{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:06Z","timestamp":1787755566014,"version":"build-2784847793"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Cases:<\/jats:title>\n                    <jats:p>Three patients with knee-level complex regional pain syndrome type 1 (CRPS1), recalcitrant to conservative interventions, elected for transfemoral amputation and osseointegration. Two patients gained independent ambulation; the third remains on crutches after a disrupted sciatic nerve targeted reinnervation. One uses no pain medication, one is weaning off, and one requires a reduced regimen after revision nerve innervation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Osseointegration seems suitable to optimize rehabilitation after amputation for CRPS1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.20.00267","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T14:51:13Z","timestamp":1610635873000},"page":"e20.00267-e20.00267","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Amputation With Osseointegration for Patients With Intractable Complex Regional Pain Syndrome"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-0656","authenticated-orcid":false,"given":"Jason Shih","family":"Hoellwarth","sequence":"first","affiliation":[{"name":"Baylor College of Medicine, Department of Pediatric Orthopaedics, Texas Children\u2019s Hospital, Houston, Texas"},{"name":"Department of Orthopaedic Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5760-6466","authenticated-orcid":false,"given":"Shakib Sameeh","family":"Al-Jawazneh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia"},{"name":"Faculty of Medicine and Health Science, The University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3069-4141","authenticated-orcid":false,"given":"Kevin","family":"Tetsworth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Royal Brisbane and Women\u2019s Hospital, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6919-8367","authenticated-orcid":false,"given":"William","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2497-7775","authenticated-orcid":false,"given":"Claudia","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia"}],"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":"Department of Orthopaedic Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1]]},"reference":[{"issue":"2","key":"bib1-20240731","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.pain.2010.04.030","article-title":"Validation of proposed diagnostic criteria (the \u201cBudapest criteria\u201d) for complex regional pain syndrome","volume":"150","author":"Harden","year":"2010","journal-title":"Pain."},{"key":"bib2-20240731","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1471-2377-10-20","article-title":"Evidence based guidelines for complex regional pain syndrome type 1","volume":"10","author":"Perez","year":"2010","journal-title":"BMC Neurol."},{"issue":"2","key":"bib3-20240731","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/pme.12033","article-title":"Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition","volume":"14","author":"Harden","year":"2013","journal-title":"Pain Med."},{"key":"bib4-20240731","first-page":"CD010853","article-title":"Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II","volume":"2","author":"Smart","year":"2016","journal-title":"Cochrane Database Syst Rev."},{"key":"bib5-20240731","first-page":"CD009416","article-title":"Interventions for treating pain and disability in adults with complex regional pain syndrome\u2010 an overview of systematic reviews","volume":"4","author":"O'Connell","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"issue":"9","key":"bib6-20240731","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1302\/2058-5241.4.190008","article-title":"Quality of life after amputation in patients with advanced complex regional pain syndrome: a systematic review","volume":"4","author":"Ayyaswamy","year":"2019","journal-title":"EFORT Open Rev."},{"issue":"7","key":"bib7-20240731","first-page":"1406","article-title":"Is the pain medicine community reluctant to discuss limb amputation in patients with intractable complex regional pain syndrome?","volume":"18","author":"Midbari","year":"2017","journal-title":"Pain Med."},{"issue":"3","key":"bib8-20240731","doi-asserted-by":"crossref","first-page":"e0043","DOI":"10.2106\/JBJS.RVW.19.00043","article-title":"Osseointegration for amputees: current implants, techniques, and future directions","volume":"8","author":"Hoellwarth","year":"2020","journal-title":"JBJS Rev."