Abstrait

Osseointegrated, percutaneously derived implants for rehabilitation after the transfemoral amputation - via the endo-exo implant system

Marcus Oergel

Osseointegrated, percutaneously guided implants - so called endo-exo prosthetics (EEP) - have been used to a limited extent since 1999 for rehabilitation after major amputation. Meanwhile, implant survival times of more than 15 years have been achieved. The obligatory colonization of the skin penetration site of the implant does not necessarily lead to an intramedullary, periprosthetic infection. This circumstance can be explained by the interconnectivity ingrowth of the bone into the three-dimensionally structured implant surface. This sufficiently prevents the formation of an infection promoting connective tissue layer between bone and metal. A total of 110 EE femoral prostheses were implanted (6 x bilaterally amputated) in 104 patients between August 1999 and October 2016. The implant is produced by casting from a CoCrMo alloy coated with titanium nitride. The first step is the implantation of the intramedullary module with subsequent wound closure. After safe osseointegration of the endomodule after 6 weeks, the skin was penetrated with docking of the components receiving the exoprosthetics in a second surgical step