Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

Laurent Frossard; Stefan Laux; Marta Geada; Peter Paul Heym; Knut Lechler

doi:10.1016/j.clinbiomech.2021.105457

Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

Clin Biomech (Bristol, Avon). 2021 Oct:89:105457. doi: 10.1016/j.clinbiomech.2021.105457. Epub 2021 Aug 24.

Authors

Laurent Frossard¹, Stefan Laux², Marta Geada², Peter Paul Heym³, Knut Lechler⁴

Affiliations

¹ YourResearchProject Pty Ltd, PO Box 143, Red Hill, QLD 4059, Australia; Griffith University, 1 Parklands Dr, Southport, QLD 4215, Australia; University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia; Queensland University of Technology, 2 George St, Brisbane, City, QLD, 4000, Australia. Electronic address: laurentfrossard@outlook.com.
² APC Prosthetics Pty Ltd, Suite 1, 170-180 Bourke Rd, Alexandria, NSW 2015, Australia.
³ Sum of Squares - Statistical Consulting, Essener Str. 100, 04357 Leipzig, Germany.
⁴ ÖSSUR, R&D, Medical Office, Grjothals 1-5, Reykjavik, Iceland.

PMID: 34454327
DOI: 10.1016/j.clinbiomech.2021.105457

Abstract

Background: This study presented the load profile applied on transfemoral osseointegrated implants by bone-anchored prostheses fitted with state-of-the-art ÖSSUR microprocessor-controlled Rheo Knee XC and energy-storing-and-returning Pro-Flex XC or LP feet during five standardized daily activities.

Methods: This cross-sectional cohort study included 13 participants fitted with a press-fit transfemoral osseointegrated implant. Loading data were directly measured with the tri-axial transducer of an iPecsLab (RTC Electronics, USA) fitted between the implant and knee unit. The loading profile was characterized by spatio-temporal gaits variables, magnitude of loading boundaries as well as onset and magnitude of loading extrema during walking, ascending and descending ramp and stairs.

Findings: A total of 2127 steps was analysed. The cadence ranged between 36 ± 7 and 47 ± 6 strides/min. The absolute maximum force and moments applied across all activities was 1322 N, 388 N and 133 N as well as 22 Nm, 52 Nm and 88 Nm on and around the long, anteroposterior and mediolateral axes of the implant, respectively.

Interpretation: This study provided new benchmark loading data applied by transfemoral bone-anchored prostheses fitted with selected ÖSSUR state-of-the-art components. Outcomes suggested that such prostheses can generate relevant loads at the interface with the osseointegrated implant to restore ambulation effectively. This study is a worthwhile contribution toward a systematic recording, analysis, and reporting of ecological prosthetic loading profiles as well as closing the evidence gaps between prescription and biomechanical benefits of state-of-the-art components. Hopefully, this will contribute to improve outcomes for growing number of individuals with limb loss opting for bionic solutions.

Keywords: Amputation; Artificial limbs; Bionics; Bone-anchored prosthesis; Kinetics; Loading; Prosthesis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Amputation, Surgical
Amputees*
Artificial Limbs*
Bone-Anchored Prosthesis*
Cross-Sectional Studies
Humans
Osseointegration