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National Conference Takeaways: Osseointegration in the U.S. – Today and Tomorrow

Nov 9, 2023 |

The 2023 National Conference boasted a variety of informative sessions covering topics relevant to the limb loss and limb difference community. Osseointegration is a procedure which is gaining popularity and giving hope to people who struggle with wearing a conventional socket. If you were unable to attend in person, learn more about the key takeaways from Osseointegration in the U.S. – Today and Tomorrow and discover if it may be right for you.


Summary: Osseointegration is a surgical technique where a metal implant is attached directly to the bone, connected to a prosthetic device, and eliminates the traditional socket. For people who cannot tolerate a socket, it offers the potential for dramatic improvement in mobility and lifestyle. Our presentation will cover the history, research, risks, and benefits of osseointegration and help attendees better understand if osseointegration is a good choice for them. 

Key Takeaways from Dr. Jeffrey Cain: 

  • Dr. Cain was in an airport crash and had both legs amputated below the knee 
  • Implant that goes into the bone, the tissue grows around the implant 
  • Lessons learned from dental implants 
  • Benefits:
    • Direct skeletal attachment
    • Elimination of the socket
    • Osseoperception
    • Improved quality of life
    • Improved gait
    • Increased step count
  • Surgical Challenges: 
    • Implant loosening/fractures 
    • Infection 
    • Stoma care 
    • Pain 
    • Expense 
    • Insurance
  • Prosthetic Challenges:
    • Impact and torque limits 
    • Prosthetic alignment 
    • Osseoperception (hot, cold, vibration, etc.) 
    • Swimming (controversial) 
    • Metal abutment
  • Two different kinds – screw fit and press fit. Screw fit is FDA-approved. The press-fit are in investigation now, expect to be FDA-approved in a year or two 
    • Screw fit – Integrum – Two stage surgery that is FDA-approved
  • For people who can’t fit into a socket, this is a viable option 
  • However, many people do get infections 
  • Resources: 
  • If you are an above-knee amputee, he thinks this is a scientifically better way to get around.  
  • If you have a socket and it’s working for you, osseointegration is not for you.

Key Takeaways from Dr. Jason Stoneback: 

  • Traditional challenges with sockets 
    • Skin friction, soft tissue breakdown/wounds 
    • Volume fluctuations throughout the day 
    • Poor proprioception
  • Replacing socket with bone-anchor prosthesis 
  • A lot of nuances in ensuring an effective outcome 
  • Femur pain, your muscles/skeleton isn’t working normally with a socket 
  • Osseointegration realigns skeletal system 
  • When you load your joints and are not aligned, you get arthritis earlier in life 
  • Two stage technique
    • Stage 1: Implant 
      • 3 months in between stage 1 and stage 2 
    • Stage 2: create flap and skin graft skin to the end of the bone
  • Rehab 
    • Stage 1: 3-6 months rest 
    • Stage 2: 3-6 months rest
  • Press-fit (not FDA approved yet) 
    • Can be done in 1 stage 
    • 6 weeks after first surgery, then outpatient surgery to load the implant
  • Right after surgery
    • PT 
    • Stoma care teaching 
    • Frequent follow up in first year 
    • Collaboration with local PCP/prosthetist
  • Ensuring success 
    • Thorough assessment of patient goals 
    • Multi-disciplinary approach 
    • Dedicated program invested in long-term care and research of amputees with OI
  • Who this is not for: 
    • Someone who does extreme sports! 
    • Kids 
    • Smokers 
    • Those with poor blood flow or on medication that impact blood flow (vascular disease, diabetes)
  • Participants report greater participation in everyday activities, better balance, better confidence, better walking, less gait variability, better posture 
  • Personalized medicine a key component of entire process 
  • Future direction: 
    • Research at University of Colorado to improve scope
      • Diabetic candidate research 
      • Vascular disease candidate research

The 2024 National Conference is coming to the Hyatt Regency Atlanta, August 7-10 in Atlanta, Georgia. We would love to see you there! Discuss your experience with osseointegration or ask peers questions on AC Connect.