Background: Osseointegrated (OI) prostheses are a novel alternative solution for patients with lower-limb amputations. Plastic surgeons are becoming increasingly involved in providing concurrent leg lifts (CLL) to reduce soft tissue redundancy around the implant. Due to limited mobility, many patients present with higher body mass indexes (BMIs) and may benefit from CLL. The aim of this study is to analyze the outcomes of obese patients with OI prostheses who received CLL.
Methods: A retrospective analysis was performed on patients who received transfemoral single-stage lower limb osseointegration between 2017 and 2023. Each patient had at least 6 months post-operative follow up. Patients with BMIs >= 30 were defined as obese. Fisher’s exact test was used with an alpha of 0.05.
Results: The study included 80 patients (53 male, 27 female) across three different BMI categories: 36 patients with normal BMIs, 32 obese patients with CLL, and 12 obese patients without CLL. Obese patients with CLL experienced lower rates of neuroma formations, hardware failures, implant exchanges, and soft tissue revisions compared to obese patients without CLL (p<0.05). Furthermore, 56% of obese patients with CLL received concurrent targeted muscle reinnervation compared to none in obese patients without CLL (p<0.05). Compared to patients with normal BMIs, obese patients without CLL had more hardware failures and implant exchanges (p<0.05). No significant differences were found in soft tissue infections, osteomyelitis, neuroma formation, limb fractures, hardware failures, or soft tissue revisions between patients with normal BMIs and obese patients who received CLL.
Conclusions: Our study showed that in patients with OI prostheses, obese patients experienced fewer complications when they received CLL versus those who did not. In addition, outcomes in obese patients with CLL were comparable to patients with normal BMIs. Our findings highlight the advantages of incorporating CLL for obese patients undergoing OI prostheses procedures.
