Lower Extremity Osseointegration Postoperative Rehabilitation Protocols: A Scoping Review.
Matan Grunfeld, Taylor J Reif, S Robert Rozbruch and 1 others
PMID 39385465WHAT IT FOUND
All published protocols follow the same progression from surgery to independent ambulation, but vary widely in timing and loading.
No protocol was validated by clinical outcomes, and none adjusted rehabilitation based on patient characteristics like age or amputation level.
Key findings
01All identified rehabilitation protocols share the same goal progression order, ending in independent full weight-bearing ambulation.
02Protocols varied significantly in surgical stages (one vs. two) and the time between them, which was the most impactful difference on rehabilitation duration.
03No published protocol was supported by clinical data validating its recommendations or adjusting for patient-specific factors like age or amputation level.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a scoping review, not a meta-analysis; it maps existing protocols but does not determine which is most effective. The included studies did not report outcome data linked to specific rehabilitation protocols, so no comparison of efficacy was possible. Protocols were described in brief paragraphs in the source articles, limiting the depth of information available. No studies adjusted rehabilitation based on patient demographics or implant characteristics, leaving a gap in personalized care guidance.
Declared interests
The authors declare no conflicts of interest. Institutional review was not necessary as this was a review of published literature.
The easy way to misread this
Do not interpret the variation in protocols as evidence that one approach is superior. The review explicitly states that no protocol was validated by clinical outcomes, and the differences in timing and loading are not based on proven efficacy.