ISPO UK ASM 2023 - Free Paper Abstracts

A review of physical improvements and quality of life in veterans, following osseointegration surgery and rehabilitation, at DMRC Stanford Hall

 

Presenter:  Mark Thoburn, Clinical Lead Prosthetist, Blatchford Ltd/Ministry of Defence, UK

E-mail:  mark.thoburn@blatchford.co.uk

Other authors@  S Geeson, S Kendall, E Lawson, D Roscoe, A Scott

 

The Aim of this project was to assess self-reported improvements in physical function and quality of life post Osseointegration (OI) surgery for transfemoral amputee veterans.

Methods:
Eight male veterans with unilateral or bilateral transfemoral amputations underwent OI surgery at the Royal Orthopaedic Hospital in Birmingham, and transferred to DMRC Stanford Hall for rehabilitation. Their rehabilitation programme was implemented by physiotherapists and prosthetists working as an interdisciplinary team, and closely followed the Osseointegration Group of Australia's Accelerated Protocol (1). This allows progressive weight bearing, aiming for full weight bearing at 12 weeks post operatively.

Patient reported outcome measures including the Prosthetic Evaluation Questionnaire (PEQ), Reintegration to Normal Living Index (RNLI) and percentage wheelchair usage, were captured pre-operatively and at the end of their rehabilitation. Subjective feedback was obtained via qualitative focus groups using a structured interview approach.

Results:
Patients report 0% wheelchair use following OI. RNLI scores pre surgery averaged 78 (range 64-100) and end of rehab averaged 95 (range 83-100). All 9 functional domain scales in the PEQ showed improvement in prosthesis-related quality of life: Ambulation pre surgery averaged 38 (range 1.9-88) and end of rehab averaged 86 (range 45.5-100). Wellbeing pre surgery averaged 50 (range 14-63.5) and end of rehab averaged 97 (range 91.5-100).

The focus groups identified increased mobility and improved participation in family life as the key improvements post-surgery. Five of the six patients interviewed stated that OI ‘changed their life for the better’.

Conclusions:
These results demonstrate that OI surgery, when supported by a robust package of rehabilitation, can significantly improve quality of life and physical outcomes in transfemoral amputees and change their lives for the better.

Reference:
 1. Al Muderis, M et al 2016. The Osseointegration Group of Australian Accelerated Protocol (OGAAP-1) for two-stage osseointegrated reconstruction of amputated limbs.