain and increasing mobility.
Osseointegration works by allowing the prosthetic limb to function better while also taking pressure off the residual limb. Thus, the procedure prevents comfort issues associated with prosthetic sockets, like blisters, friction, skin problems, and tissue degradation.
As osseointegration makes prosthetic limbs more comfortable to use and easier to don and doff, it unlocks the benefits of other advanced amputation techniques, like Targeted Muscle Reinnervation (TMR). TMR uses nerve surgery in the residual limb to enable a more natural movement from the prosthetic limb. It has also been found to reduce post-amputation pain significantly.
A few hospitals in the US offer osseointegration and TMR, such as Ohio State, Walter Reed National Military Medical Center, and Johns Hopkins Hospital.
As of 2021, the average cost of osseointegration is $54,503. It's still unclear if health insurance providers cover osseointegration procedures as it may be classified as "experimental." But this might change down the line.
A recent study published in the Plastic and Reconstructive Surgery-Global Open journal showed that an osseointegrated implant was more cost-effective than a socket-suspended prosthetic limb, especially for individuals with poorly tolerated lower-limb amputations.
The researchers still want to explore the long-term cost-effectiveness of osseointegrated implants further. If findings are positive in the future, we might see health insurance providers covering the procedure.