Osseointegrated upper limb prostheses with and without neuromuscular control: benefits and risks

Sassu P, Granberg H, Bernhardsson S, Lindström AC, Magnusson K, Nachemson A, Stadig I, Wartenberg C
Record ID 32018011318
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
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Osseointegration
  • Amputees
  • Upper Extremity
  • Artificial Limbs
  • Bone-Anchored Prosthesis
  • Electrodes, Implanted
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
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.