},{"issue":"3","key":"bib9-20240731","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/ALN.0b013e3181e3db38","article-title":"An update on the pathophysiology of complex regional pain syndrome","volume":"113","author":"Bruehl","year":"2010","journal-title":"Anesthesiology."},{"issue":"7","key":"bib10-20240731","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S1474-4422(11)70106-5","article-title":"Clinical features and pathophysiology of complex regional pain syndrome","volume":"10","author":"Marinus","year":"2011","journal-title":"Lancet Neurol."},{"issue":"6","key":"bib11-20240731","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1111\/aas.12489","article-title":"Complex regional pain syndrome type I: a comprehensive review","volume":"59","author":"Bussa","year":"2015","journal-title":"Acta Anaesthesiol Scand."},{"issue":"6","key":"bib12-20240731","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1097\/j.pain.0000000000001520","article-title":"Compared to limb pain of other origin, ultrasonographic osteodensitometry reveals loss of bone density in complex regional pain syndrome","volume":"160","author":"Bazika-Gerasch","year":"2019","journal-title":"Pain."},{"key":"bib13-20240731","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3389\/fnins.2018.00207","article-title":"Selective fiber degeneration in the peripheral nerve of a patient with severe complex regional pain syndrome","volume":"12","author":"Yvon","year":"2018","journal-title":"Front Neurosci."},{"issue":"3","key":"bib14-20240731","doi-asserted-by":"crossref","first-page":"e0213589","DOI":"10.1371\/journal.pone.0213589","article-title":"Psychosocial factors associated with poor outcomes after amputation for complex regional pain syndrome type-I","volume":"14","author":"Schrier","year":"2019","journal-title":"PLoS One."},{"issue":"19","key":"bib15-20240731","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.2106\/JBJS.J.01329","article-title":"Therapy-resistant complex regional pain syndrome type I: to amputate or not?","volume":"93","author":"Bodde","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib16-20240731","doi-asserted-by":"crossref","first-page":"930","DOI":"10.2106\/JBJS.M.00788","article-title":"Informed decision-making regarding amputation for complex regional pain syndrome type I","volume":"96","author":"Bodde","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib17-20240731","doi-asserted-by":"crossref","first-page":"838","DOI":"10.3109\/09638288.2013.822023","article-title":"Resilience in patients with amputation because of complex regional pain syndrome type I","volume":"36","author":"Bodde","year":"2014","journal-title":"Disabil Rehabil."},{"issue":"3-4","key":"bib18-20240731","doi-asserted-by":"crossref","first-page":"253","DOI":"10.3109\/17453674808988945","article-title":"Remarks on the prognosis of the posttraumatic dystrophy of the extremities","volume":"17","author":"Kler","year":"1948","journal-title":"Acta Orthop Scand."},{"key":"bib19-20240731","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.mehy.2018.08.026","article-title":"Decision making process for amputation in case of therapy resistant complex regional pain syndrome type-I in a Dutch specialist centre","volume":"121","author":"Schrier","year":"2018","journal-title":"Med Hypotheses."},{"issue":"4","key":"bib20-20240731","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1302\/0301-620X.98B4.36422","article-title":"Amputation in patients with complex regional pain syndrome: a comparative study between amputees and non-amputees with intractable disease","volume":"98-B","author":"Midbari","year":"2016","journal-title":"Bone Joint J."},{"issue":"22","key":"bib21-20240731","doi-asserted-by":"crossref","first-page":"e977","DOI":"10.5435\/JAAOS-D-19-00016","article-title":"Orthopaedic osseointegration: state of the art","volume":"27","author":"Zaid","year":"2019","journal-title":"J Am Acad Orthop Surg."},{"issue":"2","key":"bib22-20240731","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.gaitpost.2010.11.004","article-title":"Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses","volume":"33","author":"Tranberg","year":"2011","journal-title":"Gait Posture."},{"issue":"1","key":"bib23-20240731","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/JPO.0b013e3181ccc53d","article-title":"Functional outcome of transfemoral amputees fitted with an osseointegrated fixation: temporal gait characteristics","volume":"22","author":"Frossard","year":"2010","journal-title":"J Prosthet Orthot."},{"issue":"4","key":"bib24-20240731","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1682\/JRRD.2011.10.0204","article-title":"Muscle activity during stance phase of walking: comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers","volume":"50","author":"Pantall","year":"2013","journal-title":"J Rehabil Res Dev."