Article

Treatment with osseointegrated transfemoral prostheses has been shown to improve
quality of life. The treatment has been performed in Sweden since 1990 and
consists of two surgical procedures followed by rehabilitation. During the first
years, the rehabilitation process was not standardized. In 1999, a treatment
protocol called OPRA (Osseointegrated Prostheses for the Rehabilitation of
Amputees) was established. This article describes the current rehabilitation
protocol and illustrates the overall results. The OPRA rehabilitation protocol is
graded to stimulate the process of osseointegration and prepare the patient for
unrestricted prosthetic use. It includes initial training with a short training
prosthesis followed by gradually increased prosthetic activity. Between May 1990
and June 2008, we treated 100 patients with 106 implants (6 bilaterally; 61%
males, 39% females; mean age 43 years; mean time since amputation 11.5 years.)
The majority had amputations due to trauma (67%) or tumor (21%) (other = 12%).
Currently, 68 patients are using their prostheses (follow-up: 3 months- 17.5
years) and 32 are not (4 are deceased, 7 are before second surgery, 6 are in
initial training, 4 are not using prosthesis, and 11 had the implant removed).
The majority of treatment failures occurred in patients before we established the
OPRA protocol. The implementation of graded rehabilitation is considered to be of
utmost importance for improved results.

Langue : ANGLAIS