How does the operation take place?

operation

The implantation of the OGAP-OPL is performed in either a single surgery or in two stages depending on the patient's existing conditions and suitability.

As no two osseointegration patients are identical, the surgical process will vary slightly from patient to patient depending on their condition and needs.

In saying that, the first stage will generally involve:

The soft tissue is managed and redundant skin and soft tissue fat is removed in order to minimise the bone to skin distance. This leads to a reduced chance of complications. The muscle groups are rearranged to serve a functional purpose in operating the leg and the soft tissue facial layer is reorganised around the stem.

  • The bone residuum is reshaped and any bone spurs are removed.
  • The bone canal is prepared using a specialised instrument. The internal component of the implant is press fitted into the bone canal securing early stability and future bone ingrowth.
  • If there is a neuroma causing nerve pain the nerves involved will be addressed surgically by excision of the painful neuroma and deep positioning of the residual nerve into the muscle group to minimise future nerve issues.
  • The stump is refashioned in a cosmetic manner and the wound is closed in layers.
  • A period of six to eight weeks takes place after the first stage to allow for osseointegration. This is then followed by the second stage.

Involved in the second stage is:

  • The creation of a circular skin opening (the stoma) at the base of the stump. Through this opening the dual cone adaptor is connected to the internal stem, which is already integrated in the bone. The remaining components of the prosthesis can then be attached externally.

If the surgery is performed in a single stage, all of the above will take place during the one procedure.

Partial weight-bearing and the fitting of the lower prosthesis can take place as early as a few days after the second surgery. This is done under careful supervision of the team. It is now that the rehabilitation stage and gait training can begin.


Care

Care should be paid to the opening (stoma) through which the external adaptor passes out of the stump. There will be a small amount of discharge from the stoma. This amount varies from patient to patient and some have none at all.

With normal daily hygiene the risk of infection is very low. Washing once a day in the shower, paying attention to the stump and stoma is all that is needed.

Factors to be considered

Factors to be consideredHundreds of satisfied osseointegration users can testify that this technology offers significant and unparalleled advantages compared to a traditional suction prosthesis.

For many who were unable to use a socket prostheisis, it has allowed them to walk again after years of being bound to a wheelchair or crutches. Sensible handling of the prosthesis and simple common sense can prevent any chance of future problems.

In order to ensure the implant is safely integrated into the bone you are required to only partial weight-bear for the first 12 weeks. This means walking with at least one crutch or walking stick for this time period.

While it is a very exciting time and the urge to push yourself is often strong, it is recommended that you build up your walking slowly to avoid any injuries caused by pushing yourself too hard too soon.

Care should be paid to the opening (stoma) through which the external adaptor passes out of the stump. There will be a small amount of discharge from the stoma. This amount varies from patient to patient and some have none at all.

With normal daily hygiene the risk of infection is very low.  Washing once a day in the shower, paying attention to the stump and stoma is all that is needed.

As a general rule, excessive rotation such as pivoting and sharp twisting should be avoided. However, if high levels of strain should occur the safety shear pins in the external implant system will break to protect against a bone fracture occurring. The system yields and the bone remains undamaged. Safety is a priority and the system has been designed to protect the bone during any large strain or vigorous movements. The safety pins are easily exchanged by the prosthetist and in the near future there is the possibility they will be able to be replaced by the patient.

The implant is made of titanium, which is coated with a rough surface of a plasma spray which allows for the bone to grow into the implant. In addition there is a layer of hydroxyapitate coating which attracts bone cells to adhere and grow into. These materials are extremely biocompatible in endoprosthetics. The body will not reject the implant and there is no permanent medication required.

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