Aims The Intraosseous Transcutaneous Amputation Prosthesis (ITAP) may improve quality of life for amputees by avoiding soft-tissue complications associated with socket prostheses and by improving sensory feedback and function. It relies on the formation of a seal between the soft tissues and the implant and currently has a flange with drilled holes to promote dermal attachment. Despite this, infection remains a significant risk. This study explored alternative strategies to enhance soft-tissue integration.
Materials and Methods The effect of ITAP pins with a fully porous titanium alloy flange with interconnected pores on soft-tissue integration was investigated. The flanges were coated with fibronectin-functionalised hydroxyapatite and silver coatings, which have been shown to have an antibacterial effect, while also promoting viable fibroblast growth in vitro. The ITAP pins were implanted along the length of ovine tibias, and histological assessment was undertaken four weeks post-operatively.
Results The porous titanium alloy flange reduced epithelial downgrowth and increased soft-tissue integration compared with the current drilled flange. The addition of coatings did not enhance these effects.
Conclusion These results indicate that a fully porous titanium alloy flange has the potential to increase the soft-tissue seal around ITAP and reduce susceptibility to infection compared with the current design.
Cite this article: Bone Joint J 2017;99-B:393–400.
M. Chimutengwende-Gordon: Study design, Surgery, Histology, Data collection and analysis, Writing the paper.
C. Pendegrass: Supervision, Data/manuscript review.
G. Blunn: Supervision, Data/manuscript review.
This research was funded by an MRC Clinical Research Training Fellowship awarded to M. Chimutengwende-Gordon.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This is an open-access article distributed under the terms of the Creative Commons (CC-BY) license, which permits copying and redistributing the material in any medium or format, remixing, transforming and building upon the material for any purpose, even commercially, provided the original author and source are credited, and changes made are indicated. This may be done in a reasonable manner, but not in any way that suggests the licensor endorses you or your use.
This article was primary edited by P. Page and first proof edited by G. Scott.
Supplementary material. Further information regarding the surface preparation, the surgical details and the histological section is included alongside the online version of this article at www.bjj.boneandjoint.org.uk.
- Received April 30, 2016.
- Accepted October 7, 2016.
- ©2017 Chimutengwende-Gordon et al