The Osseointegration Group of Australia Accelerated Protocol (OGAAP-1) for Two-Stage Osseointegrated Reconstruction of Amputees

The primary objective of this study was to describe the Osseointegration Group of Australia Accelerated Protocol two-stage strategy (OGAAP-1) using transcutaneous prostheses with press-fit fixation for the osseointegrated reconstruction of amputated limbs. The secondary objective was to assess the clinical outcomes regarding the efficacy of the OGAAP-1 program in 50 unilateral transfemoral amputees. The study included 34 males and 16 females, aged 24-73 (mean 49.4) years, with a minimum one-year follow-up. Outcome measures included the Q-TFA and SF-36 questionnaires, K-levels, 6MWT and TUG tests, both pre- and post-operatively. Adverse events included infection, revision surgery, fractures, and implant failures. Follow-up results demonstrated highly significant improvement in all five outcome measures. A total of 20 participants were adverse event-free; 18 patients had superficial infections that resolved with antibiotics, four of whom also underwent debridement of their stoma. Refashioning of the soft tissue residuum was performed on six patients, and four fractures occurred resulting from increased activity levels. There was one implant fatigue failure, and one failure of osseointegration related to an undersized implant; both were revised successfully. These results confirm the OGAAP-1 is a suitable alternative for amputees experiencing socket-related discomfort, and reduces recovery time compared to other available alternatives.