{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:18Z","timestamp":1787755098977,"version":"build-2784847793"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2017,9,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osseointegration is an alternative treatment for amputees who are unable to wear or have difficulty wearing a socket prosthesis. Although the majority of limb amputations are due to vascular disease, such amputations have been perceived as a contraindication to osseointegration surgery. We report the outcomes of osseointegrated reconstruction in a series of 5 patients with limb amputation due to peripheral vascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Five patients with transtibial amputation and a history of peripheral vascular disease who received an osseointegration implant from 2014 to 2015 were followed for 12 months. Clinical and functional outcomes were assessed, including pain, the amount of time the patient wore the prosthesis, mobility, walking ability, and quality of life. Adverse events, including infection, fracture, implant failure, revision surgery, additional amputation, and death, were monitored and recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five transtibial amputees (56 to 84 years of age) followed for 1 year after osseointegration surgery were included in this case series. The mobility of all patients was improved at the time of follow-up. Three patients were wheelchair-bound prior to the surgery but all 5 were able to walk and perform daily activities at the time of follow-up. Four of the 5 patients were pain-free at 12 months postoperatively, and all 5 were using the osseointegrated prosthesis. Two patients had a single episode of superficial soft-tissue infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>An osseointegrated implant may be considered a feasible alternative to the conventional socket prosthesis for patients with peripheral vascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.16.01295","type":"journal-article","created":{"date-parts":[[2017,9,20]],"date-time":"2017-09-20T20:01:25Z","timestamp":1505937685000},"page":"1516-1523","source":"Crossref","is-referenced-by-count":49,"title":["Osseointegrated Transtibial Implants in Patients with Peripheral Vascular Disease"],"prefix":"10.2106","volume":"99","author":[{"given":"Robin","family":"Atallah","sequence":"first","affiliation":[{"name":"Department of Surgery (R.A.), Physical Therapy, Department of Orthopaedics (R.L.), and Osseointegration, Department of Surgery (P.F.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao Jiao","family":"Li","sequence":"additional","affiliation":[{"name":"Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Lu","sequence":"additional","affiliation":[{"name":"Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruud","family":"Leijendekkers","sequence":"additional","affiliation":[{"name":"Department of Surgery (R.A.), Physical Therapy, Department of Orthopaedics (R.L.), and Osseointegration, Department of Surgery (P.F.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Paul","family":"Fr\u00f6lke","sequence":"additional","affiliation":[{"name":"Department of Surgery (R.A.), Physical Therapy, Department of Orthopaedics (R.L.), and Osseointegration, Department of Surgery (P.F.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2010-7185","authenticated-orcid":false,"given":"Munjed","family":"Al Muderis","sequence":"additional","affiliation":[{"name":"Australian School of Advanced Medicine, Macquarie University, North Ryde, New South Wales, Australia"},{"name":"School of Medicine, The University of Notre Dame Australia, Auburn, New South Wales, Australia"},{"name":"Norwest Private Hospital, Bella Vista, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"12","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1111\/j.1445-2197.2007.04330.x","article-title":"Par\u00e9 and prosthetics: the early history of artificial limbs","volume":"77","author":"Thurston","year":"2007","journal-title":"ANZ J Surg."},{"issue":"9","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1080\/0963828031000090434","article-title":"Health related quality of life and related factors in 539 persons with amputation of upper and lower limb","volume":"25","author":"Demet","year":"2003","journal-title":"Disabil Rehabil."},{"issue":"3","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/03093640108726601","article-title":"Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems","volume":"25","author":"Hagberg","year":"2001","journal-title":"Prosthet Orthot Int."},{"issue":"11","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.1016\/j.apmr.2013.05.020","article-title":"Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses","volume":"94","author":"Van de Meent","year":"2013","journal-title":"Arch Phys Med Rehabil."},{"issue":"4","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.apmr.2004.09.003","article-title":"Dermatologic conditions associated with use of a lower-extremity prosthesis","volume":"86","author":"Dudek","year":"2005","journal-title":"Arch Phys Med Rehabil."