Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review

Abstract Purpose: This study aimed to provide an overview of a) the used measurement instruments in studies evaluating effects on quality of life (QoL), function, activity and participation level in patients with a lower extremity amputation using bone-anchored prostheses compared to socket prostheses and b) the effects themselves. Method: A systematic literature search was conducted in MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science. Included studies compared QoL, function, activity and/or participation level in patients with bone-anchored or socket prostheses. A best-evidence synthesis was performed. Results: Out of 226 studies, five cohort and two cross-sectional studies were eligible for inclusion, all had methodological shortcomings. These studies used 10 different measurement instruments and two separate questions to assess outcome. Bone-anchored prostheses were associated with better condition-specific QoL and better outcomes on several of the physical QoL subscales, outcomes on the physical bodily pain subscale were inconclusive. Outcomes on function and activity level increased, no change was found at participation level. The level of evidence was limited. Conclusions: There is a need for a standard set of instruments. There was limited evidence that bone-anchored prostheses resulted in higher QoL, function and activity levels than socket prostheses, in patients with socket-related problems. Implications for Rehabilitation Use of bone-anchored prostheses in combination with intensive outpatient rehabilitation may improve QoL, function and activity level compared with socket prosthesis use in patients with a transfemoral amputation and socket-related problems. All clinicians and researchers involved with bone-anchored prostheses should use and publish data on QoL, function, activity and participation level. There needs to be an agreement on a standard set of instruments so that interventions for patients with a lower extremity amputation are assessed consistently.

[1]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[2]  Pelvic motion in trans-femoral amputees in the frontal and transverse plane before and after special gait re-education , 2003, Prosthetics and orthotics international.

[3]  S. Middeldorp,et al.  Association between weight or body mass index and hand osteoarthritis: a systematic review , 2009, Annals of the rheumatic diseases.

[4]  K. Hagberg,et al.  A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: A prospective study of 51 patients. , 2014, The bone & joint journal.

[5]  E. Mackenzie,et al.  Use and Satisfaction with Prosthetic Devices Among Persons with Trauma-Related Amputations: A Long-Term Outcome Study , 2001, American journal of physical medicine & rehabilitation.

[6]  H. Aschoff,et al.  [Implantation of the endo-exo femur prosthesis to improve the mobility of amputees]. , 2011, Operative Orthopädie und Traumatologie.

[7]  C. V. van Eck,et al.  Clinical outcome of osseointegrated prostheses for lower extremity amputations: a systematic review of the literature , 2015 .

[8]  E. Zimerson,et al.  Skin disorders in amputees. , 2000, Journal of the American Academy of Dermatology.

[9]  M. Lundberg,et al.  My prosthesis as a part of me: a qualitative analysis of living with an osseointegrated prosthetic limb , 2011, Prosthetics and orthotics international.

[10]  David Ewins,et al.  Muscle activity during stance phase of walking: comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers. , 2013, Journal of rehabilitation research and development.

[11]  J. Groothoff,et al.  Clinical rehabilitation of the amputee: A retrospective study , 1996, Prosthetics and orthotics international.

[12]  A. Clausen,et al.  Implantation der Endo-Exo-Femurprothese zur Verbesserung der Mobilität amputierter Patienten , 2011, Operative Orthopädie und Traumatologie.

[13]  Helen Scott,et al.  Lower Limb Prosthetic Outcome Measures: A Review of the Literature 1995 to 2005 , 2006 .

[14]  Andrea Furlan,et al.  Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group , 2003, Spine.

[15]  K. Hagberg,et al.  Consequences of non-vascular trans-femoral amputation: A survey of quality of life, prosthetic use and problems , 2001, Prosthetics and orthotics international.

[16]  H. Aschoff,et al.  10 Jahre Endo-Exo-Femurprothetik zur Rehabilitation nach Oberschenkelamputation – Daten, Fakten und Ergebnisse , 2012, Zeitschrift für Orthopädie und Unfallchirurgie.

[17]  K. Hagberg,et al.  Osseointegrated Titanium Implants for Limb Prostheses Attachments: Infectious Complications , 2010, Clinical orthopaedics and related research.

[18]  P. van der Wurff,et al.  The Evaluation of Daily Life Activities after Application of an Osseointegrated Prosthesis Fixation in a Bilateral Transfemoral Amputee , 2015, Medicine.

[19]  Shawn C Marshall,et al.  Dermatologic conditions associated with use of a lower-extremity prosthesis. , 2005, Archives of physical medicine and rehabilitation.

[20]  J. Kärrholm,et al.  Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses. , 2009, Gait & posture.

[21]  G. Hawthorne,et al.  A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments , 2001, Annals of medicine.

[22]  Horst Heinrich Aschoff,et al.  Transcutaneous, distal femoral, intramedullary attachment for above-the-knee prostheses: an endo-exo device. , 2010, The Journal of bone and joint surgery. American volume.

[23]  D S Childress,et al.  A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation. , 2000, Journal of rehabilitation research and development.

[24]  T. Byrt.  How good is that agreement? , 1996, Epidemiology.

[25]  K. Hagberg,et al.  Socket Versus Bone-Anchored Trans-Femoral Prostheses: Hip Range of Motion and Sitting Comfort , 2005, Prosthetics and orthotics international.

[26]  Francis Guillemin,et al.  Health related quality of life and related factors in 539 persons with amputation of upper and lower limb , 2003, Disability and rehabilitation.

