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Bone-anchored prostheses for lower limb amputation in a French cohort with 1–15 years of follow-up: implant survival rates, mechanical complications, and reported outcomes

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Abstract

Purpose

To evaluate the implant survival rate, mechanical complications, and reported patient outcomes of bone-anchored prostheses for patients with lower limb amputation in France after 1–15 years of follow-up.

Methods

This retrospective cohort study included patients who underwent surgery at a single center in France between 2007 and 2021. The primary outcomes were the implant survival rate and functional scores assessed by the Questionnaire for Transfemoral Amputees (Q-TFA). Secondary outcomes were adverse events that occurred during follow-up.

Results

The cohort consisted of 20 bone-anchored prostheses in 17 patients. The main level of amputation was transfemoral (82%, n = 14). The main reason for amputation was trauma (n = 15). The mean age at amputation was 32 (range 15–54) years, and the mean age at the first stage of osseointegration was 41 (range 21–58) years. The Kaplan–Meier survival curve showed respective survival rates of 90%, 70%, and 60% at 2, 10, and 15 years. All Q-TFA scores were significantly improved at last the follow-up. Eleven patients (65%) experienced mechanical complications. In total, 37 infectious events occurred in 13 patients (76%), mainly comprising stage 1 infections (68%, n = 25). Only two cases of septic loosening occurred (12%), leading to implant removal.

Conclusion

This is the first French cohort of bone-anchored prostheses and among the series with the longest follow-up periods. The findings indicate that bone-anchored prostheses are safe and reliable for amputee patients who have difficulties with classic prostheses.

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Data availability

All data relevant to the study are included in the article or are available as supplementary files.

Code availability

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Bordeaux University Hospital, Place Amélie Raba-Léon, 33000, Bordeaux, France

    Clara Thouvenin & Thierry Fabre

  2. Orthopaedic Surgery Department, Polyclinique St Roch Montpellier, 560 Av. du Colonel André Pavelet dit Villars, 34000, Montpellier, France

    Marion Bertrand-Marchand

  3. Physical Medicine and Rehabilitation Center, Tour de Gassies, 33523, Bruges, France

    Rémi Klotz

  4. Infectious and Tropical Diseases Department, Bordeaux University Hospital, Place Amélie Raba-Léon, 33000, Bordeaux, France

    Mathilde Puges

  5. Plastic Surgery, Hand Surgery and Burns Unit, FX Michelet Center, Bordeaux University Hospital, Place Amélie Raba-Léon, 33000, Bordeaux, France

    Anaïs Delgove

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  1. Clara Thouvenin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CT, MBM and AD. The first draft of the manuscript was written by CT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Clara Thouvenin.

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Thouvenin, C., Bertrand-Marchand, M., Klotz, R. et al. Bone-anchored prostheses for lower limb amputation in a French cohort with 1–15 years of follow-up: implant survival rates, mechanical complications, and reported outcomes. Eur J Orthop Surg Traumatol 34, 885–892 (2024). https://doi.org/10.1007/s00590-023-03738-0

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