},{"issue":"3","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S0190-9622(00)90227-5","article-title":"Skin disorders in amputees","volume":"42","author":"Lyon","year":"2000","journal-title":"J Am Acad Dermatol."},{"issue":"6","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1682\/JRRD.2013.06.0133","article-title":"Prevalence of heat and perspiration discomfort inside prostheses: literature review","volume":"51","author":"Ghoseiri","year":"2014","journal-title":"J Rehabil Res Dev."},{"issue":"Suppl 2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"180","DOI":"10.2106\/JBJS.J.00806","article-title":"Transcutaneous, distal femoral, intramedullary attachment for above-the-knee prostheses: an endo-exo device","volume":"92","author":"Aschoff","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib9-20230810","first-page":"175","article-title":"Osseointegration in skeletal reconstruction and rehabilitation: a review","volume":"38","author":"Br\u00e5nemark","year":"2001","journal-title":"J Rehabil Res Dev."},{"issue":"4","key":"bib10-20230810","first-page":"347","article-title":"Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws","volume":"5","author":"Adell","year":"1990","journal-title":"Int J Oral Maxillofac Implants."},{"key":"bib11-20230810","first-page":"1","article-title":"Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period","volume":"16","author":"Br\u00e5nemark","year":"1977","journal-title":"Scand J Plast Reconstr Surg Suppl."},{"issue":"11","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1080\/09638288.2016.1186752","article-title":"Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review","volume":"39","author":"Leijendekkers","year":"2017","journal-title":"Disabil Rehabil."},{"issue":"1","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1302\/0301-620X.96B1.31905","article-title":"A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: a prospective study of 51 patients","volume":"96-B","author":"Br\u00e5nemark","year":"2014","journal-title":"Bone Joint J."},{"issue":"1","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/03093640701553922","article-title":"Osseointegrated trans-femoral amputation prostheses: prospective results of general and condition-specific quality of life in 18 patients at 2-year follow-up","volume":"32","author":"Hagberg","year":"2008","journal-title":"Prosthet Orthot Int."},{"issue":"11","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1016\/j.apmr.2014.07.009","article-title":"Outcome of percutaneous osseointegrated prostheses for patients with unilateral transfemoral amputation at two-year follow-up","volume":"95","author":"Hagberg","year":"2014","journal-title":"Arch Phys Med Rehabil."},{"issue":"11","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"900","DOI":"10.2106\/JBJS.15.00808","article-title":"Safety of osseointegrated implants for transfemoral amputees: a two-center prospective cohort study","volume":"98","author":"Al Muderis","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"2947","DOI":"10.1007\/s11999-014-3695-6","article-title":"Implant survival, adverse events, and bone remodeling of osseointegrated percutaneous implants for transhumeral amputees","volume":"472","author":"Tsikandylakis","year":"2014","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3109\/17453674.2015.1068635","article-title":"Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases","volume":"86","author":"Khemka","year":"2015","journal-title":"Acta Orthop."},{"issue":"10","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1007\/s11999-010-1370-0","article-title":"Osseointegrated titanium implants for limb prostheses attachments: infectious complications","volume":"468","author":"Tillander","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1358836X0100600i102","article-title":"Peripheral arterial disease\u2014epidemiological aspects","volume":"6","author":"Criqui","year":"2001","journal-title":"Vasc Med."},{"issue":"8","key":"bib21-20230810","first-page":"875","article-title":"Limb amputation and limb deficiency: epidemiology and recent trends in the United States","volume":"95","author":"Dillingham","year":"2002","journal-title":"South Med J."},{"issue":"1","key":"bib22-20230810","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1757-1146-5-12","article-title":"What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?","volume":"5","author":"Lazzarini","year":"2012","journal-title":"J Foot Ankle Res."},{"issue":"3","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.apmr.2007.11.005","article-title":"Estimating the prevalence of limb loss in the United States: 2005 to 2050","volume":"89","author":"Ziegler-Graham","year":"2008","journal-title":"Arch Phys Med Rehabil."},{"issue":"4","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.avsg.2014.12.005","article-title":"Domains that determine quality of life in vascular amputees","volume":"29","author":"Suckow","year":"2015","journal-title":"Ann Vasc Surg."},{"issue":"8","key":"bib25-20230810","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.apmr.2015.04.001","article-title":"Suicidal ideation among individuals with dysvascular lower extremity amputation","volume":"96","author":"Turner","year":"2015","journal-title":"Arch Phys Med Rehabil."