Amputation treatment
This new technique goes back to well-established findings of tooth-implants. The main idea is a bone-anchored and skin penetrating implant that allows the attachment of an artificial knee-joint and lower leg prosthesis. It therefore essentially differs from the conventional socket-prosthesis and can provide remarkable advantages for a suitable patient. By now the procedure can also be performed for lower leg amputees and has therefore proved its value as an Endo-Exo-Tibia-Prosthesis as well.
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Yearly many patients lost their leg or hand due to the accident or some disease and … and they suffered from an amputation of a leg, most likely an above knee amputation, and this has meant a dramatic change of their life and lifestyle. This company as the exclusive distributor of the ESKA Orthopaedic illuminates a relatively new method available for rehabilitation after amputation known as the Endo-Exo-Femur-Prosthesis n. Grundei ®. (EEP)
This new technique goes back to well-established findings of tooth-implants. The main idea is a bone-anchored and skin penetrating implant that allows the attachment of an artificial knee-joint and lower leg prosthesis. It therefore essentially differs from the conventional socket-prosthesis and can provide remarkable advantages for a suitable patient. By now the procedure can also be performed for lower leg amputees and has therefore proved its value as an Endo-Exo-Tibia-Prosthesis as well.
How can we help an amputee?
We see you as an individual who deserves the best care before, during and after surgery.
Our team consists of experts in their field of amputee care who will approach your situation as unique. Using a team approach they will assess what is best for you.
Our team accompanies you from the first counsel, the operation by orthopedic surgeon (for implantation of the prosthesis) and throughout the post-op period with rehabilitation including physiotherapist and prosthetists. As well as follow up. We also maintain a close relationship with you after you regained your mobility to make sure you always have a partner to return if there are any problems.
Independent mobility and quality of life will have a new meaning for you.
We believe the process of surgery and rehabilitation should be as easy as possible
Treatment Pathway
1. Meet with the Osseointegration Group Of IRAN team at the Osseointegration Clinic (Iranian Osteointegration Group {IOG})
2. The Orthopedic surgeon who educated and doing operation for implantation of this product, refers patient for
3. Group agrees to proceed
4. Get CT scan, radiography and bone densitometry.
5. Operative planning
6. Make a contract with patient
7. Prostheses will made (custom made)
8. Importing the product from Germany
9. Doing the first step of surgery (endo part)
10. Doing the second step of surgery after minimum 45 days (exo part)
11. Installation the knee joint and ankle joint
12. Prosthetics/Physio for rehab and follow up
13. Prosthetics/Physio complete pre-op build up and muscle rehab
Surgery
The implantation of the EEP is usually done in three steps, either in general or local anesthesia the first two steps.
The first step:
During the first step the skin and soft tissue covering the lower end of the remaining bone is opened using the old scars. Sometimes the soft tissue is remodeled to get rid of scar tissue and to position the bone in a desirable way. The bone is then uncovered and shortened to an extend that is calculated before surgery. After that, the intramedullary femoral shaft is implanted without cement in the femur and has a spongy configured relief surface, which ensures a safe osseointegration in femoral shaft. The surface consists of a three-dimensional, open-cell interconnecting grid structure that is adapted to the osseous spongiosa, a drain is put into the stump and the soft tissue coat is closed again.
In the following weeks (6 or 8 weeks) osseoingeration takes place which means the bone grows into the implant and forms a stable bond with it, within this time you can use wheelchair or orthopedic stick.
The second step:
During a second stage operation about 6 weeks later the circular skin opening (stoma) is created using a core-cutter. With this step, the skin perforating opening from inside to the outside of the body is performed. Then the exo-module of the prosthesis is attached to the internal implant stem via a” bridge module “.
In accordance with the stability of the soft tissue as well as x-ray follow-ups partial weight bearing can then be started together with physiotherapists and prosthetists.
The third stage:
The qualified and certified prosthesis has to, after a predetermined structure specification (Trochanter sagittal line – flexion angle degree of mobility), determine the knee joint position.
This happens two days after the second operation and the prosthesis can
Initiate and accompany a partial weight load monitoring.
In addition, after successful own Prosthesis Pass from their attending doctor to follow up and control the ESKA endo-stem adapted exo-prosthesis care concept.
Further prosthetic fitting of the knee- and/or lower leg prosthesis is then done under guidance of a prosthetist. The aim is to make it possible to use an artificial exo-prosthesis.
This means that only a few days after the second step procedure partial weight-bearing can usually be achieved and prosthetic alignment can be started. This all happens together with the surgeon, the prosthetist as well as physiotherapists.
Hygiene and Care
To avoid complications associated with the stoma area a disciplined stump- and stoma care are inevitable. We advise to:
• clean the stoma as well as the exo-modules using fresh water and non-perfumed soap at least twice daily.
• Using a non-shedding shaving brush or a shower stream can be useful as well.
• For skin care we recommend non-perfumed skin protection crèmes. Altogether this care takes about 10 minutes each day and can be done together with daily routine body care.
• Disinfection of the stoma or regular treatment with antiseptic fluids cannot prevent the natural bacterial flora from colonizing this area and should not be done because we know nowadays that it does not help to prevent any ascending infection and may on the contrary even lead to more irritation.
• We want the skin’s normal flora to grow in the stoma region to create a healthy, stable and homeostatic surrounding, which we believe is the best shield against infection.
Consider that An excessive rotational move (torque) of the prosthesis should be avoided as a matter of principle. If an immoderate force is nevertheless applied, a shear pin at the inner part of the dual cone adaptor breaks off and therefore prevents the bone from taking up too much load and fracturing. So this system saves and relieves the bone from too much burden. The implants are made of a casted cobalt-chromium-molybdenum-alloy (CoCrMo) and have a titan-niobium coating (TiNb). This material prevents allergic reactions. An EEP does therefore not require any permanent medication
® Endo–Exo Implantation systems
“Endo-Exo- implantation systems are made for prosthetic rehabilitation after limb-amputation, which makes the conventional socket prosthesis unnecessary…
The physiologic course of motions during ambulation as well as the human anatomy have been taken into account and served as the archetype during development of the EEP.