},{"issue":"13","key":"bib25-20240731","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1002\/bjs.11005","article-title":"Systematic review of the safety and efficacy of osseointegration prosthesis after limb amputation","volume":"105","author":"Kunutsor","year":"2018","journal-title":"Br J Surg."},{"issue":"10","key":"bib26-20240731","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.2106\/JBJS.RVW.17.00037","article-title":"Osseointegration for lower-limb amputation: a systematic review of clinical outcomes","volume":"5","author":"Hebert","year":"2017","journal-title":"JBJS Rev."},{"issue":"2","key":"bib27-20240731","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1302\/0301-620X.102B2.BJJ-2019-0697.R2","article-title":"Periprosthetic osseointegration fractures are infrequent and management is familiar","volume":"102-B","author":"Hoellwarth","year":"2020","journal-title":"Bone Joint J."},{"issue":"11","key":"bib28-20240731","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":"7","key":"bib29-20240731","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1007\/s10439-010-9966-9","article-title":"A comparative finite-element analysis of bone failure and load transfer of osseointegrated prostheses fixations","volume":"38","author":"Tomaszewski","year":"2010","journal-title":"Ann Biomed Eng."},{"key":"bib30-20240731","first-page":"4060","article-title":"Stress analysis of osseointegrated transfemoral prosthesis: a finite element model","volume":"2005","author":"Zhang","year":"2005","journal-title":"Conf Proc IEEE Eng Med Biol Soc."},{"issue":"10","key":"bib31-20240731","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.clinbiomech.2008.06.012","article-title":"FE stress analysis of the interface between the bone and an osseointegrated implant for amputees--implications to refine the rehabilitation program","volume":"23","author":"Lee","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)."},{"issue":"6","key":"bib32-20240731","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1002\/jor.23376","article-title":"Periprosthetic cortical bone remodeling in patients with an osseointegrated leg prosthesis","volume":"35","author":"Haket","year":"2017","journal-title":"J Orthop Res."},{"key":"bib33-20240731","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jmbbm.2012.06.015","article-title":"Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses","volume":"15","author":"Tomaszewski","year":"2012","journal-title":"J Mech Behav Biomed Mater."},{"issue":"8","key":"bib34-20240731","doi-asserted-by":"crossref","first-page":"e303","DOI":"10.1097\/BOT.0000000000001488","article-title":"Radiographic evaluation of bone remodeling around osseointegration implants among transfemoral amputees","volume":"33","author":"Thomson","year":"2019","journal-title":"J Orthop Trauma."},{"issue":"12","key":"bib35-20240731","doi-asserted-by":"crossref","first-page":"2524","DOI":"10.1002\/jor.24445","article-title":"Proximal bone remodeling in lower limb amputees reconstructed with an osseointegrated prosthesis","volume":"37","author":"Thomson","year":"2019","journal-title":"J Orthop Res."},{"issue":"6","key":"bib36-20240731","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."},{"key":"bib37-20240731","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13018-016-0348-3","article-title":"Osseointegrated total hip replacement connected to a lower limb prosthesis: a proof-of-concept study with three cases","volume":"11","author":"Khemka","year":"2016","journal-title":"J Orthop Surg Res."},{"issue":"10","key":"bib38-20240731","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/j.apmr.2017.08.025","article-title":"Osseointegrated implants in patients with diabetes mellitus: a case series","volume":"98","author":"Jawazneh","year":"2017","journal-title":"Arch Phys Med Rehabil."},{"issue":"18","key":"bib39-20240731","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.2106\/JBJS.16.01295","article-title":"Osseointegrated transtibial implants in patients with peripheral vascular disease: a multicenter case series of 5 patients with 1-year follow-up","volume":"99","author":"Atallah","year":"2017","journal-title":"J Bone Joint Surg Am."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.20.00267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:23Z","timestamp":1787751863000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.20.00267"}},"subtitle":["A Report of 3 Cases"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.20.00267","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}