},{"issue":"6","key":"bib26-20230810","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.apmr.2007.11.034","article-title":"Rehabilitation setting and associated mortality and medical stability among persons with amputations","volume":"89","author":"Dillingham","year":"2008","journal-title":"Arch Phys Med Rehabil."},{"issue":"5","key":"bib27-20230810","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.ahj.2012.12.002","article-title":"High mortality risks after major lower extremity amputation in Medicare patients with peripheral artery disease","volume":"165","author":"Jones","year":"2013","journal-title":"Am Heart J."},{"issue":"8","key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1177\/1538574413503715","article-title":"Lower extremity amputations: factors associated with mortality or contralateral amputation","volume":"47","author":"Shah","year":"2013","journal-title":"Vasc Endovascular Surg."},{"issue":"7","key":"bib29-20230810","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1302\/0301-620X.98B7.37547","article-title":"The Osseointegration Group of Australia Accelerated Protocol (OGAAP-1) for two-stage osseointegrated reconstruction of amputated limbs","volume":"98-B","author":"Muderis","year":"2016","journal-title":"Bone Joint J."},{"issue":"1","key":"bib30-20230810","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1186\/s12891-016-1341-z","article-title":"Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol","volume":"17","author":"Leijendekkers","year":"2016","journal-title":"BMC Musculoskelet Disord."},{"issue":"5","key":"bib31-20230810","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1682\/JRRD.2003.11.0167","article-title":"Questionnaire for Persons with a Transfemoral Amputation (Q-TFA): initial validity and reliability of a new outcome measure","volume":"41","author":"Hagberg","year":"2004","journal-title":"J Rehabil Res Dev."},{"issue":"12","key":"bib33-20230810","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1016\/j.apmr.2008.05.021","article-title":"Six-minute walk test in persons with transtibial amputation","volume":"89","author":"Lin","year":"2008","journal-title":"Arch Phys Med Rehabil."},{"issue":"7","key":"bib34-20230810","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/S0003-9993(99)90234-4","article-title":"The timed \u201cup and go\u201d test: reliability and validity in persons with unilateral lower limb amputation","volume":"80","author":"Schoppen","year":"1999","journal-title":"Arch Phys Med Rehabil."},{"issue":"6","key":"bib35-20230810","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care."},{"issue":"3","key":"bib36-20230810","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/eurpub\/12.3.171","article-title":"Physical activity and coronary heart disease in older adults. A systematic review of epidemiological studies","volume":"12","author":"Batty","year":"2002","journal-title":"Eur J Public Health."},{"issue":"22","key":"bib37-20230810","doi-asserted-by":"crossref","first-page":"2961","DOI":"10.1001\/jama.283.22.2961","article-title":"Physical activity and risk of stroke in women","volume":"283","author":"Hu","year":"2000","journal-title":"JAMA."},{"issue":"9","key":"bib38-20230810","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1056\/NEJM199908263410904","article-title":"A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women","volume":"341","author":"Manson","year":"1999","journal-title":"N Engl J Med."},{"issue":"2","key":"bib39-20230810","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1161\/01.STR.29.2.380","article-title":"Leisure-time physical activity and ischemic stroke risk: the Northern Manhattan Stroke Study","volume":"29","author":"Sacco","year":"1998","journal-title":"Stroke."},{"issue":"5","key":"bib41-20230810","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1097\/01.mlr.0000258615.42478.55","article-title":"The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years","volume":"45","author":"Cella","year":"2007","journal-title":"Med Care."},{"issue":"5","key":"bib42-20230810","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1177\/0309364615579315","article-title":"Characterizing mobility from the prosthetic limb user\u2019s perspective: Use of focus groups to guide development of the Prosthetic Limb Users Survey of Mobility","volume":"40","author":"Hafner","year":"2016","journal-title":"Prosthet Orthot Int."},{"issue":"9","key":"bib43-20230810","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.2106\/00004623-199909000-00006","article-title":"Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness","volume":"81","author":"Swiontkowski","year":"1999","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201709200-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:37:25Z","timestamp":1787751445000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201709200-00003"}},"subtitle":["A Multicenter Case Series of 5 Patients with 1-Year Follow-up"],"short-title":[],"issued":{"date-parts":[[2017,9,20]]},"references-count":41,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.16.01295","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,20]]}}}