ArticleArchives of orthopaedic and trauma surgery2022
Management, outcome, and novel classification system of periprosthetic fractures in patients with transcutaneous osseointegrated prosthetic systems (TOPS)-a retrospective cohort analysis.
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Bone-anchored prostheses for transfemoral amputation: a systematic review of outcomes, complications, patient experiences, and cost-effectiveness.Frontiers in rehabilitation sciences · 2024Pooled it
- German translation and initial measurement properties of the Q-TFA in transfemoral bone-anchored prosthesis users.BMC musculoskeletal disorders · 2026Article
- Observational
- Femoral fracture risk in transfemoral amputees with bone-anchored prosthetic limbs during activities of daily living.Journal of orthopaedic surgery and research · 2025Article
- Advantages of customization of osseointegrated implants in transfemoral amputees: a comparative analysis of surgical planning.Journal of orthopaedic surgery and research · 2024Article
- Transfemoral Osseointegration in Association With Total Hip Replacement: Observational Cohort Study of Patients With Follow-Up Exceeding 2 Years.Arthroplasty today · 2024Article
- ReliableFrontiers in bioengineering and biotechnology · 2024Article
- Development of an evidence-based diagnostic algorithm for infection in patients with transcutaneous osseointegration following amputation.Journal of bone and joint infection · 2024Article
- Limb Amputations in Cancer: Modern Perspectives, Outcomes, and Alternatives.Current oncology reports · 2023Review
- Review
- Osseointegration for Lower-Extremity Amputees: Operative Considerations from the Plastic Surgeon's Perspective.JBJS reviews · 2022Article
- Association Between Osseointegration of Lower Extremity Amputation and Mortality Among Adults.JAMA network open · 2022Observational
- [Functional rehabilitation after transfemoral amputation : Shaft prosthesis or endo-exo prosthesis?]Der Unfallchirurg · 2022Review
- Transcutaneous Osseointegration for Amputees as a Result of Sepsis Management: A Case Series of Nine Patients with a Mean Follow-up of 4 Years.Strategies in trauma and limb reconstructionReview
- Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTranscutaneous osseointegrated prosthetic systems (TOPS) are anchored prosthetic systems for major limb loss. Sometimes TOPS patients suffer from periprosthetic fractures. The aim of this study was to analyze the management and outcomes of periprosthetic fractures in patients with TOPS and to introduce a novel classification system for this entity. MATERIAL/
methodsSince 2010, 140 patients were treated with TOPS after transfemoral amputation in two centers in Germany. Fifteen patients sustained periprosthetic fractures, with five intra- and ten postoperative fractures. The outcome was analyzed by Prosthesis Mobility Questionnaire (PMQ), K-level and prosthesis wear time per day. A subgroup analysis for the body mass index (BMI) was performed.
resultsAll postoperative fractures were treated with implant-retaining osteosynthesis. Fourteen fractures healed without complications after a mean of 3 months. One postoperative fracture developed a clinically asymptomatic firm non-union. No Endo-Fixstem had to be removed. For the fracture and control group, a significant increase of the PMQ (p < 0.001) and K-level (p < 0.001) was observed after TOPS treatment compared to the preoperative baseline. Furthermore, the subgroup analysis showed a significant increase of the PMQ and K-level for both normal weight (p = 0.002) and overweight patients (p < 0.001). Of interest, overweight patients even showed a significantly higher increase in scores compared to normal weight patients, regardless of periprosthetic fracture.
conclusionPeriprosthetic fractures do not necessarily worsen outcomes of TOPS treatment. Proper classification and standardized appropriate treatment strategies according to fracture morphology are paramount for reliably good outcomes. We recommend to not remove or exchange the implant (Endo-Fixstem) even if it is assembly. Higher BMI did not have an impact onto rehabilitation success after TOPS to major limb loss of the lower extremity.
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