Key Articles on Osseointegration Prostheses (2015–2025)
Ten-Year Follow-Up Study (Hagberg et al., 2023):
This prospective cohort study evaluated the 10-year clinical outcomes of knee-level amputees treated with the OPRA implant system between 1999 and 2007, including 51 patients. At the end of ten years, patients showed significant improvements in prosthesis usage, mobility, and physical function scores compared to preoperative levels, with no deterioration in any parameter. The implant survival rate without revision at year ten was 83%, deep infection-free rate was 65%, and serious mechanical complication-free rate was 17%, noting that mechanical issues tended to increase in the late period.
Fifteen-Year Experience Analysis (Juhnke et al., 2015):
This retrospective study analyzed 69 patients treated with leg prostheses using the ILP (Integral-Leg-Prosthesis) method, focusing on the effects of implant design improvements. Early designs had higher infection rates at the stoma site, while the latest design treated 39 patients with no additional surgery due to infection. A simple wound hygiene protocol protected patients from chronic antibiotic use, and design improvements significantly reduced associated risks.
Systematic Review of Clinical Outcomes (van Eck & McGough, 2015):
Covering literature from 1946 to 2014 and including 540 patients, this review showed that 82–90% of patients using osseointegrated prostheses wore their prostheses daily, and 95% were satisfied with the results. While quality of life scores were satisfactory, complication rates were high: skin problems 30–54%, superficial infections 28–55%, and deep implant infections 2–41%. Overall, these prostheses increased satisfaction but required frequent intervention for skin-related issues.
Safety and Efficacy Review (Kunutsor et al., 2018):
This review of 22 studies reported significant improvements in walking ability, mobility, and quality of life compared to the socket prosthesis period. Infection rates varied widely (1–77%), but most cases involved superficial tissue infections treatable with antibiotics. No cases of additional amputation or mortality were reported due to the procedure.
Clinical Outcome Measures Review (Al Muderis et al., 2018):
Analyzing 21 observational studies, this review concluded that osseointegrated prostheses provide clinical outcomes comparable to or exceeding traditional socket prostheses in most areas. Osseointegration is a promising alternative, but higher-quality, long-term studies are needed to establish it as a standard of care.
Multicenter Safety Study (Al Muderis et al., 2016):
Conducted in Australia and the Netherlands with 86 patients, this study found that 36% of patients experienced no complications, while 34% had only minor superficial infections. Severe bone infections were very rare; the most common issues were tissue overgrowth at the stoma and mechanical fractures of prosthetic connectors. The overall safety profile was deemed acceptable.
One-Year Follow-Up and Performance (Atallah et al., 2020):
In this prospective study of 90 patients, one year after surgery, prosthesis usage time and global health scores increased significantly. Only one patient experienced implant loss due to deep bone infection, while superficial infections were controlled with appropriate treatments. The method significantly improved physical quality of life in a short period.
Quality of Life Comparison and Meta-Analysis (Tan et al., 2025):
This recent meta-analysis comparing bone-anchored prostheses with socket prostheses found that osseointegration significantly improved quality of life and physical mobility (6-Minute Walk Test). No differences were found between screw-type (OPRA) and press-fit (ILP/OPL) implants in terms of quality of life gains. The method shows potential as a primary treatment option for patients unable to use socket prostheses.