A study published in the Burns journal has revealed for the first time that transcutaneous osseointegration for amputees (TOFA) surgery, a procedure that surgically implants a prosthetic anchor into the bone of amputees, can be successfully performed among individuals with burn trauma.
This research, conducted by Dr. Amanullah Haidary, Jason S. Hoellwarth, Kevin Tetsworth, Atiya Oomatia, and Professor Munjed Al Muderis, represents the first report of osseointegration surgery for burned amputees.
Traditionally, osseointegration has been considered too risky for amputees with burn injuries due to concerns about skin compatibility and potential complications. However, this study challenges that notion, demonstrating that TOFA can provide significant mobility and quality of life benefits for burn amputees.
The research team conducted a retrospective chart review of five patients with a history of burn trauma who underwent osseointegration surgery. The patients were followed up for an average of 3.8 years, during which no issues of skin compatibility or pain associated with the TOFA implant were observed. While three patients required subsequent surgical debridement, the complications were successfully managed.
One of the key findings of the study was that the rehabilitation benefits of TOFA for burn amputees are most strongly influenced by their overall medical and physical condition, rather than their specific burn injury. This suggests that judicious use of TOFA for appropriately selected burn amputees is both safe and merited.
The study also reported improvements in mobility, with a significant increase in the K-level mobility score for the patients who underwent TOFA. K-levels are a rating system used to indicate a person’s rehabilitation potential. The system is a rating from 0 through 4 and it indicates a person’s potential to use a prosthetic device. The K2+ mobility category increased from 0 out of 5 to 4 out of 5, indicating a substantial improvement in functional ability.
Dr. Haidary and his team emphasized that while complications such as infection can occur, they are familiarly managed and should not deter burn amputees from considering TOFA as a viable option for rehabilitation. The benefits in terms of improved quality of life and mobility far outweigh the potential risks.
This groundbreaking research fills a critical gap in knowledge regarding the use of TOFA for burn amputees and opens up new possibilities for improving the lives of individuals who have undergone amputations due to burn trauma. The findings provide hope for burn amputees who have struggled with traditional socket-mounted prosthetic limbs, which often result in frequent skin problems and reduced quality of life.
The implications of this study are significant, as it paves the way for a broader application of TOFA in burn amputees, offering them a more effective and comfortable alternative to traditional prosthetic devices. Further research in this area is warranted to explore the full potential of TOFA for burn amputees and refine the selection criteria for optimal patient outcomes.
Professor Munjed Al Muderis owns Osseointegration Holdings Pty Ltd (“OH”) and Osseointegration International Pty Ltd (“OI”). OI exclusively distributes the OPL implant system worldwide.
For more information, please refer to the full research article published in the Burns journal: https://www.sciencedirect.com/science/article/pii/S0305417923000347
