Bone-Anchored Prostheses for Transtibial Amputation: A Systematic Review of Outcomes, Complications, and Cost-Effectiveness.
Mayank Rehani, Diana Zidarov, Natalie Habra et al.
✦ AI-curated · Sources linked
In 30 seconds
This PRISMA-guided systematic review assessed clinical outcomes, complications, and cost-effectiveness of transtibial osseointegration in adults with transtibial amputation. Nineteen studies involving 102 individuals met inclusion criteria; most evaluated press-fit fixation and had 1-3 years of follow-up. Reported outcomes suggested improvements in health-related quality of life, mobility, and prosthesis use. Superficial infection was the most common adverse event, while serious complications such as loosening with implant loss were less common. The evidence base was limited, including only one cost-effectiveness study.
Key findings
- The review included 19 studies involving 102 individuals; most studies had 1-3 years of follow-up.
- Studies reported improved health-related quality of life, mobility, and prosthesis use after osseointegration.
- Superficial infection was the most common adverse event and was generally managed with oral antibiotics.
- No periprosthetic fractures or implant breakages were reported; one cost-effectiveness study used estimated utilities and limited costs.
Why it matters
For people unable to tolerate socket prostheses, osseointegration may offer functional and quality-of-life benefits. These potential gains must be considered alongside infection risk and the possibility of serious complications. The small evidence base and short follow-up in most studies mean that current findings provide an incomplete basis for judging longer-term outcomes or economic value.
What to keep in mind
Evidence came from only 19 studies involving 102 individuals, with most studies reporting 1-3 years of follow-up. The single cost-effectiveness analysis used estimated utilities and limited costs; no qualitative studies were identified.