Endo-Exo Prosthesis: Stage 2 - Femoral Stem Prosthesis

Generic CT-based finite element models of an intact femoral bone and amputated bone implanted with models of two existing direct-fixation implants, the OPRA system (Integrum AB) and the ISP Endo/Exo prosthesis (ESKA Implants AG) were created for this study. Adaptive bone-remodeling simulations used the heel-strike and toe-off loads from a normal walking cycle.

To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA).
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Brånemark PI (September 1983). “Osseointegration and its experimental background”. The Journal of Prosthetic Dentistry 50 (3): 399–410. doi:10.1016/S0022-3913(83)80101-2. PMID 6352924

[Endo-exo prostheses following limb-amputation].

5, MAY 2006 649 Non-invasive distal femoral expandable endoprosthesis for limb-salvage surgery in paediatric tumours A.
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148-157 - Traitement des fractures du fémur distal sur prothèse totale de genou - EM consulte.
Distal locking stem for revision femoral loosening and peri-prosthetic of a femoral flap.

[The endo-exo prosthesis treatment ..

* Dempsey.
growing prosthesis; attachment tube; total hip arthroplasty; Distal femoral implant with PE inlay (UHMWPE), curved femoral stem of different diameters.

the knee joint in the case of a trans-femoral ..

Transcutaneous, distal femoral.
Read "Periprosthetic Bone Remodeling Around a Prosthesis for Distal Femoral Tumors" on DeepDyve - Instant access to the journals.
knee mechanism for distal femoral endoprosthetic reconstructions.

Fifteen years of experience with Integral-Leg-Prosthesis: ..

Prosthetic replacement in cases of difficult soft tissue and bone conditions is often challenging. After above-knee amputation, the Endo-Exo femoral prosthesis (EEFP), which is a percutaneous implant attached directly to the bone, can represent an alternative approach. Because its structure is similar to cancellous bone, over time the bone is incorporated into the implant, thus minimizing micromovements and preventing formation of unwanted connective tissue structures at the bone-implant interface. The experience gathered so far with the EEFP in 37 patients after above-knee amputation appears to indicate that this is an alternative to soft tissue shaft prostheses, but should be reserved for selected patients. Initial results with the bone guided prosthesis after above-knee amputation are very promising.

Amputee and Prosthetic Terminology at Award …

N2 - An alternative solution to conventional stump–socket prosthetic limb attachment is offered by direct skeletal fixation. This study aimed to assess two percutaneous trans-femoral implants, the OPRA system (Integrum AB, Göteborg, Sweden), and the ISP Endo/Exo prosthesis (ESKA Implants AG, Lübeck, Germany) on bone failure and stem–bone interface mechanics both early post-operative (before bony ingrowth) and after full bone ingrowth. Moreover, mechanical consequences of implantation of those implants in terms of changed loading pattern within the bone and potential consequences on long-term bone remodeling were studied using finite-element models that represent the intact femur and implants fitted in amputated femora. Two experimentally measured loads from the normal walking cycle were applied. The analyses revealed that implantation of percutaneous prostheses had considerable effects on stress and strain energy density levels in bone. This was not only caused by the implant itself, but also by changed loading conditions in the amputated leg. The ISP design promoted slightly more physiological strain energy distribution (favoring long-term bone maintenance), but the OPRA design generated lower bone stresses (reducing bone fracture risk). The safety factor against mechanical failure of the two percutaneous designs was relatively low, which could be improved by design optimization of the implants.