Osseointegrated prostheses for the rehabilitation of amputees (OPRA): results and clinical perspective

ABSTRACT

Introduction: Patients who undergo extremity amputation have historically used socket prosthetics to ambulate and perform daily functions; however, these prosthetics can be limited by poor terminal control and wear issues. In patients who have difficulty wearing their prostheses or with upper extremity amputations, osseointegrated implants may offer better function and quality of life. The Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA) was the first such device to become commercially available. Clinical trials have demonstrated benefit in patient gait, prosthetic use, and overall well-being, and new implants may be applied for various amputation levels.

Areas covered: The OPRA, the most studied osseointegrated prosthetic stem, is reviewed, presenting indications, surgical procedure, complications, and results of clinical studies.

Expert commentary: Osseointegration for amputees is an expanding field that has the potential to enhance rehabilitative potential. The OPRA implant is an effective device with a long life-span and low complication profile.

KEYWORDS:

• Amputation
• Osseointegration
• Prosthesis
• Rehabilitation
• Trauma
• Tumor
• OPRA

Article Highlights

• The OPRA system was the first osseointegration implant introduced and the only one that has currently achieved FDA approval

• The OPRA is currently only indicated for traumatic or oncologic transfemoral amputations

• Off-label or experimental applications include transtibial, transhumeral, transradial, and thumb/digit amputations

• The OPRA osseointegration procedure permits the use of a prosthesis in patients who could not otherwise and permits direct osseous control of the terminal device, improving function and proprioceptive feedback

• Device improvements including interface materials, electronic communication, and decreased procedures may improve costs, complications, and patient function and satisfaction

• Compared to socket-type prostheses, the OPRA system results in improved gait parameters, increased prosthetic wear, and improved limb-specific and quality of life scores

Declaration of interest

JA Forsberg is an unpaid consultant for Zimmer-Biomet and a paid consultant for the Solsidan Group. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Information Resources

Additional information about this device can be found at the following websites, which are sponsored by the product company:

http://www.opraosseointegration.com

https://integrum.se

Reviewer disclosures

One peer review is associated with the company manufacturing the OPRA system and was involved in the development of the OPRA system. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.