Use of an Osseointegrated Intraosseous Transcutaneous Amputation Prosthesis for Amputated Fingers Is Followed by Frequent Infection and Implant Removal

Abstract

ABSTRACT Introduction We report on the outcomes of using a custom-built osseointegrated (OI) intraosseous transcutaneous amputation prosthesis (ITAP) as a bone anchor for prosthetic reconstruction of a series of amputated fingers. The aim of ITAP was to reduce the risk of failure due to infection by creating a biological seal at the skin-implant interface. Methods and Results A total of 14 patients who suffered from amputations of their digits at a variety of different levels were recruited. Eleven patients (20 implants) underwent treatment with an implant based on the ITAP principle. With the exception of one patient (1 implant), all implants were removed by 9 years after insertion. Patients requested removal because of recurrent infections, exposure of the flange structure (unique to ITAP), loosening of the implant, and inability to secure a prosthesis to the implant. Conclusions The ITAP principle does not work when used as part of the design of an OI bone anchor for prosthetic reconstruction after finger amputation. Clinical Relevance Statement This study suggests that there are major problems with the principles underlying the design of the ITAP implant when used in humans. Future studies of OI implants using the principles of ITAP may be at risk of similar problems.