Cargando…

Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review

BACKGROUND: This study aimed to provide an overview of device-related complications occurring in individuals with an upper or lower extremity amputation treated with a screw, press-fit or other type of bone-anchored implant as well as interventions related to these complications. METHOD: A systemati...

Descripción completa

Detalles Bibliográficos
Autores principales: Atallah, Robin, Leijendekkers, Ruud A., Hoogeboom, Thomas J., Frölke, Jan Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084937/
https://www.ncbi.nlm.nih.gov/pubmed/30092081
http://dx.doi.org/10.1371/journal.pone.0201821
_version_ 1783346253301547008
author Atallah, Robin
Leijendekkers, Ruud A.
Hoogeboom, Thomas J.
Frölke, Jan Paul
author_facet Atallah, Robin
Leijendekkers, Ruud A.
Hoogeboom, Thomas J.
Frölke, Jan Paul
author_sort Atallah, Robin
collection PubMed
description BACKGROUND: This study aimed to provide an overview of device-related complications occurring in individuals with an upper or lower extremity amputation treated with a screw, press-fit or other type of bone-anchored implant as well as interventions related to these complications. METHOD: A systematic literature search was conducted in the MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science databases. The included studies reported on device-related complications and interventions occurring in individuals with bone-anchored prostheses. The outcomes evaluated were death, infection, bone/device breakage, implant loosening, soft tissue complications, systemic events, antibiotic and surgical treatment. Subgroup analyses were performed for the following groups: a) implant type (screw, press-fit and other types of implants) and b) level of amputation (transfemoral, transtibial and upper extremity amputation). RESULTS: Of 309 studies, 12 cohort studies were eligible for inclusion, all of which had methodological shortcomings and 12 studies were excluded due to complete overlap of patient data. Implant infection were rare in certain transfemoral implants (screw: 2–11%, press-fit: 0–3%, Compress: 0%) but common in transtibial implants (29%). The same was observed for implant loosening, in transfemoral (screw: 6%, press-fit: 0–3%, Compress: 0%), transtibial implants (29%) as well as for upper extremity implants (13–23%). Intramedullary device breakage were rare in transfemoral implants (screw: 0%, press-fit: 1%, Compress: unknown) but frequent in individuals with transradial implants (27%) and absent in transtibial implants. Soft tissue infections and complications were common and underreported in most articles. CONCLUSIONS: Major complications (e.g. implant infection, implant loosening and intramedullary device breakage) are rare in transfemoral bone-anchored prosthesis and seem to occur less frequently in individuals with press-fit implants. Minor complications, such as soft tissue infections and complications, are common but are substantially influenced by the learning curve, implant design and surgical technique. Data for patients treated with a transtibial, upper extremity or Compress implant are underreported, precluding definitive conclusions. There is a need for either an international database to report on or a standard core set of complications as well as the need to follow classification systems that result in unequivocal data.
format Online
Article
Text
id pubmed-6084937
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-60849372018-08-18 Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review Atallah, Robin Leijendekkers, Ruud A. Hoogeboom, Thomas J. Frölke, Jan Paul PLoS One Research Article BACKGROUND: This study aimed to provide an overview of device-related complications occurring in individuals with an upper or lower extremity amputation treated with a screw, press-fit or other type of bone-anchored implant as well as interventions related to these complications. METHOD: A systematic literature search was conducted in the MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science databases. The included studies reported on device-related complications and interventions occurring in individuals with bone-anchored prostheses. The outcomes evaluated were death, infection, bone/device breakage, implant loosening, soft tissue complications, systemic events, antibiotic and surgical treatment. Subgroup analyses were performed for the following groups: a) implant type (screw, press-fit and other types of implants) and b) level of amputation (transfemoral, transtibial and upper extremity amputation). RESULTS: Of 309 studies, 12 cohort studies were eligible for inclusion, all of which had methodological shortcomings and 12 studies were excluded due to complete overlap of patient data. Implant infection were rare in certain transfemoral implants (screw: 2–11%, press-fit: 0–3%, Compress: 0%) but common in transtibial implants (29%). The same was observed for implant loosening, in transfemoral (screw: 6%, press-fit: 0–3%, Compress: 0%), transtibial implants (29%) as well as for upper extremity implants (13–23%). Intramedullary device breakage were rare in transfemoral implants (screw: 0%, press-fit: 1%, Compress: unknown) but frequent in individuals with transradial implants (27%) and absent in transtibial implants. Soft tissue infections and complications were common and underreported in most articles. CONCLUSIONS: Major complications (e.g. implant infection, implant loosening and intramedullary device breakage) are rare in transfemoral bone-anchored prosthesis and seem to occur less frequently in individuals with press-fit implants. Minor complications, such as soft tissue infections and complications, are common but are substantially influenced by the learning curve, implant design and surgical technique. Data for patients treated with a transtibial, upper extremity or Compress implant are underreported, precluding definitive conclusions. There is a need for either an international database to report on or a standard core set of complications as well as the need to follow classification systems that result in unequivocal data. Public Library of Science 2018-08-09 /pmc/articles/PMC6084937/ /pubmed/30092081 http://dx.doi.org/10.1371/journal.pone.0201821 Text en © 2018 Atallah et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Atallah, Robin
Leijendekkers, Ruud A.
Hoogeboom, Thomas J.
Frölke, Jan Paul
Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title_full Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title_fullStr Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title_full_unstemmed Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title_short Complications of bone-anchored prostheses for individuals with an extremity amputation: A systematic review
title_sort complications of bone-anchored prostheses for individuals with an extremity amputation: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084937/
https://www.ncbi.nlm.nih.gov/pubmed/30092081
http://dx.doi.org/10.1371/journal.pone.0201821
work_keys_str_mv AT atallahrobin complicationsofboneanchoredprosthesesforindividualswithanextremityamputationasystematicreview
AT leijendekkersruuda complicationsofboneanchoredprosthesesforindividualswithanextremityamputationasystematicreview
AT hoogeboomthomasj complicationsofboneanchoredprosthesesforindividualswithanextremityamputationasystematicreview
AT frolkejanpaul complicationsofboneanchoredprosthesesforindividualswithanextremityamputationasystematicreview