Proximal bone remodeling in lower limb amputees reconstructed with an osseointegrated prosthesis

Seamus Thomson*, William Lu, Hala Zreiqat, Jiao Jiao Li, Kevin Tetsworth, Munjed Al Muderis

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    11 Citations (Scopus)


    Mobility outcomes and changes in bone mineral density (BMD) of the spine and femoral necks in response to unilateral osseointegrated implants was investigated over a 3-year period. A total of 48 unilateral amputees who received an osseointegrated implant, comprising 33 trans-femoral amputees (TFA) and 15 trans-tibial amputees (TTA), underwent dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine (L2–L4) and femoral necks at baseline, 1-, and 3-years follow-ups. Mobility outcomes, including the Six-Minute-Walk Test (6MWT) and Timed-Up-and-Go (TUG), were measured before surgery, at 1 year, and more than 2 years following the osseointegration procedure. We observed a significant increase (p < 0.05) in Z-score values in the femoral neck of the amputated side in TFA patients without a femoral neck lag screw at the 1- and 3-year follow-ups, as well as in TFA patients with a lag screw present at 3-year follow-up. The BMD at 1-year follow-up was found to be positively correlated with pre-surgery 6MWT values in patients who were mobile using a traditional socket prosthesis before receiving an osseointegrated implant. These results suggest that osseointegrated implants induce a physiological response in the femoral neck of recipients and appear to be evidence of restored biomechanical loading in the proximal femur.

    Original languageEnglish
    Pages (from-to)2524-2530
    Number of pages7
    JournalJournal of Orthopaedic Research
    Issue number12
    Publication statusPublished - 1 Dec 2019


    • bone
    • clinical
    • clinical outcomes
    • gait
    • rehabilitation
    • trauma


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