Press-fit Osseointegration for the Transtibial Amputee

There is often a general opinion that transtibial amputees have good enough quality of life and mobility and that substantial innovation in their rehabilitation may not be necessary. Specifically, although osseointegration had proven successful and beneficial for over 20 years, the original implant has not been described to reconstruct any transtibial amputees, despite its described use for patients with transhumeral and finger amputations. In reality, studies focusing on quality of life and actual long-term prosthesis use rather than short laboratory evaluations consistently recognize that the blessing of better mobility carries the curse of more frequent problems due to the socket such as skin breakdown and pain. Only a few transtibial osseointegration procedures had been performed in the world prior to the patient described in this case. This case describes the first transtibial amputee for whom our group provided osseointegration, in 2014. Amputees are, of course, a very diverse population. Many struggle with mobility and may be nearly confined to a wheelchair. In the profiled case, the patient was actually rather highly mobile and active, with relatively recent declines due to socket-related problems. We feel his situation is informative specifically because of that: Yes, osseointegration can often improve the mobility and quality of life for amputees who are essentially intolerant of a prosthesis and as a result may be essentially wheelchair-bound. However, osseointegration definitely can also confer measured and perceived mobility and quality of life benefits even to amputees who have high levels of functional mobility.