Loads at the implant-prosthesis interface during free and aided ambulation in osseointegrated transfemoral prostheses
Journal article, 2020

Bone-anchored attachment of amputation limb prostheses is increasingly becoming a clinically accepted alternative to conventional socket suspension. The direct transfer of loads demands that the percutaneous implant system and the residual bone withstand all forces and moments transferred from the prosthesis. This study presents load measurements recorded at the bone-anchored attachment in 20 individuals with unilateral transfemoral amputation performing the everyday ambulatory activities: level ground walking, stairs ascent/descent and slope ascent/descent. Mean peak values for the sample populations across activities ranged from 498–684 N for the resultant force, 26.5–39.8 Nm for the bending moment, and 3.1–5.5 Nm for the longitudinal moment. Significant differences with respect to level walking were found for the resultant force during stairs ascent, (higher, p = 0.002), and stairs descent, (lower, p = 0.005). Using a crutch reduced the peak resultant forces and the peak bending moments with averages ranging from 5.5–12.6 % and 13.2–15.6 %, respectively. Large inter-participant variations were observed and no single activity resulted in consistently higher loading of the bone-anchored attachment across the participants. Results from this study can guide future development of percutaneous osseointegrated implant systems for limb prostheses and their rehabilitation protocols.


Bone-anchored prosthesis

Load measurement

Transfemoral amputation

Daily walking activities


Alexander Thesleff


Center for Bionics and Pain Research

Chalmers, Electrical Engineering, Signal Processing and Biomedical Engineering, Biomedical Signals and Systems

Eva Häggström

University of Gothenburg

Roy Tranberg

University of Gothenburg

Roland Zügner

University of Gothenburg

Anders Palmquist

University of Gothenburg

Max Jair Ortiz Catalan

University of Gothenburg

Sahlgrenska University Hospital

Center for Bionics and Pain Research


IEEE Transactions on Medical Robotics and Bionics

2576-3202 (ISSN) 2576-3202 (eISSN)

Vol. 2 3 497-505

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Areas of Advance

Health Engineering

Life Science Engineering (2010-2018)

Subject Categories

Medical Materials



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