Intraosseous Transcutaneous Amputation Prosthesis (ITAP) compared to Exoprosthesis in veterinary medicine - a literature review.

Abstract

Objective: This literature review aims to provide an overview of the existing literature on intraosseous transcutaneous amputation prosthesis (ITAP) and stump socket prosthesis in amputated animals. The goal is to compare the advantages and disadvantages of ITAP with exoprosthesis use, given the importance of limb-sparing procedures in contemporary veterinary medicine.

Materials and methods: A systematic research adhering to the PRISMA protocol was conducted using a time span from 2000 to 2023, focusing on papers detailing the clinical application of ITAP or exoprosthesis in small animals.

Results: This review encompasses 8 studies, 5 of them offering insights into the use of exoprosthesis in dogs and cats and 3 into ITAPs. Among the patients receiving an ITAP, 2 out of 6 experienced complications such as implant loosening and breakage. Studies on stump socket prostheses identified 10 different complications, occurring 93 times in 96 canine patients, with some patients showing more than one complication. However, in the studies assessing the quality of life, 31 out of 48 owners reported that their dogs had a good or excellent quality of life post-surgery.

Conclusion: Both approaches have their pros and cons. Stump socket prostheses may offer better adaptability and simpler application, but owners must be vigilant about daily maintenance to prevent pressure sores or infections, often necessitating adaptations due to stump changes. In contrast, ITAP avoids these complications but requires assurance of proper skin and bone integration. The positive aspect of both prosthesis types lies in restoring quadrupedal gait, alleviating strain on other limbs and maintaining physiological posture, particularly crucial for animals with preexisting conditions. It is crucial to carefully evaluate the outcomes and potential complications of each prosthesis type, prioritizing the patient's well-being.

Clinical relevance: Limb amputation is an important decision in veterinary medicine, where alternative options beyond total limb amputation should be thoroughly discussed. Partial limb amputation, along with prosthetic devices, can greatly benefit patients, provided careful consideration and planning are undertaken.