[27]  Jacqueline S. Hebert,et al.  Selection of outcome measures in lower extremity amputation rehabilitation: ICF activities , 2009, Disability and rehabilitation.

[28]  K. Hagberg,et al.  Reproducibility of the physiological cost index among individuals with a lower-limb amputation and healthy adults. , 2011, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[29]  K. Hagberg,et al.  Osseointegrated trans-femoral amputation prostheses: Prospective results of general and condition-specific quality of life in 18 patients at 2-year follow-up , 2008, Prosthetics and orthotics international.

[30]  M. Pitkin,et al.  Design features of implants for direct skeletal attachment of limb prostheses. , 2013, Journal of biomedical materials research. Part A.

[31]  P. Ford,et al.  Support needs and quality of life in oral cancer: a systematic review. , 2014, International journal of dental hygiene.

[32]  T Takken,et al.  Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review. , 2012, Osteoarthritis and cartilage.

[33]  A. Esquenazi,et al.  Developing Core Sets for Persons Following Amputation Based on the International Classification of Functioning, Disability and Health as a Way to Specify Functioning , 2009, Prosthetics and orthotics international.

[34]  B. Singh,et al.  Osseoperception in Implants Supported Prosthesis - A Review , 2012 .

[35]  K. Hagberg,et al.  One hundred patients treated with osseointegrated transfemoral amputation prostheses--rehabilitation perspective. , 2009, Journal of rehabilitation research and development.

[36]  Elisabeth Hansson,et al.  Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up. , 2014, Archives of physical medicine and rehabilitation.

[37]  K. Hagberg,et al.  Vibrotactile evaluation: osseointegrated versus socket-suspended transfemoral prostheses. , 2013, Journal of rehabilitation research and development.

[38]  B. H. Thomas,et al.  A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. , 2004, Worldviews on evidence-based nursing.

[39]  Kersti A M Samuelsson,et al.  Effects of lower limb prosthesis on activity, participation, and quality of life: a systematic review , 2012, Prosthetics and orthotics international.

[40]  K. Hagberg,et al.  Comparison of prosthetic costs and service between osseointegrated and conventional suspended transfemoral prostheses , 2013, Prosthetics and orthotics international.

[41]  Pieter U Dijkstra,et al.  Determinants of skin problems of the stump in lower-limb amputees. , 2009, Archives of physical medicine and rehabilitation.

[42]  Kathryn Ziegler-Graham,et al.  Estimating the prevalence of limb loss in the United States: 2005 to 2050. , 2008, Archives of physical medicine and rehabilitation.

[43]  J. Czerniecki,et al.  Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. , 2000, Archives of physical medicine and rehabilitation.

[44]  David Ewins,et al.  Surface electromyographic activity of five residual limb muscles recorded during isometric contraction in transfemoral amputees with osseointegrated prostheses. , 2011, Clinical biomechanics.

[45]  Laurent Frossard,et al.  Functional Outcome of Transfemoral Amputees Fitted With an Osseointegrated Fixation: Temporal Gait Characteristics , 2010 .

[46]  E. Waters,et al.  Criteria for the systematic review of health promotion and public health interventions. , 2005, Health promotion international.

[47]  B. Rydevik,et al.  Osseointegration in skeletal reconstruction and rehabilitation: a review. , 2001, Journal of rehabilitation research and development.

[48]  A. Hughes,et al.  A systematic review of the key factors affecting tissue viability and rehabilitation outcomes of the residual limb in lower extremity traumatic amputees. , 2014, Journal of tissue viability.

[49]  Laurent A. Frossard,et al.  Osseointegrated prosthetic limb for amputees: Over one hundred cases , 2015 .

[51]  G. Cummings,et al.  Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. , 2012, Journal of evaluation in clinical practice.

[52]  A. Khemka,et al.  Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases , 2015, Acta orthopaedica.

[53]  H. Dickson,et al.  Systematic review of concepts measured in individuals with lower limb amputation using the International Classification of Functioning, Disability and Health as a reference , 2011, Prosthetics and orthotics international.

[54]  A. Williams,et al.  International classification of functioning, disability, and health: ICF-CY World Health Organization , 2013 .

[55]  D. Juhnke,et al.  [Evaluation of 10 years experience with endo-exo femur prostheses - background, data and results]. , 2012, Zeitschrift fur Orthopadie und Unfallchirurgie.

[56]  A. Khemka,et al.  Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases , 2016, Journal of Orthopaedic Surgery and Research.

[57]  J. Sullivan,et al.  Rehabilitation of the transfemoral amputee with an osseointegrated prosthesis: The United Kingdom experience , 2003, Prosthetics and orthotics international.

[58]  H. Aschoff,et al.  Die Endo-Exo-Femurprothese – ein neues Konzept zur knochengeführten, prothetischen Versorgung von oberschenkelamputierten Patienten , 2009, Zeitschrift fur Orthopadie und Unfallchirurgie.

[59]  M. Hopman,et al.  Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses. , 2013, Archives of physical medicine and rehabilitation.

[60]  A. Cieza,et al.  Content comparison of health-related quality of life (HRQOL) instruments based on the international classification of functioning, disability and health (ICF) , 2005, Quality of Life Research.

[61]  J. Higgins,et al.  Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. , 2007, International journal of epidemiology.

[62]  J. Groothoff,et al.  Epidemiology of lower limb amputees in the north of the Netherlands: Aetiology, discharge destination and prosthetic use , 1997, Prosthetics and orthotics international.