Incidence of amputees who could benefit from an osseointegrated prosthesis.

BACKGROUND

Transfemoral and transhumeral amputees rely on socket prosthetics, which are susceptible to difficulties with fit, skin integrity, pain, and biomechanical disadvantage, ultimately decreasing prosthetic limb utilization. Osseointegrated percutaneous prosthetic systems may help eliminate these challenges. However, no study has identified the estimated number of patients who may be candidates for osseointegrated prosthetics.

OBJECTIVES

To indentify the estimated number of patients who may be candidates for osseointegrated prosthetics using the National Inpatient Sample (NIS) Database.

STUDY

DESIGN

Observational.

METHODS

We queried the National Inpatient Sample (NIS) database for all above knee amputations (AKA) and above elbow amputations (AEA) occurring between 2001 and 2014, in patients aged 22‒65, using International Classification of Diseases-9 procedure codes 84.17 and 84.07, respectively. International Classification of Diseases-9 diagnosis codes for the amputation were categorized as dysvascular, malignancy, prosthetic joint infection, trauma, and other. Weighted National Estimates (WNE) were calculated using NIS sampling weights. Amputations secondary to dysvascular conditions, prosthetic joint infections, or nonconnective tissue neoplasms were excluded as contraindications for osseointegration surgery.

RESULTS

The NIS query revealed a WNE of 362,867 AKAs and 5544 AEAs performed between 2001 and 2014. Applying exclusion criteria, there were 1776 AKAs (WNE: 8444) and 415 AEAs (WNE: 1984). Seven patients had both AKA and AEA. A mean estimate of 603 transfemoral and 142 transhumeral amputees may be candidates for osseointegration each year.

CONCLUSIONS

Our analysis of the NIS reveals that 745 US civilians per year, including 603 AKA and 142 AEA patients, may be candidates for an osseointegrated percutaneous prosthetic system. This amounts to an estimated incidence of 2/million/year in the US population.