Osseointegration of the Tibia After a Primary Amputation : JBJS Essential Surgical Techniques

Journal Logo

Subspecialty Procedures

Osseointegration of the Tibia After a Primary Amputation

Geiger, Erik J. MD1,a; Hoellwarth, Jason S. MD1; Reif, Taylor J. MD1; Rozbruch, S. Robert MD1

Author Information
JBJS Essential Surgical Techniques: October-December 2022 - Volume 12 - Issue 4 - p e22.00005
doi: 10.2106/JBJS.ST.22.00005
  • Open
  • Associated Video
  • Disclosures


{"href":"EST Tall Playlist Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"","caption":"","object-id":[{"pub-id-type":"doi","id":"10.2106/JBJS.ST.22.00005.vid1"},{"pub-id-type":"other","content-type":"media-stream-id","id":"JBJSST2200005"},{"pub-id-type":"other","content-type":"media-source","id":""}]}

Published outcomes of this procedure can be found at: JB JS Open Access. 2021 Sep 3;6(3):e21.00072, and Ann Plast Surg. 2020 Jul;85(S1 Suppl 1):S33-6.


1. Leijendekkers RA, van Hinte G, Frölke JP, van de Meent H, Nijhuis-van der Sanden MW, Staal JB. Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review. Disabil Rehabil. 2017 Jun;39(11):1045-58.
2. Van de Meent H, Hopman MT, Frölke JP. Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses. Arch Phys Med Rehabil. 2013 Nov;94(11):2174-8.
3. Brånemark R, Berlin O, Hagberg K, Bergh P, Gunterberg B, Rydevik B. A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: A prospective study of 51 patients. Bone Joint J. 2014 Jan;96-B(1):106-13.
4. Haque R, Al-Jawazneh S, Hoellwarth J, Akhtar MA, Doshi K, Tan YC, Lu WY, Roberts C, Al Muderis M. Osseointegrated reconstruction and rehabilitation of transtibial amputees: the Osseointegration Group of Australia surgical technique and protocol for a prospective cohort study. BMJ Open. 2020 Oct 20;10(10):e038346.
5. Leijendekkers RA, van Hinte G, Frölke JP, van de Meent H, Atsma F, Nijhuis-van der Sanden MW, Hoogeboom TJ. Functional performance and safety of bone-anchored prostheses in persons with a transfemoral or transtibial amputation: a prospective one-year follow-up cohort study. Clin Rehabil. 2019 Mar;33(3):450-64.
6. Reetz D, Atallah R, Mohamed J, van de Meent H, Frölke JPM, Leijendekkers R. Safety and Performance of Bone-Anchored Prostheses in Persons with a Transfemoral Amputation: A 5-Year Follow-up Study. J Bone Joint Surg Am. 2020 Aug 5;102(15):1329-35.
7. Tillander J, Hagberg K, Hagberg L, Brånemark R. Osseointegrated titanium implants for limb prostheses attachments: infectious complications. Clin Orthop Relat Res. 2010 Oct;468(10):2781-8.
8. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008 Mar;89(3):422-9.
9. Hoellwarth JS, Tetsworth K, Rozbruch SR, Handal MB, Coughlan A, Al Muderis M. Osseointegration for Amputees: Current Implants, Techniques, and Future Directions. JBJS Rev. 2020 Mar;8(3):e0043.
10. Zaid MB, OʼDonnell RJ, Potter BK, Forsberg JA. Orthopaedic Osseointegration: State of the Art. J Am Acad Orthop Surg. 2019 Nov 15;27(22):e977-85.
11. Hagberg K, Brånemark R. Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems. Prosthet Orthot Int. 2001 Dec;25(3):186-94.
12. Dudek NL, Marks MB, Marshall SC, Chardon JP. Dermatologic conditions associated with use of a lower-extremity prosthesis. Arch Phys Med Rehabil. 2005 Apr;86(4):659-63.
13. Hoellwarth JS, Al-Jawazneh SS, Tetsworth K, Lu W, Roberts C, Al Muderis M. Amputation With Osseointegration for Patients With Intractable Complex Regional Pain Syndrome: A Report of 3 Cases. JBJS Case Connect. 2021 Jan 14;11(1):00267.
14. Akhtar MA, Hoellwarth JS, Al-Jawazneh S, Lu W, Roberts C, Al Muderis M. Transtibial Osseointegration for Patients with Peripheral Vascular Disease: A Case Series of 6 Patients with Minimum 3-Year Follow-up. JB JS Open Access. 2021 Jun 23;6(2):e20.00113.
15. Reif TJ, Khabyeh-Hasbani N, Jaime KM, Sheridan GA, Otterburn DM, Rozbruch SR. Early Experience with Femoral and Tibial Bone-Anchored Osseointegration Prostheses. JB JS Open Access. 2021 Sep 3;6(3):e21.00072.
16. Hebert JS, Rehani M, Stiegelmar R. Osseointegration for Lower-Limb Amputation: A Systematic Review of Clinical Outcomes. JBJS Rev. 2017 Oct;5(10):e10.
17. Atallah R, Li JJ, Lu W, Leijendekkers R, Frölke JP, Al Muderis M. Osseointegrated Transtibial Implants in Patients with Peripheral Vascular Disease: A Multicenter Case Series of 5 Patients with 1-Year Follow-up. J Bone Joint Surg Am. 2017 Sep 20;99(18):1516-23.
18. Hoellwarth JS, Tetsworth K, Kendrew J, Kang NV, van Waes O, Al-Maawi Q, Roberts C, Al Muderis M. Periprosthetic osseointegration fractures are infrequent and management is familiar. Bone Joint J. 2020 Feb;102-B(2):162-9.
19. Hoellwarth JS, Al Muderis M, Rozbruch SR. Cementing Osseointegration Implants Results in Loosening: Case Report and Review of Literature. Cureus. 2020 Feb 21;12(2):e7066.
20. Marano AA, Modiri O, Rozbruch SR, Otterburn DM. Soft Tissue Contouring at the Time of Osseointegrated Implant Reconstruction for Lower Extremity Amputation. Ann Plast Surg. 2020 Jul;85(S1)(Suppl 1):S33-6.

Supplemental Digital Content

Copyright © 2022 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved