Osseointegration’s Effect on Balance and Perceived Function in Individuals With Lower Leg Amputations: A Critically Appraised Topic

Clinical Scenario: Lower-extremity amputees (LEA) commonly experience socket prosthesis (SP) complications that interfere with their perceived function and quality of life. Osseointegration (OI) requires prosthesis implementation directly into the intramedullary shaft. This alternative may be an answer for amputees who struggle with their SP and desire to regain comfortable and confident function in a prosthetic. Clinical Question: Does OI provide better functional and balance outcomes in LEA than SP users? Summary of Findings: Participants with OI prostheses showed improvements in perceived balance and disability despite little improvement in spatiotemporal measures during the 10-m walk tests. Each study showed clinically important differences in median Activities-Specific Balance Confidence Scale scores. Clinical Bottom Line: Patients with LEA may utilize OI as an alternative to traditional SP. Each outcome measured demonstrates OI produces the same functional ability as those with an SP. However, it may increase perceived balance and function, which may positively affect quality of life. OI does have its risks, but those risks may still be an improvement from the difficulties experienced with their SP. Strength of Recommendation: Consistent Center for Evidence-Based Medicine scale Level 3 findings support OI as an alternative to SP in providing increased perceived balance and function in LEA.