Article

Integral-Leg-Prosthesis (ILP) is a comparatively new attachment system that
allows direct skeletal docking of artificial limbs. Between January 1999 and
December 2013, 69 patients with transfemoral amputation were fitted with ILPs by
a single German surgeon. Device design iterations and surgical techniques evolved
during these years. For the purposes of comparison,
patients receiving the first
two designs and procedure iterations were placed in group 1 and the patients
fitted with the final design were placed in group 2. Infection rate and planned
and unplanned surgical interventions were statistically compared using Fisher
exact test. Data demonstrated that the high rate of stoma-associated infections
seen in group 1 was dramatically reduced in group 2. Of the 39 patients with 42
implants in group 2, none had operative interventions secondary to infection. All
group 2 patients remained infection-free without the use of antibiotics by
following a simple but defined wound-hygiene protocol.
We concluded that the
final iteration of the osseointegrated intramedullary device with a low energy
surface at the soft tissue and prosthesis interface allowed a biologically stable
skin stoma that remained infection-free without chronic use of antibiotics. The
reduction in the infection rate was attributed to the clinically based,
empirically driven changes in design and surgical techniques.

Langue : ANGLAIS