Transcutaneous osseointegration after limb amputation. A review over 27 years

Intramedullary, bone-anchored (osseointegrated), transcutaneous docking of artificial limbs has been in clinical use for more than 25 years. This system of prosthetic limb attachment is a valuable treatment option in the rehabilitation of patients after limb amputation. Only a few centers are systematically investigating this topic worldwide so that current knowledge on this special treatment option is still limited; however, mainstream medical opinion still regards percutaneous skeletal prosthetic docking with some skepticism. Concerns remain about possible ascending infections along the skin perforating device and this has indeed been a limiting factor in the widespread implementation of this technology and has also been rejected by many orthopedic surgeons. There are also reservations among institutions responsible for exoprosthetic treatment. Ultimately, the advantages and disadvantages of this treatment procedure must be explained in detail to the patients themselves in order to reduce fears and concerns and to be able to bring the overstretched expectations back to reality.