Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases

Aditya Khemka*, Chalak I. FarajAllah, Sarah J. Lord, Belinda Bosley, Munjed Al Muderis

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)
    89 Downloads (Pure)


    Background: Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an osseointegrated implant for prosthetic attachment.

    Methods: We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to a THR with a modular revision stem and a stoma was created. Clinical outcomes were assessed at baseline and 1.5-2.5-year follow-up using standard measures of health-related quality of life, ambulation, and activity levels including the Short Form-36 (SF-36), Questionnaire for Transfemoral Amputees (Q-TFA), Timed Up and Go test, and 6-min walk test.

    Results: Patient age ranged from 35 to 65years. There were no major adverse events, but there was one case of superficial infection. All patients showed improved Q-TFA and SF-36 scores. Two patients who were wheelchair-bound at baseline became community ambulators, and the third patient exhibited improved ambulation.

    Conclusions: This study demonstrated the feasibility of combining a THR with an osseointegrated implant in transfemoral amputees.

    Original languageEnglish
    Article number13
    Pages (from-to)1-7
    Number of pages7
    JournalJournal of Orthopaedic Surgery and Research
    Publication statusPublished - 19 Jan 2016

    Bibliographical note

    Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


    • amputee
    • joint replacement
    • osseointegration
    • transfemoral


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