When a father of three was injured on the job in 2019, his prognosis looked dire. The man, who worked in a charcoal factory, was pinned to a machine for three hours, necessitating the amputation of his left leg on site. Once he was freed and airlifted to a hospital in Springfield, Missouri, his right leg was amputated as well. Following a two-month hospital stay, the patient was fitted with five different prostheses for the left limb, but each was uncomfortable and didn’t function well.
Today, after an innovative procedure from WashU Medicine orthopedic specialists at Barnes-Jewish Hospital in St. Louis, this same patient has returned to leading a full life, caring for his children, playing hockey and even training for a Paralympic team.
It’s estimated that more than half a million people in the United States experience limb loss annually, but traditional prostheses can cause socket-related issues such as sores, lead to phantom limb pain and contribute to poor balance, all obstacles that affect a patient’s recovery and quality of life. WashU Medicine orthopedic specialists at Barnes-Jewish Hospital are addressing these outcomes through osseointegration, a groundbreaking surgery in which a metal implant is anchored directly into the bone of a residual limb so that a prosthesis can be attached. WashU Medicine and Barnes-Jewish Hospital is the only center in our region to offer the osseointegration procedure.
Primary benefits of osseointegration include:
- Allows people with above-the-knee amputations, who may have less residual limb to support a prosthetic, a more secure placement for a new limb
- Allows for increased mobility and function, improving patients’ quality of life, with most bearing full weight on the prosthesis about a year following the surgery
- Allows patients to more fully feel and experience the surface beneath them, similar to a full limb
Additional benefits of osseointegration include:
- Reduction or elimination of pain, skin irritations, ulcers and perspiration
- Elimination of socket-related problems in traditional prosthetics
- Increased range of motion and limb strength
- Intuitive awareness of limb positioning in space
- Allows for weight gain/loss
- Comfort during sitting (for lower limbs)
How osseointegration works
Osseointegration consists of a two-stage surgery process, in which an implant is first inserted into the bone of the patient’s residual limb. A waiting period of three to six months is observed, during which time the patient heals. Following this period, a second surgery is performed, at which point another implant that penetrates the patient’s skin is inserted. On average, the osteointegration process takes six months total.
In November 2023, Ian English, MD, MA, a WashU Medicine orthopedic surgeon at Barnes-Jewish Hospital, along with Christopher McAndrew, MD, MSc, a WashU Medicine orthopedic trauma surgeon at Barnes-Jewish Hospital, began the osseointegration process on the aforementioned double amputee patient, inserting the first implant into the patient’s femur. They then performed a bone graft and sutured the skin closed over the implanted metal device.
After a few months’ time, the implant integrated into the bone, at which point the next stage of the process was executed with another surgery. The muscle was opened and trimmed, and an additional implant that would attach to the prosthesis was inserted. For the second surgery, English and McAndrew were supported by David Brogan, MD, MSc, a WashU Medicine orthopedic surgeon at Barnes-Jewish Hospital who also performs osseointegration procedures.
Candidates for osseointegration
The ideal candidate for osseointegration is a transfemoral amputee who:
- Is between the ages of 22-65
- Is free from infections
- Does not have diabetes
- Weighs less than 220 pounds
- Currently has or is anticipated to have socket issues due to recurrent skin issues such as ulcers, pain, short limb length, scarring or skin grafts, excessive sweating or restricted mobility
Call 314-514-3500 to schedule a consultation today.
