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Bone-Anchored Protheses

The treatment with bone-anchored or osseointegrated amputation prosthesis is a method that enables a patient to attach an amputation prosthesis without the use of a socket. This is made possible by surgically implanting a titanium screw into the bone.  

This method was developed by Swedish Professor Per-Ingvar Brånemark in the 1960s, when he discovered that titanium is not rejected by the body but instead integrates with the surrounding bone tissue. The discovery was initially used for the prosthetic replacement of teeth. Today, osseointegration is also used for leg, arm, hand, thumb and facial prosthetics, as well as the anchorage of hearing aids.  

A bone-anchored prosthesis is easy to attach and stable to wear, allowing you to move more freely and safely. Studies on patients with transfemoral amputation show that a bone-anchored prosthesis improves quality of life and offers a greater degree of freedom in everyday life for the majority of patients. 

Get to know the team 

Henrik Malchau 

MD, Professor 

Arun Patel 

MD 

Ann Hammarstedt 

Surgery coordinator and registered nurse 

Coordinates all contact between patients and the treatment team. 

Physiotherapist Kerstin Hagberg 

PhD, Assoc. Prof. Department of Prosthetics and Orthotics 

Kerstin Hagberg became a Registered Physiotherapist in 1978 and was recently appointed Associate Professor. She works at the Department of Prosthetics and Orthotics (OTA) at the rehabilitation centre for lower limb amputees, known as the Walking School, and at the Center for Advanced Reconstruction of Extremities (C.A.R.E.) at Sahlgrenska University Hospital. 

“As part of the C.A.R.E. team I can combine hands-on rehabilitation of amputees coming for osseointegration treatment with research, the perfect match for me really. It is a true privilege to work with such an exciting patient group. Patients interested in this treatment all share a great determination.”

Overview of treatment process

Bone-anchored prosthesis - lower extremities and upper extremities 

Team assessment with orthopaedic surgeon, physical therapist and orthopaedic engineer. 

First operation (S1), 5–7 days of hospitalization. 

Second operation (S2), 6 months later.10–14 days of hospitalization. 

6 weeks after S2: check-up and rehabilitation start using short training prosthesis. Instructions for daily training at home over the next 6–8 weeks. 

12 weeks after S2: check-up and rehabilitation start using long prosthesis. Instructions on how much the prosthesis may be used and gradual increase of activities. 

6 months after S2, check-up and X-ray – poss. start walking without crutches. 

12 months after S2, check-up and X-ray. 

Continued follow-ups: 2, 3, 5, 7, 10, 15 years after operation (S2) and thereafter every fifth year throughout life. 

As with any type of surgical treatment, there is a risk of complications that may change the treatment or impair the outcome. Superficial infections around the skin-abutment area are common. These can often be treated with extra precise cleaning, but sometimes oral antibiotic treatment is required. 

Serious complications such as loosening of the fixture due to insufficient osseointegration process or deep infection may occur. 

Breakage of any of the distal parts (abutment and/or abutment screw) are quite common and can easily be exchanged/fixed with a minor surgery at the clinic. 


Updated: 2021-10-20 09:35