First step for pros­thet­ics

Pi­o­neer­ing pro­ce­dure for above-knee am­putees

Cape Times - - METRO - LISA ISAACS [email protected]

A NEW pro­ce­dure that can dras­ti­cally im­prove the lives of leg am­putees was re­cently per­formed for the first time in South Africa.

The pro­ce­dure in­volves a rev­o­lu­tion­ary new type of pros­the­sis that does away with tra­di­tional suc­tion sock­ets by di­rectly at­tach­ing an am­putee’s pros­thetic limb to their skele­ton.

Pro­fes­sor Nando Fer­reira from Stel­len­bosch Univer­sity’s Divi­sion of Orthopaedics, who was the lead sur­geon, col­lab­o­rated with the In­sti­tute for Orthopaedics and Rheuma­tol­ogy at Medi­clinic Winelands, pros­thetist Eu­gene Ros­souw, and as­so­ciate pro­fes­sor Mun­jed al Mud­eris of the Osseoin­te­gra­tion Group of Aus­tralia, to per­form South Africa’s first osseoin­te­gra­tion pros­the­sis im­plant on Novem­ber 5.

The re­cip­i­ent was a 28-year-old woman who suf­fered a trau­matic above-knee am­pu­ta­tion in 2009. Since then, she has strug­gled with her socket pros­the­sis, which in­ter­feres with her oc­cu­pa­tion and daily life.

The pa­tient has pro­gressed well, and her first pros­the­sis fit­ment was done two weeks after the surgery.

She has be­gun a 12-weeks re­ha­bil­i­ta­tion pro­to­col that in­volves pro­gres­sive weight bear­ing while us­ing two crutches for six weeks, fol­lowed by an­other six weeks us­ing one crutch.

The pro­ce­dure was orig­i­nally de­vel­oped in Aus­tralia by Al Mud­eris, the Aus­tralian sur­geon who pi­o­neered osseoin­te­gra­tion and de­vel­oped the Osseoin­te­gra­tion Group of Aus­tralia Osseoin­te­gra­tion Pros­thetic Limb (OGAP-OPL) pros­the­sis, the sur­gi­cal tech­nique, and the re­ha­bil­i­ta­tion pro­to­col over the last decade.

About 750 surg­eries have been per­formed, mostly in Aus­tralia.

“The OGAP-OPL is a rev­o­lu­tion­ary pros­the­sis that does away with tra­di­tional suc­tion sock­ets by at­tach­ing an am­putee’s pros­thetic limb to the skele­ton. This af­fords am­putees unique ad­van­tages and can dras­ti­cally trans­form their qual­ity of life,” Fer­reira said.

Am­putees fre­quently suf­fer prob­lems with tra­di­tional suc­tion sock­ets, in­clud­ing skin ir­ri­ta­tion, poor fit due to sweat­ing and vol­ume changes of the stump through­out the day, dis­com­fort while sit­ting, and the time it takes to at­tach and re­move a pros­the­sis.

These socket-re­lated prob­lems are elim­i­nated with an osseoin­te­gra­tion pros­the­sis.

Re­cip­i­ents also have a bet­ter per­cep­tion of the body’s po­si­tion and move­ment and can feel the sur­face they are walk­ing on, al­low­ing them to walk with more con­fi­dence.

The osseoin­te­gra­tion pros­the­sis re­stores the nor­mal anatom­i­cal align­ment of the thigh bone, which sig­nif­i­cantly re­duces com­mon gait de­vi­a­tions in above-knee am­putees.

How­ever, the pro­ce­dure is not with­out com­pli­ca­tions, most sig­nif­i­cantly in­fec­tion around the im­plant and frac­tures of the re­main­ing bone.

“Can­di­dates are care­fully screened for suit­abil­ity and cur­rently only in­di­vid­u­als suf­fer­ing se­vere socket prob­lems that sig­nif­i­cantly in­ter­fere with work and daily life are con­sid­ered for this pro­ce­dure,” Fer­reira said.

“The unique de­sign, ma­te­ri­als and man­u­fac­tur­ing process of the OGAPOPL al­lows bone to grow into the sur­face of the im­plant.”

STEL­LEN­BOSCH Univer­sity pro­fes­sor Eu­gene Ros­souw and as­so­ciate pro­fes­sor Mun­jed al Mud­eris of the Osseoin­te­gra­tion Group of Aus­tralia, per­formed South Africa’s first osseoin­te­gra­tion pros­the­sis im­plant.

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