400 Section - Transfemoral and transtibial press-fit osseointegration: first functional Chilean experience. A case series

Objectives : To report the first Chilean experience with press-fit Osseointegration Prosthetic Limb (OPL) implants in lower-limb amputees, and describe early gait and functional outcomes, pain and opioid use, and early complications in adults with transfemoral and transtibial amputation who underwent osseointegration and a structured postoperative rehabilitation programme.

Design: Single-centre observational case series conducted at a trauma and rehabilitation centre in Chile. Adults with unilateral transfemoral or transtibial amputation who underwent lower-limb press-fit Osseointegration Prosthetic Limb (OPL) implantation and completed a postoperative rehabilitation programme were included. Baseline assessments recorded demographics, comorbidities, body mass index, time from amputation to osseointegration, opioid use and indication for OI. Follow-up at 3, 6 and 12 months documented OI-related complications, timed up-and-go (TUG), 7-m gait parameters (velocity, cadence, symmetry), posturography (load symmetry) and walking-aid use.

Results: Six adults were included (median age 42 years; 83% men; 3 TF, 3 TT). Median time from amputation to OI was 4.3 years; BMI remained stable. Superficial wound/skin infections occurred in 4/6 patients and were managed medically; no deep implant infections were observed. Four patients used opioids at baseline; three reduced their regimen. Median TUG decreased from 12.4 s at baseline to 11.1, 10.6 and 10.3 s at 3, 6 and 12 months, respectively. In the three patients with 12-month data, 7-m gait velocity increased from 0.71 to 1.23 m/s, cadence from 87.5 to 105.6 steps/min and load on the OI limb from 47% to 50% of total body weight, allowing withdrawal of walking aids and independent gait.

Conclusion: Press-fit OPL osseointegration in TF and TT amputees was feasible and associated with progressive gains in gait and functional performance, greater load symmetry and reduced opioid use, with mainly superficial early complications. This small, uncontrolled single-centre case series provides exploratory, hypothesis-generating data that support developing larger comparative studies and structured rehabilitation protocols around osseointegration.