Transcutaneous osseointegration for oncologic amputees with and without radiation therapy: an observational cohort study

Jason Shih Hoellwarth*, Kevin Tetsworth, Muhammad Adeel Akhtar, Atiya Oomatia, Munjed Al Muderis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Context: Transcutaneous osseointegration for amputees (TOFA) consistently confers significant improvement in mobility and quality of life (QOL) for amputees using a traditional socket prosthesis. Limb radiation therapy (XRT) Has traditionally been considered hard contraindication against TOFA but has never actually been examined. Aims: This study evaluated the changes in mobility and QOL, and also the complications, for oncologic amputees provided TOFA: 9 with XRT, and 23 with no radiation therapy (NRT). Settings and Design: A retrospective registry review of all oncologic amputees was performed. Subjects and Methods: The patients' mobility (daily prosthesis wear hours, K-level, Timed Up and Go, and 6-min walk test [6MWT]) and QOL survey data (Questionnaire for Persons with a Transfemoral Amputation) were compared before TOFA and at the latest follow-up. Statistical Analysis Used: Fisher's exact test for frequencies, and Student's t-test for means (significance, P < 0.05). Results: Regarding mobility, the cohorts were similar to one another before and after TOFA, and both cohorts improved following osseointegration (statistically significant: XRT wear hours [P = 0.029], NRT K-level [P < 0.001], and NRT 6MWT [P = 0.046]). Both cohorts' QOL was also similar before and after TOFA, and both cohorts again improved following osseointegration (significant differences: XRT problem score [P = 0.021], NRT problem score [P < 0.001], and NRT global score [P < 0.001]). Three XRT patients (33%) and one NRT patient (4%) required removal (P = 0.048). Conclusions: While radiation therapy may be associated with increased risk of postoperative implant loosening, it seems unjustifiable to flatly contraindicate osseointegration for oncologic amputees solely because of prior limb irradiation.

Original languageEnglish
Pages (from-to)32-39
Number of pages8
JournalJournal of Limb Lengthening and Reconstruction
Volume8
Issue number1
DOIs
Publication statusPublished - 2022

Bibliographical note

Copyright the Journal of Limb Lengthening & Reconstruction 2022. 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.

Keywords

  • Oncologic amputee
  • oncologic osseointegration
  • osseointegration
  • radiation osseointegration
  • radiation therapy
  • sarcoma

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