>> Hi, my name is Dr. Rozbruch and I'm the Director of the Limb Salvage
and Amputation Reconstruction Center at Hospital for Special Surgery.
I'm going to spend a few minutes with you today showing you a case
of osseointegration amputation reconstruction surgery and we'll focus on a particular patient,
Randy, to help illustrate the details of this surgery and the immense advantages.
Amputation reconstruction using osseointegration is an exciting new technology where bone--
where the prosthesis is actually anchored into the bone.
And that changes the whole way that amputation reconstruction is done.
There's a direct skeletal connection between the prosthetic leg and the patient's bone.
Well, it turns out that bone anchored prosthesis had better outcomes
and function than sockets in many studies.
And despite their concern about infection, it turns out that severe infections
in implant loosening is actually quite rare.
The advantages of osseointegration come down to that there are no socket issues.
It allows you to get rid of the socket.
Socket as people who have sockets know often lead
to problems including pressure sores, poor fit and pinching.
And this is particularly true when the residual limb doesn't fit well into the socket.
With osseointegration, there's improved control of the prosthetic leg
with improved energy transfer by the direct skeletal connection.
Patients report that there's improved proprioception
and this is all especially helpful with short and wide residual leg.
Here's an example of Randy and the direct skeletal connection of the prosthetic leg.
The blue arrow shows the implant in the femur.
You've got a front view and a side view.
And then you have an actual picture of the implant as well.
The bone grows into the implant, hence the name osseointegration.
The dual cone is illustrated by the red arrow on the front view, the side view
and the actual photograph of the implant.
And that is the connection between the implant in the bone and the outside world
that allows the prosthetic leg to get connected via an adaptor.
And in this particular picture, there's just a gauze wrapped around the dual cone,
which we usually use for the first few weeks after surgery to collect any minor drainage,
but eventually that gets eliminated.
This is a picture of Randy on the day that he got his leg connected
and we typically will use a loading protocol where we gradually increase the amount
of weight and the duration of loading.
We have a great team at Hospital for Special Surgery
that are handling osseointegration amputation reconstruction,
including dedicated physical therapists and prosthetic and orthotist.
>> That's what I do.
>> One of the main advantages of osseointegration is the improved energy transfer
between the bone and the prosthetic leg.
And that's illustrated in Randy doing some of these exercises.
These were pictures taken just two weeks after the leg was connected.
We've been collaborating with Dr. Al Muderis from osseointernational in Sydney, Australia.
And in fact, the implant that you see is an example of the osseointernational implant.
The process for making this implant is very precise.
It starts with an X-ray.
It's followed by a CT scan where the custom-made implant is size to the patient's bone.
And from that, a very specific custom-made implant is created
that fits directly into the patient bone.
I want to thank you for your attention.
I hope that this has been informative and I've been please
to share this exciting new technology
of osseointegration amputation reconstruction surgery.