Please check your email for the verification action. You may continue to use the site and you are now logged in, but you will not be able to return to the site in future until you confirm your email address.
Aims. The Intraosseous Transcutaneous Amputation Prosthesis (ITAP)
may improve quality of life for amputees by avoiding soft-tissue
complications associated with socket prostheses and by improving
sensory feedback and function. It relies on the formation of a seal
between the soft tissues and the implant and currently has a flange
with drilled holes to promote dermal attachment. Despite this, infection
remains a significant risk. This study explored alternative strategies
to enhance soft-tissue integration. Materials and Methods. The effect of ITAP pins with a fully porous titanium alloy flange
with interconnected pores on soft-tissue integration was investigated.
The flanges were coated with fibronectin-functionalised hydroxyapatite
and silver coatings, which have been shown to have an antibacterial
effect, while also promoting viable fibroblast growth in
vitro. The ITAP pins were implanted along the length of
ovine tibias, and histological assessment was undertaken four weeks
post-operatively. Results. The porous titanium alloy flange reduced epithelial downgrowth
and increased soft-tissue integration compared with the current
drilled flange. The addition of coatings did not enhance these effects. Conclusion. These results indicate that a fully porous titanium alloy flange
has the potential to increase the soft-tissue seal around ITAP and
reduce susceptibility to infection compared with the current design. Cite this article: Bone Joint J 2017;99-B:393–400