Authors' objectives: For adult individuals with congenital deficiency or amputation of an upper limb, what are the benefits and risks with neuromuscular osseointegrated prostheses controlled by implanted electrodes (I1) compared with non-neuromuscular osseointegrated prostheses (C1) in terms of function, activities of daily living, health-related quality of life, reoperation, and complications? How does each of these types of osseointegrated prostheses (I1 and I2) compare with standard, myoelectric, socket prostheses controlled by surface electrodes (C2)?

Authors' results and conclusions: This HTA report is based on few studies, mostly case series. Worldwide, very few patients have been provided with osseointegrated upper limb prostheses and publications all stem from one hospital. The outcomes we sought to assess were scarcely reported, and comparative data were mostly lacking. Comparing neuromuscular (I1) with non-neuromuscular, osseointegrated prostheses (C1), the certainty of evidence for any difference in function is very low. Yet patients with neuromuscular, osseointegrated prostheses expressed that they experienced benefits in terms of function. Two serious adverse events were reported in one patient who was hospitalised due to sepsis; later another infection led to removal of the implanted electrodes. No studies compared neuromuscular, osseointegrated (I1) with myoelectric socket prostheses (C2). Comparing non-neuromuscular, osseointegrated (I2) with myoelectric socket prostheses (C2), the certainty of evidence for improved function of osseointegrated prostheses is very low. Various complications, including serious adverse events, in relation to osseointegrated fixation were reported. Additional substantial costs for prostheses with osseointegration and neuromuscular control must be considered.

Project Status: Completed

URL for project: https://mellanarkiv-offentlig.vgregion.se/alfresco/s/archive/stream/public/v1/source/available/sofia/su4372-1728378332-599/surrogate/2022_132%20OI%20Prostheses.pdf

Year Published: 2022

URL for published report: https://mellanarkiv-offentlig.vgregion.se/alfresco/s/archive/stream/public/v1/source/available/sofia/su4372-1728378332-599/surrogate/2022_132%20OI%20Prostheses.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Organisation Name: The Regional Health Technology Assessment Centre

Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden

Contact Name: hta-centrum@vgregion.se

Contact Email: hta-centrum@vgregion.se