{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T17:47:27Z","timestamp":1782668847776,"version":"3.54.5"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n            <jats:title>Case Description:<\/jats:title>\n            <jats:p>Osseointegration is a relatively new technique for prosthetic limb attachment that offers various improvements for patients with amputation and facilitates joint preservation. We present a case of implant loosening during rehabilitation in a patient with transtibial amputation that was successfully managed through a combination of measures, aiming to promote re-osseointegration of the implant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>Not much is known about structured management of adverse events after osseointegration. Septic or aseptic loosening is currently regarded as implant failure, prompting removal and possible re-implantation at a later stage. The objective of this case report was to evaluate the feasibility of salvaging a loosened implant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Study Design:<\/jats:title>\n            <jats:p>Case report.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Treatment:<\/jats:title>\n            <jats:p>A novel treatment approach was employed to enable renewed osseointegration of the implant. First, the bone-implant interface was disrupted and renewed through axial rotation and distal repositioning of the implant. Afterwards, extracorporal shockwave therapy and antibiotic treatment were administered. Prosthetic rehabilitation was then started anew. Regular follow-up x-rays and clinical evaluations were conducted, including standardized outcome tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes:<\/jats:title>\n            <jats:p>These combined measures led to a successful re-osseointegration of the implant. In a 21-month follow-up, the patient regained a stable and secure gait pattern, using his prosthesis every day for 15 hours and scoring above average on standardized outcome measures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>This represents the first report of implant salvage after failed primary osseointegration. As the associated risks of this novel treatment are very low, investigations are warranted to evaluate this approach on a larger scale.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/0309364620953985","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T03:18:16Z","timestamp":1600139896000},"page":"76-80","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Successful salvage via re-osseointegration of a loosened implant in a patient with transtibial amputation"],"prefix":"10.1097","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0092-568X","authenticated-orcid":false,"given":"Clemens","family":"Gstoettner","sequence":"first","affiliation":[{"name":"Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-7354","authenticated-orcid":false,"given":"Stefan","family":"Salminger","sequence":"additional","affiliation":[{"name":"Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria"},{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Sturma","sequence":"additional","affiliation":[{"name":"Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria"},{"name":"Department of Bioengineering, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veith","family":"Moser","sequence":"additional","affiliation":[{"name":"AUVA Trauma Hospital Lorenz B\u00f6hler\u2014European Hand Trauma Center, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hausner","sequence":"additional","affiliation":[{"name":"AUVA Trauma Hospital Lorenz B\u00f6hler\u2014European Hand Trauma Center, Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rickard","family":"Br\u00e5nemark","sequence":"additional","affiliation":[{"name":"Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden"},{"name":"Biomechatronics Group, Center for Extreme Bionics, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar C","family":"Aszmann","sequence":"additional","affiliation":[{"name":"Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of 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