Osseointegration Europe

A pre-surgical assessment is critical to ensure the patient’s safety, satisfaction and the procedure’s success. Years of experience in looking after patients with amputations and their specific needs have let us develop algorithms enabling us to verify whether the osseointegration procedure is a suitable solution for each patient.

This assessment also helps us decide about other medical procedures necessary to optimise your general condition before the osseointegration surgery.
At the Paley European Institute you will be assessed primarily by a team of orthopaedic surgeons and, depending on your needs, you may be consulted by a physiotherapist, a prosthetist, a clinical psychologist or our pain management team and an anaesthetist. You may also be referred to an internal medicine specialist or surgeon (a vascular surgeon, for example) if needed.

We will answer all your questions and connect you with other osseointegration patients for experience exchange and peer support. For some patients, it is important that during the first visits, they are accompanied by a family member or friend, who will support them through the assessment and decision-making process.

After the orthopaedic clinical examination, the PEI Team will assess your X-rays, CT scans and any other relevant imaging. We will be able to thoroughly plan for your surgery, including the plan for your soft tissues (scars, ulcerations, abundant skin etc), bone length and implant size, to maximize the prosthetic stability and allow for early rehabilitation.

Thanks to the meticulous pre-surgical assessment and planning, the surgery does not take longer than necessary and there is a very low risk of unplanned intraoperative events. Our team will meet you before the operation to go through the surgical plan again and to answer your questions.

The surgery is usually performed under general anaesthesia, and additional regional blocks may be used for better pain control after the operation.  

1. First, the soft tissues are prepared to create the best functional and aesthetic stump.
2. Then the bone is prepared to accommodate the planned implant.
3. Further, the implant is carefully fitted inside the bone and checked for stability.
4. Finally, the procedure is completed by closing the muscles and skin and creating a circular opening (stoma), allowing the tip of the implant to come through the skin.

You will remain an inpatient at the hospital for several days to make sure you are comfortable, your pain is well controlled, and you begin to mobilize. You will start rehabilitation and the protocol will be adjusted to your abilities and intraoperative findings.

You will be discharged from the hospital only after gaining sufficient independence.

Finally, you will start a fully personalised outpatient physiotherapy and follow-up visits, to check the healing of your soft tissues and bone, and to assess the progress

The rehabilitation protocol is performed in 3 stages. In the most common situation, you will undergo:

Weeks 1-2: Initial loading – you can start loading the implant on the first day after surgery, with maximum of 5kg. Every day you can increase the loading by 5kg. Initial loading is completed when the target of is 50kg or half the patient’s body weight is achieved. 

Weeks 3-6: Fitting of a light training prosthesis and the start of gait training exercises.  

Weeks 7-14: Fitting of the definitive prosthesis, continuation of gait training exercises and mobilisation with crutches. 

If you return to your home country prior to completing the 3 months of prescribed rehabilitation, we will provide your physio team and your surgeon in your home country with all instructions. You will be expected to attend periodic follow-up visits either in person or via Telehealth. Also, the prosthetic components will need to be checked by your local prosthetist twice a year. Some of the external components of the Osseointegration implant will need replacing due to regular use and material wearing out.