High-Leg Amputations and Osseointegration

What Is Meant by Amputation?

An amputation is a form of surgery performed to eliminate all or a part of a limb. A person needs amputation if they experience any severe injury or infection or any other underlying health conditions like Peripheral Arterial Disease (PAD). Many people lead an active lifestyle post-amputation of any limb.

Some form of amputation involves

• Above-knee amputation is where the part of the thigh, knee, shin, toes, or foot is eliminated.

• Below-knee amputation is where the lower leg, foot, or toes are removed.

• Arm amputation.

• Hand amputation.

• Toe amputation.

• Finger amputation.

What Is the Need for Amputation?

Amputation is required to prevent the spread of infection to other parts of the body and to manage pain. The most common condition where amputation is required is when wound healing is not proper. This can happen when there is reduced blood flow to the limb. Amputation will be recommended if the limb cannot be corrected after a severe injury.

Amputation is necessary if

• There is the presence of cancerous tumors in the limb.

• Frostbite.

• Gangrene (tissue death).

• Neuroma (thickening of nerve tissue).

• Severe tissue injury.

• Diabetes.

What Is Meant by Leg Amputation?

Those arteries that supply to the leg may get blocked or narrowed. Due to this, the circulation to the legs may be reduced. This causes pain in the feet or foot during the night, causes ulceration, or black patches in the toes or legs. If such arterial conditions are left untreated, the reduced blood circulation can increase pain. Where there is reduced blood flow, the tissue in the legs eventually will die due to reduced nutrients and oxygen, which results in infection and gangrene. In the case of gangrene, the infection can spread from the affected region to other regions. Amputation is the last option the surgeon recommends if there is no way to improve the circulation. The main regions where amputation is done are:

• Below the knee region.

• Through the knee.

• Through the thigh.

The site of amputation is based on the region's circulation level. Usually, doctors will perform amputation below the knee so the person can walk using artificial limbs post-surgery.

What Are the Complications of Leg Amputation?

Some common complications are:

• Due to poor blood supply, the wound healing process may be slow, and at times, there may be a requirement for further amputation above the knee if there is no proper wound healing.

• If the amputated region gets infected, it needs to be treated using antibiotics.

• Aches and pain are common in the treated region and can be present for several months.

• There may be chest infection post-surgery, usually seen in smokers, and need to be treated using antibiotics and physiotherapy.

Amputation can occur for various reasons, but a common reason is some chronic medical conditions that can impact the blood flow. If amputation is required, the surgeon should explain the procedure and the recovery time to the person.

What Are the Risks Related to Amputation?

Some common risk factors are:

• Blood clots in the limbs can travel to the lungs.

• Breathing issues.

• Bleeding.

• Slow and poor wound healing.

What Is Meant by Osseointegration?

Osseointegration is an advanced reconstructive procedure for amputated limbs, which is used in the case of traditional prostheses. In the case of osseointegration, the implant will be directly attached to the bone of the remaining limb. This method provides patients with a better quality of life. It also enhances mobility and function without prosthesis-associated problems such as sweating, pinching, muscle weakness, or skin irritation. Osseointegrated bone attachments can be implanted in:

• Humerus, upper arm bone.

• Radius or ulna, forearm bone.

• Femur, thigh bone.

• Tibia, lower leg bone.

What Are the Advantages of Osseointegration?

Some common advantages are:

• Enhance Body Awareness:

Walking with such a prosthesis will provide a direct connection to and through the skeleton system, resulting in good balance, sensing the position and movements, and feeling the sense of bone even without seeing.

• Enhanced Gait and Mobility:

With enhanced body awareness, the person will have a natural gait. The osseointegrated prosthesis will help enhance the range of motion and help in muscle growth. The prosthesis used in osseointegration takes very little time to clip on or off.

• Decreased Pain:

Some socket fitting prosthesis causes pain due to pinching, sweating, skin irritation, nerve pain, sores, or ulcers. Socket prostheses usually exert pressure on nerves, which can result in enhanced pain. Osseointegrated prostheses are bone-anchored prostheses that cause reduced pain.

• There Is No Fit Issue:

All the bone-anchored prostheses are customized to fit perfectly in the person’s body. Because each body is unique, and in the case of socket prosthesis, finding a properly fitting prosthesis is very difficult. This can result in multiple visits to the doctor to correct the fitting issue.

Who Can Have Osseointegrated Prosthesis?

Osseointegrated implants can be used on those people who are having a bad experience with the prosthesis used at the present or do not want to use any sort of traditional prosthesis. Socket prostheses are challenging to fit into patients with residual limbs that are scarred, wide, or short. Osseointegrated prostheses are implanted into the residual bone. Usually, with traditional prostheses, the person may feel pain.

What Is the Recovery Time When Osseointegration Surgery Is Performed?

Usually, the person will be made to stay in the hospital for three to four days. It takes about three months for the growth of the bone around the implant to be placed. Many people can walk without using crutches in three months post-surgery.

What Are the Risks Related to Osseointegration Surgery?

There are reduced risks of osseointegration, such as:

• Implant loosening.

• Fracture.

• Infection.

How Long Does This Prosthesis Last?

After a successful osseointegration surgery, the implant should last for many years. The prosthetist needs to change some parts of the prosthetic over time.

Conclusion

Amputation is a procedure where some body parts, such as limbs, are removed due to reduced blood flow or infection. Amputation is usually done to prevent the spread of infection. Amputation is recommended in case of some chronic condition or any traumatic injury. Osseointegration is a procedure that enhances bone ingrowth into the implant placed. An artificial implant is placed and anchored into the bone, which grows into the implant.