We understand the struggle of living with chronic pain. Many of our patients come to us because they’ve exhausted standard treatment options. This is certainly true for people living with Complex Regional Pain Syndrome.
If you’ve not heard of Complex Regional Pain Syndrome, commonly referred to by the acronym, CRPS, then don’t feel too bad. Though estimates vary, studies suggest that it affects around 1 in every 20,000 people, and so is extremely rare.
It tends to affect the legs, and causes severe pain that normally doesn’t respond to even the strongest pain medication, as well as changes to the temperature, colour and size of the affected limb. It often develops following minor injury, and can spread from the injury site to other parts of the leg.
Medical consensus has tended to avoid amputation as a therapeutic option for CRPS patients. This is due to the perceived risk of recurrence after surgery, which could negatively impact the patient’s ability to wear a traditional socket prosthetic. Over the last decade, however, Prof. Munjed Al Muderis has pioneered the use of surgical therapies for people living with CRPS.
Amputation may seem dramatic, but where patients are unable to benefit from other forms of therapy, it provides hope of being able to return to normal life. Once amputated, osseointegration can allow normal movement again.
Although the number of people with CRPS undergoing amputation and osseointegration remains relatively low, their outcomes have been hugely important. In fact, research published by the Osseointegration Group team has shown that this approach can be beneficial for those with CRPS Type 1, who have failed to respond to conventional treatment.[1]
In this case, amputation and osseointegration was performed simultaneously, alongside Targeted Muscle Reinnervation (TMR) which, like Reinnervated Peripheral Nerve Interfaces (RPNI) reduces the risk of post-operative neuropathic pain. Following rehabilitation, the patient was able to return to walking normally, without pain.
If you have been diagnosed with CRPS, and are interested in hearing more about osseointegration, get in touch.
References:
[1] Hoellwarth, J.S., Tetsworth, K., Al Muderis, M. (2024). Simultaneous Transfemoral Amputation and Press-Fit Osseointegration for the Patient with Severe Complex Regional Pain Syndrome. In: Rozbruch, S.R., Hamdy, R. (eds) Limb Lengthening and Reconstruction Surgery Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-02767-8_529-1
