The effectiveness of the bone bridge transtibial amputation technique: A systematic review of high-quality evidence

Jason T. Kahle, M. Jason Highsmith, John Kenney, Tim Ruth, Paul A. Lunseth, Janos Ertl

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature. Methods: Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent. Results: Nine articles were identified to be pertinent to one of the topics: Perioperative Care, Acute Care, Subjective Analysis and Function. Two articles sorted into multiple topics. Two articles were sorted into the Perioperative Care topic, 4 articles sorted into the Acute Care topic, 2 articles into the Subjective Analysis topic and 5 articles into the Function topic. Discussion: There are no high quality (level one or two) clinical trials reporting comparisons of the bone bridge technique to traditional methods. There is limited evidence supporting the clinical outcomes of the bone bridge technique. There is no agreement supporting or discouraging the perioperative and acute care aspects of the bone bridge technique. There is no evidence defining an interventional comparison of the bone bridge technique. Conclusion: Current level III evidence supports a bone bridge technique as an equivalent option to the non-bone bridge transtibial amputation technique. Formal level I and II clinical trials will need to be considered in the future to guide clinical practice. Clinical relevance: Clinical Practice Guidelines are evidence based. This systematic literature review identifies the highest quality evidence to date which reports a consensus of outcomes agreeing bone bridge is as safe and effective as alternatives. The clinical relevance is understanding bone bridge could additionally provide a mechanistic advantage for the transtibial amputee.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalProsthetics and Orthotics International
Volume41
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Amputation
Bone and Bones
Perioperative Care
Amputees
Clinical Trials
Practice Guidelines
Databases

Keywords

  • biomechanics
  • orthopedic surgery
  • prosthesis
  • prosthesis design
  • Prosthesis interface mechanics
  • surgical methods

ASJC Scopus subject areas

  • Medicine(all)
  • Health Professions (miscellaneous)
  • Rehabilitation

Cite this

The effectiveness of the bone bridge transtibial amputation technique : A systematic review of high-quality evidence. / Kahle, Jason T.; Highsmith, M. Jason; Kenney, John; Ruth, Tim; Lunseth, Paul A.; Ertl, Janos.

In: Prosthetics and Orthotics International, Vol. 41, No. 3, 2017, p. 219-226.

Research output: Contribution to journalArticle

Kahle, Jason T. ; Highsmith, M. Jason ; Kenney, John ; Ruth, Tim ; Lunseth, Paul A. ; Ertl, Janos. / The effectiveness of the bone bridge transtibial amputation technique : A systematic review of high-quality evidence. In: Prosthetics and Orthotics International. 2017 ; Vol. 41, No. 3. pp. 219-226.
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abstract = "Background: This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature. Methods: Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent. Results: Nine articles were identified to be pertinent to one of the topics: Perioperative Care, Acute Care, Subjective Analysis and Function. Two articles sorted into multiple topics. Two articles were sorted into the Perioperative Care topic, 4 articles sorted into the Acute Care topic, 2 articles into the Subjective Analysis topic and 5 articles into the Function topic. Discussion: There are no high quality (level one or two) clinical trials reporting comparisons of the bone bridge technique to traditional methods. There is limited evidence supporting the clinical outcomes of the bone bridge technique. There is no agreement supporting or discouraging the perioperative and acute care aspects of the bone bridge technique. There is no evidence defining an interventional comparison of the bone bridge technique. Conclusion: Current level III evidence supports a bone bridge technique as an equivalent option to the non-bone bridge transtibial amputation technique. Formal level I and II clinical trials will need to be considered in the future to guide clinical practice. Clinical relevance: Clinical Practice Guidelines are evidence based. This systematic literature review identifies the highest quality evidence to date which reports a consensus of outcomes agreeing bone bridge is as safe and effective as alternatives. The clinical relevance is understanding bone bridge could additionally provide a mechanistic advantage for the transtibial amputee.",
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