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Biomechanical Characterisation of Bone-anchored Implant Systems for Amputation Limb Prostheses: A Systematic Review

Journal article
Authors A. Thesleff
Rickard Brånemark
B. Hakansson
M. Ortiz-Catalan
Published in Annals of Biomedical Engineering
Volume 46
Issue 3
Pages 377-391
ISSN 0090-6964
Publication year 2018
Published at Institute of Clinical Sciences
Pages 377-391
Language en
Keywords Bone-anchored prostheses, Osseointegration, Direct skeletal attachment, percutaneous osseointegrated prostheses, suspended transfemoral, prostheses, direct skeletal attachment, quality-of-life, radiographic, evaluation, socket prostheses, titanium implants, amputees, rehabilitation, vibrotactile, Engineering
Subject categories Orthopedics


Bone-anchored limb prostheses allow for the direct transfer of external loads from the prosthesis to the skeleton, eliminating the need for a socket and the associated problems of poor fit, discomfort, and limited range of movement. A percutaneous implant system for direct skeletal attachment of an external limb must provide a long-term, mechanically stable interface to the bone, along with an infection barrier to the external environment. In addition, the mechanical integrity of the implant system and bone must be preserved despite constant stresses induced by the limb prosthesis. Three different percutaneous implant systems for direct skeletal attachment of external limb prostheses are currently clinically available and a few others are under investigation in human subjects. These systems employ different strategies and have undergone design changes with a view to fulfilling the aforementioned requirements. This review summarises such strategies and design changes, providing an overview of the biomechanical characteristics of current percutaneous implant systems for direct skeletal attachment of amputation limb prostheses.

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