Surgical complications and implant survival of the Osseointegrated Prostheses for the Rehabilitation of Amputees system in patients with combat-related limb loss: a retrospective cohort study

Purpose To assess implant survival, postoperative complications, and infection-related risk factors in veteran amputees treated with a bone-anchored prosthetic system.Methods This retrospective study analysed clinical data from 49 veterans of the Russo-Ukrainian war who underwent implantation of the Osseointegrated Prostheses for the Rehabilitation of Amputees (OPRA) system for upper or lower limb amputation in 2023-2024. Implant survival and complication rates were analysed at one-year follow-up after the second surgical stage (S2).Results The first stage of OPRA was performed in 49 patients (51 implants): 21 transfemoral, 27 transhumeral, and transtibial. Three patients declined S2, and one humeral implant was explanted after S1. The S2 was completed in 45 patients (47 implants). At one-year follow-up after S2, implant survival was 97.9% with one of 47 implants explanted because of septic loosening. Infectious complications occurred in 18% of patients, including Grade 4 infection in 2%. Beyond one year (median follow-up, 18.7 months), two additional implants were explanted (periprosthetic fracture, n = 1; septic loosening, n = 1).Conclusion OPRA implantation in veteran amputees demonstrated favourable short-term implant survival (97.9% at one-year follow-up after S2), although longer-term follow-up is required.