Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 4, 2015
   Pages 407 — 420

Abstract — Fifteen years of experience with Integral-Leg-Prosthesis: Cohort study of artificial limb attachment system

Dora-Lisa Juhnke, MD;1 James P. Beck, MD;2 Sujee Jeyapalina, PhD;3 Horst H. Aschoff, MD4*

1Klinik f??r Allgemein-, Gef????-, und Viszeralchirurgie, Martin-Luther-Krankenhaus, Berlin, Germany; 2Department of Orthopaedics, University of Utah School of Medicine, and Department of Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT; 3Department of Bioengineering, University of Utah, Salt Lake City, UT; 4Clinic for Plastic, Hand, and Reconstructive Surgery, SANA Kliniken L??beck, L??beck, Germany

Abstract — Integral-Leg-Prosthesis (ILP) is a comparatively new attachment system that allows direct skeletal docking of artificial limbs. Between January 1999 and December 2013, 69 patients with transfemoral amputation were fitted with ILPs by a single German surgeon. Device design iterations and surgical techniques evolved during these years. For the purposes of comparison, patients receiving the first two designs and procedure iterations were placed in group 1 and the patients fitted with the final design were placed in group 2. Infection rate and planned and unplanned surgical interventions were statistically compared using Fisher exact test. Data demonstrated that the high rate of stoma-associated infections seen in group 1 was dramatically reduced in group 2. Of the 39 patients with 42 implants in group 2, none had operative interventions secondary to infection. All group 2 patients remained infection-free without the use of antibiotics by following a simple but defined wound-hygiene protocol. We concluded that the final iteration of the osseointegrated intramedullary device with a low energy surface at the soft tissue and prosthesis interface allowed a biologically stable skin stoma that remained infection-free without chronic use of antibiotics. The reduction in the infection rate was attributed to the clinically based, empirically driven changes in design and surgical techniques.

Key words: above-knee amputation, amputation, device design, infection rate, Integral-Leg-Prosthesis, osseointegrated prosthesis, prosthesis, skeletal docking system, titanium niobium oxynitride surface coating, transfemoral amputation.


View HTML ¦ View PDF ¦ Contents Vol. 52, No.4

This article and any supplementary material should be cited as follows:
Juhnke D, Beck JP, Jeyapalina S, Aschoff HH. Fifteen years of experience with Integral-Leg-Prosthesis: Cohort study of artificial limb attachment system. J Rehabil Res Dev. 2015;52(4):407–20.
http://dx.doi.org/10.1682/JRRD.2014.11.0280
ResearcherID: James P. Beck, MD: F-9407-2015; Sujee Jeyapalina, PhD: F-9375-2015; Horst H. Aschoff, MD: F-9751-2015
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