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Direct bone attachment and osseointegration

Most prostheses are attached to the exterior of the body in a non-permanent way. The stump and socket method can cause significant pain in the amputee, which is why the direct bone attachment has been explored extensively.

Osseointegration is a method of attaching the artificial limb to the body by a prosthetic implant. This method is also sometimes referred to as exoprosthesis (attaching an artificial limb to the bone), or endo-exoprosthesis. Endoprosthesis are prosthetic joint implants which remain wholly inside the body such as knee and hip replacement implants.

The method works by inserting a titanium bolt into the bone at the end of the stump. After several months the bone attaches itself to the titanium bolt and an abutment is attached to the titanium bolt. The abutment extends out of the stump and the (removable) artificial limb is then attached to the abutment. Some of the benefits of this method include the following:

The main disadvantage of this method is that amputees with the direct bone attachment cannot have large impacts on the limb, such as those experienced during jogging, because of the potential for the bone to break.