Christian  Blöchle,Fungwe  Jah,Horst H.  Aschof,
Comparative analysis between bone-guided (endo-exo) prostheses and soft-tissue guided shaft prostheses for rehabilitation after thigh amputation, with special emphasis on its socio-economic aspects
Journal of Surgery and Rehabilitation
2019
2733-2551
http://dx.doi.org/10.31487/j.JSR.2019.01.03
https://www.sciencerepository.org/comparative-analysis-between-bone-guided-endo-exo-prostheses-and-soft-tissue-guided-shaft-prostheses-for-rehabilitation-after-thigh-amputation_JSR-2019-1-103 
Abstract: Background: A prompt and effective rehabilitation after a thigh amputation has significant advantages in
terms of the functional and psychological acceptance of the prosthetic restoration. As at now the
rehabilitation after thigh amputation is carried mainly by soft tissue guided shaft prostheses. Over the years,
various authors reported on a variety of problems with shaft prosthetics. In Sweden, for example, an
alternative procedure was developed based on dental implantology in the 1990s, in which the transmission
of thigh stump to exo-prosthesis takes place by means of an intramedullary, percutaneously guided implant
(OPRA procedure). OPRA stands for "Osseointegrated Prosthesis for the Rehabilitation of Amputees". This
special procedure involving two surgical steps was first performed in 1999 in Lübeck. There are now more
than 200 patients worldwide with Endo-exo-femoral prosthetics.
Methods/Design: During a period of 14 years (1999-2013), 75 patients were treated with the endo-exofemoral prosthesis in the Sana Clinic Lübeck. Patients were included in the study who had the endo-exofemoral prosthesics for at least 12 months and who reliably had regular check-ups. Based on this, a random
sample of a total of twenty-one (21) patients treated with the endo-exo-femoral prosthesis between 1999
and 2012 was obtained. Since a total of nineteen of the twenty-one patients had experience with soft tissue
guided shaft prostheses, we took the opportunity to ask them about their subjective experience with the
prosthetics. For this purpose, a questionnaire was drawn up with 49 very extensive questions. The content
of the questions relates to endo-exo prostheses and soft tissue guided shaft prostheses, family, socioeconomic, quality of life and patient satisfaction.
Conclusion: Based on this analysis, the Integral Leg Prosthesis (ILP) is of great benefit in the health and
socio-economic aspects of rehabilitationKeywords: Osseointegration, Integral Leg Prosthesis (ILP), Endo-Exo-Femurprosthesis (EEFP)