Osseointegrationthe Dorset Ortho story so far.....

Matthew Hughes

Why Osseointegration?

• Despite extensive research,

socket problems still exist.

• Unfortunately most AK

patients will encounter some

socket-residium interface

issues at some point.

• These issues tend to worsen

with age.

Background

• 2015 contact with Osseo group of Australia

• First patient had their surgery Oct 2015.

• Australia visit Jan 2016

- three surgeries seen, one being a DO patient.

• Set up of programme for DO patients wishing

to undergo this process privately.

Patients to date

• 14 Osseo patients

• 12 treated by Munjed in Sydney

- 2 inherited patients who underwent surgery in

Germany with Aschoff.

• 10 unilateral TF patients

• 1 unilateral TT (elective primary)

• 1 bilateral TT

Case Study 1

• 72 year old female

• Left TF amp of 23 years

• NHS England funded treatment at DO

• Appointment History:

• Extended stay in Australia due to prolonged

loading as a result of age and bone density

Case Study 1

Pre OI 1 year Post OI

TUAG 9s 6s

Houghton 8/12 11/12

ABC - UK 61 (low on stairs, ramps, crowds) 98.75

LCI-5 26/28 & 19/28 (45/56) low on

stepping, walking outside and stairs

28/28 & 28/28 (56/56)

Case Study 2

• Male, 29

• Right TT, elective primary

• Crush and degloving injury, Dec ’14

• 9 surgeries to try to salvage foot and ankle

• OI surgery August ’17

• TF implant therefore quicker loading process.

• Pain relief - zero

Case Study 2

• 75 hours Rehab at DO

– 3 weeks resi (Sept, Nov & Dec)

– Week 1 reduction of swelling and encourage healing

– Week 2 gait re-education (off crutches)

– Week 3 conditioning

• Walking kids to school (1 mile each way)

• Fishing

• Set up business (fishing supplies)

Complications

• 1 x TF stress fracture, fixed locally with DHS

• 2 x falls both TF patients. Not as a direct

result of OI

– 1 x fractured neck of femur, fixed locally and re-

loaded prior to commencing walking.

– 1 x damaged dual cone adaptor and internal

screw. Replaced screw and dual cone adaptor,

back on feet within 48 hours.

• Norbert Kang and Alex

Woollard, The Royal Free,

London

• MDT team, monthly clinics

• Surgery and full rehab

packages

• 4 patients to date

- 4 patients to date

- 3 x TF, 1 x TH

The UK Story

No patient would revert back to wearing

sockets

What does the future hold?

Thanks for listening!Any Questions?