March 27, 2020

What to expect before Osseointegration surgery?

Written by Dr Matija Krkovic

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After an initial consultation with Mr Matija Krkovic, patients who qualify for the osseointegration procedure will be referred to The London Prosthetic clinic and Pace Rehabilitation for further assessment of their condition and needs. If physiotherapy assessment confirms suitability for the osseointegration, functional tests results will be collected using the following tests:

  1. 6 min walking test
  2. Timed up and go test
  3. Amputee mobility predictor assessment tool (AMPnoPRO and AMPPRO)
  4. Duration of Suction Socket Suspension system use per week.

The current prosthetic situation for each patient will be reviewed and advice provided before the operation.  It is important to note that following privately funded osseointegration surgery, amputees may not be able to continue receiving certain NHS prosthetic services. There may be a need for privately funded prosthetic components to be purchased.

Before surgery, all potential patients will be reviewed by a Clinical Psychologist, Dr Laura Toplis, who will undertake a psychological review and prepare a report regarding the patient’s suitability for osseointegration.

Life quality scores will be collected:

  1. SF-36,
  2. EQ-5D-5L,
  3. Questionnaire for transfemoral amputees(Q-TFA) and
  4. Toronto Extremity Scoring System will be collected during the clinical appointments.

Thereafter, a CT scan of the stump will be taken to allow preoperative templating for the procedure. Images will be sent to Signature Orthopaedics for templating purposes. All implants will be custom made. During this appointment patients will be explained the risks associated with the procedure by Mr Krkovic, and if they are happy to consent to the procedure.

All patients will be sent for a preoperative assessment with the anaesthetic team at Addenbrooke’s hospital where they will have their procedure performed. Depending on the patient’s comorbidities further investigations may be ordered in order to ensure that each patient is fit enough to undergo surgery.

Prior to the surgery all mobile patients will be assessed in the computer assisted 3D gait analysis lab at Addenbrooke’s hospital. This is where 3D motion capture cameras, in combination with sensor-embedded walkways provides the team with the data to measure the forces applied through the patient’s leg/prosthesis during the normal walking cycles. The aim is to get an objective assessment of patient’s walking properties whilst using a socket type prosthesis. Those patients who are wheelchair bound will not be assessed preoperatively.

All patients will have the opportunity to ask any questions to Mr Matija Krkovic at any point before the osseointegration surgery.

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