Evidence map›Paper›PMID 40979932›Full record

ReviewStrategies in trauma and limb reconstruction

Transcutaneous Osseointegration for Amputees as a Result of Sepsis Management: A Case Series of Nine Patients with a Mean Follow-up of 4 Years.

Alexis C Panzures, Muhammad A Akhtar, Jason S Hoellwarth, Kevin Tetsworth, Munjed Al Muderis

Abstract readReview
In one paragraph

Review in Strategies in trauma and limb reconstruction. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexis C PanzuresEdinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, Lothian, United Kingdom.ORCID https://orcid.org/0009-0004-2364-4391
Muhammad A AkhtarDepartment of Trauma and Orthopaedics, Victoria Hospital Kirkcaldy, NHS Fife, Kirkcaldy, Fife, United Kingdom.
Jason S HoellwarthDepartment of Orthopedic Surgery, Osseointegration Limb Replacement Center, Hospital for Special Surgery, New York, New York, United States.
Kevin TetsworthDepartment of Orthopaedic Surgery, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
Munjed Al MuderisDepartment of Orthopedic Surgery, Limb Reconstruction Centre, Macquarie University Hospital, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Transcutaneous osseointegration following amputation (TOFA) is an alternative to standard prosthesis by directly anchoring a metal implant to the skeletal residuum. However, there is a paucity of data concerning whether TOFA is safe and reasonable for patients with lower limb amputation to manage complications of sepsis. The primary aim of this study was to record adverse post-TOFA events for nine patients (15 limbs) whose index amputations were performed to manage sepsis-related complications. The secondary aim was to compare the pre- and post-TOFA mobility and quality of life (QoL). Methods: A retrospective review of our practice's prospectively maintained osseointegration database was performed. Patients with transfemoral and/or transtibial osseointegration for a limb in which the original amputation was performed to manage sepsis, at least two years prior to the study date, were included. This yielded nine patients with 15 osseointegrated limbs. Adverse events were antibiotics for infection or unplanned surgery. Outcomes were recorded using the SF-36 Health Survey and the Questionnaire for persons with a transfemoral amputation. Formal mobility evaluations included a 6-minute walk test and physician-determined K-levels. Results: The cohort had a mean age of 42.8 ± 6.5 (range: 35.0-52.4) years. The mean body mass index (BMI) was 27.2 ± 11.0 (18.4-54.5). Six patients (67%) underwent bilateral osseointegration, and three (33%) patients underwent unilateral osseointegration. Six patients (67%) representing 12 limbs (80%) had an uneventful course post-osseointegration. One (11%) patient had intravenous antibiotics to manage a superficial infection. One (11%) other patient had a periprosthetic femur fracture managed by open reduction internal fixation. No systemic complications, additional surgeries, or implant removals occurred. 75% (6/8) achieved K-level ≥ 2 post-osseointegration. There was no significant change in the 6-minute walk test. Conclusion: Lower limb osseointegration is a safe and effective rehabilitation option for patients whose amputations were a result of sepsis. Clinical significance: Further judicious use of TOFA for these patients seems highly merited. How to cite this article: Panzures AC, Akhtar MA, Hoellwarth, JS,

Indexed as

AmputeeOsseointegrationSepsisSepsis amputationTranscutaneous osseointegration

Identifiers

PMID40979932
PMCPMC12445137

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.