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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?