Osseointegration prosthesis at AOFE Clniics

Osseointegration prostheses represent a significant advancement in amputee rehabilitation, offering increased mobility, comfort, and overall quality of life for individuals with limb amputations. This essay explores the application of osseointegration prostheses at AOFE Clinics in the Netherlands, drawing on insights from various sources.

Introduction to Osseointegration Prostheses

Osseointegration is a technique where an orthopedic implant is directly inserted into the bone of a limb’s stump, allowing for the attachment of a prosthesis. This technique was originally developed in dentistry in the 1960s and has since been adapted for orthopedic applications, including limb prostheses​. ​Unlike traditional socket prostheses, osseointegrated prostheses are anchored directly to the bone, leading to better proprioception, balance, and overall mobility​​​

AOFE Clinics and their approach

AOFE Clinics, an independent treatment center in the Netherlands, specializes in amputation medicine and employs osseointegration to offer better flexibility and mobility to patients with leg amputations. They use a technique that involves inserting an orthopedic implant through the skin into the bone, which can then be connected to an artificial limb using a click system. This method is known as the osseointegration or bone-anchoring prosthesis​

Advantages of Osseointegration prosthesis

Improved Function and Mobility: Osseointegration offers enhanced proprioception, balance, and gait. The direct connection of the implant with the bone allows the prosthetic limb to act more like a natural extension of the body​

Reduced Discomfort and Pain: Traditional socket prostheses often cause issues such as pinching, sweating, muscle weakness, and skin irritation. Osseointegration reduces these problems significantly, leading to a more comfortable experience for the user​

Customization and Compatibility: The prostheses are custom-made to fit the patient’s body, eliminating issues related to ill-fitting traditional prosthetics. They are also compatible with advanced technologies like myoelectric (bionic) prostheses, enhancing functionality for arm and hand prostheses​

Reduction in Nerve Pain: Osseointegration can reduce nerve pain in the residual limb, often caused by neuromas and exacerbated by socket prostheses. Surgical procedures such as targeted muscle reinnervation (TMR) can be performed alongside osseointegration to further alleviate pain​

Procedure and Recovery

Osseointegration surgery can be performed in one or two stages, depending on the implant type and patient needs. The implant is custom-made and inserted into the residual limb bone, then connected to a dual post or dual cone. The average hospital stay is three to four days, and most patients can walk without crutches within about three months post-surgery​

​​Safety and Longevity

Osseointegration prostheses are considered safe, with a low risk of complications like implant loosening, fracture, or infection. The implants are designed to last many years, with the possibility of changing connection parts over time if needed​

Osseointegration prostheses represent a paradigm shift in amputee rehabilitation. AOFE Clinics’ specialized approach in employing this technique provides amputees with an enhanced quality of life, marked by greater mobility, reduced pain, and increased comfort compared to traditional prosthetic solutions. As the technology and surgical techniques continue to evolve, osseointegration prostheses are poised to become a mainstay in amputee care, offering a beacon of hope and functionality for individuals facing limb loss.

New reimbursement system in The Netherlands

In the Netherlands, a significant change is set to occur regarding the funding of osseointegration prostheses, commonly referred to as click prostheses. Starting January 1, 2024, a new reimbursement system will be implemented through health insurance providers for the treatment involving click prostheses. This marks a considerable shift from the past, where the high costs associated with this operation made it inaccessible for many. With the introduction of this new reimbursement system, more individuals requiring osseointegration prostheses will have the opportunity to undergo this life-changing operation, making it a more viable option for those in need.

Targeted Muscle Reinnervation or TMR surgery

Targeted Muscle Reinnervation (TMR surgery) is another innovative treatment offered by AOFE Clinics, further enhancing the capabilities and comfort of amputees using osseointegration prostheses. TMR is a surgical procedure that reassigns nerves that were once controlling the amputated limb. This reassignment is done to remaining muscles, allowing these nerves to continue to send and receive signals. The procedure significantly reduces the incidence of neuromas (painful nerve growths) and phantom limb pain, which are common issues faced by amputees. TMR also enhances the control and functionality of myoelectric prostheses, offering patients a higher degree of dexterity and a more natural limb use experience.