Follow up to osseointegration
Thomas Cutler
Description
Collection
Title:
Follow up to osseointegration
Creator:
Thomas Cutler
Date:
3/15/2019
Text:
Dear List,
We are constantly told that due to all of the problems that originate from sockets, there must be a concerted effort to push for osseointegration in order to eliminate said socket. The prosthetist is assured that somewhere in all of this, they will have some type of role assigned to them.
I was able to follow up with the Keep Walking osseointegration implant folks in Spain and they told me that they had a problem… of the 23 people (TF patients) who eagerly volunteered to participate in the study and get an internal implant, only 3 wanted to keep going and get the percutaneous version. They actually sounded troubled at the amount of resistance that they received from subjects. The 2018 article (page 3) reported that the exclusion criteria was “Patients with the Keep Walking System with no socket related stump problems”. Interesting…
The rest were very satisfied since they reported 25% faster walking and 82% less pain. Why mess with what works? The socket was weight bearing and less volume-dependent. One last thing… I always question the validity of number of hours worn daily for the prosthesis. A weight bearing residual limb can be a functional support (supported by a chair during hygiene or cooking, etc) for engaging in ADL’s. Pardon the odd comparison, but just because a certain segment of users are glad to remove a bra when they get home at the end of a day doesn’t meant that they want to forego it as they’re gallivanting around town. (I’m sure that Kramer would admit to this also being the case with the “bro” or the “manssier” if you recall the Seinfeld episode)
…huh… so, in my humble estimation, it looks to me like we don’t have a “socket” problem so much as we have a “lack of implant options” problem. And considering the preponderance of amputations resulting from vascular issues, which approach seems to carry less liability and have lower associated costs? And unlike the infection risks and activity limitations of percutaneous OI, what’s the downside of an internal weight-bearing implant? If the other companies had included this in their patents, I wonder if they would be supporting it more vigorously…
This is where we need to pay attention to author initials in the “conflict of interest” section of journal articles.
Tom Cutler, CPO, FAAOP
Limbitless LLC
Sent from Mail< <URL Redacted>> for Windows 10
We are constantly told that due to all of the problems that originate from sockets, there must be a concerted effort to push for osseointegration in order to eliminate said socket. The prosthetist is assured that somewhere in all of this, they will have some type of role assigned to them.
I was able to follow up with the Keep Walking osseointegration implant folks in Spain and they told me that they had a problem… of the 23 people (TF patients) who eagerly volunteered to participate in the study and get an internal implant, only 3 wanted to keep going and get the percutaneous version. They actually sounded troubled at the amount of resistance that they received from subjects. The 2018 article (page 3) reported that the exclusion criteria was “Patients with the Keep Walking System with no socket related stump problems”. Interesting…
The rest were very satisfied since they reported 25% faster walking and 82% less pain. Why mess with what works? The socket was weight bearing and less volume-dependent. One last thing… I always question the validity of number of hours worn daily for the prosthesis. A weight bearing residual limb can be a functional support (supported by a chair during hygiene or cooking, etc) for engaging in ADL’s. Pardon the odd comparison, but just because a certain segment of users are glad to remove a bra when they get home at the end of a day doesn’t meant that they want to forego it as they’re gallivanting around town. (I’m sure that Kramer would admit to this also being the case with the “bro” or the “manssier” if you recall the Seinfeld episode)
…huh… so, in my humble estimation, it looks to me like we don’t have a “socket” problem so much as we have a “lack of implant options” problem. And considering the preponderance of amputations resulting from vascular issues, which approach seems to carry less liability and have lower associated costs? And unlike the infection risks and activity limitations of percutaneous OI, what’s the downside of an internal weight-bearing implant? If the other companies had included this in their patents, I wonder if they would be supporting it more vigorously…
This is where we need to pay attention to author initials in the “conflict of interest” section of journal articles.
Tom Cutler, CPO, FAAOP
Limbitless LLC
Sent from Mail< <URL Redacted>> for Windows 10
Citation
Thomas Cutler, “Follow up to osseointegration,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/209415.
