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Introduction

Burjeel Medical City continues to lead the way in advanced surgical interventions with a groundbreaking osseointegration procedure performed on a 57-year-old patient with a history of transtibial amputation. This innovative approach addresses common socket-related complications, offering improved mobility and quality of life for amputees facing chronic prosthetic challenges.

Patient History

The patient presented with significant socket-related issues stemming from a short residual limb. Years of conventional prosthetic use had resulted in thickening of the distal stump and callosity formation, despite previous skin grafting interventions. As a non-smoker with Type 2 diabetes, the patient represented a suitable candidate for this advanced surgical approach.

Clinical Assessment

Examination revealed clear evidence of soft tissue thickening and callosity at the distal end of the residual limb, consistent with chronic socket-related pressure and friction. The medical team noted healed graft sites on distal sections of the stump without any signs of active infection or ulceration, confirming candidacy for the procedure.

Surgical Approach

Under the expert guidance of a specialized surgical team including Dr. Munjed Al Muderis, Dr. Michael George Uglow, Dr. Ahmed Hammouda, and anesthesiologist Dr. Ahmed Omran, the osseointegration procedure was meticulously performed at Burjeel Medical City’s state-of-the-art surgical facility.

The surgical technique involved:

• Minimal skin incision using a corer to preserve tissue integrity
• Conservative soft tissue dissection to maintain stability and vascularity
• Preservation of posterior soft tissue and hyperkeratotic skin to minimize stoma infection risk
• Sequential reaming of the distal tibial medullary canal from 8mm to 23mm
• Fluoroscopy-guided broaching up to 24mm for precise implant positioning
• Insertion of an OPL Tibial Type D implant (24×80mm) with press-fit fixation

This approach achieved excellent rotational stability with minimal bleeding upon tourniquet release, eliminating the need for flap refashioning.

Benefits of Osseointegration

Osseointegration represents a revolutionary advancement for amputees facing challenges with traditional socket prosthetics. By directly anchoring the prosthetic limb to the bone, this technique eliminates common issues such as:

• Socket discomfort and pain
• Skin irritation and breakdown
• Limited range of motion
• Difficulty with prosthetic fitting
• Reduced proprioception and stability

Patients typically experience improved mobility, enhanced sensory feedback, and greater freedom from the limitations of socket-based systems.

Burjeel Medical City’s Advanced Surgical Capabilities

This procedure showcases Burjeel Medical City’s commitment to providing cutting-edge surgical interventions across its network of facilities in Abu Dhabi, Dubai, Al Ain, Sharjah, Al Dhafra, and Oman. With 70 operating rooms and specialized equipment including 7 catheterization laboratories, Burjeel Medical City’s surgical infrastructure supports complex procedures that transform patients’ lives.

Conclusion

The successful osseointegration procedure demonstrates the advanced surgical capabilities available at Burjeel Medical City facilities. By embracing innovative techniques, the team of orthopedic surgeons continues to provide life-changing solutions for patients with complex medical challenges, maintaining Burjeel Medical City’s position at the forefront of healthcare excellence in the region.

Experts

Prostate cancer is one of the most common cancers in men. The prostate is a gland that makes some of the fluid that helps to nourish and transport sperm. Prostate cancer starts when cells in the prostate grow abnormally and crowd out normal tissue. The tumor grows slowly at first, but as it gets bigger, it can damage nearby tissues, causing pain and other problems. Most prostate cancers grow slowly and do not spread to other parts of the body. But some are aggressive and have a high chance of spreading to other organs, such as the bones and lymph nodes.

Symptoms of Prostate Cancer

The most common signs are:

• Difficulty urinating, either dribbling or a weak flow
• A feeling that you have to urinate more often than usual
• Pain or burning while urinating
• Blood in your urine or semen

Causes of Prostate Cancer

It’s estimated that more than 40% of men will develop prostate cancer at some point. The causes of prostate cancer are not well understood, but researchers have found that certain factors can increase a man’s risk of developing it. These include

Age: As men get older, their risk of developing increases. It is more common in men over the age of 50.

Diet: Eating a diet high in red meat or dairy products may increase your risk.

Family History: If a close relative has been diagnosed with the condition, you’re at higher risk for developing it yourself.

Infection: Infection by the sexually transmitted virus HPV increases your risk of developing both low-grade and high-grade prostate cancers.

Diagnosis

Prostate cancer is diagnosed by a combination of physical examination, blood tests, and biopsies.

Physical Examination. The doctor will examine the prostate for swelling, lumps, or other abnormalities. The doctor may also order a digital rectal exam (DRE) to check the prostate for lumps and abnormalities.

Blood Tests Determine elevated levels of PSA (prostate-specific antigen) and DRE2-3 (a protein produced by many cancers).

Digital Rectal Exam (DRE) may also be performed to identify any abnormalities in the prostate.

Biopsy. The diagnosis of prostate cancer can be confirmed with a biopsy of tissue samples taken from your prostate gland during an examination known as a transrectal ultrasound guided needle biopsy (TRUS-NB). This procedure involves inserting an ultrasound probe into your rectum so that the doctor can see inside your body and guide a thin needle over your prostate gland.

Treatment

Treatment of prostate cancer varies based on the disease’s stage and the patient’s age. Treatment options include surgery, radiation therapy, hormone therapy, and chemotherapy. 

Radiation therapy is used for patients with early-stage disease that has not spread to local lymph nodes and for patients with advanced-stage disease that is confined to the prostate gland. In external beam radiation therapy (EBRT), a machine directs a beam of high-energy radiation at the tumor from outside the body. 

Brachytherapy involves placing radioactive seeds directly inside or around the tumor. 

Hormone therapy involves taking drugs such as luteinizing hormone-releasing hormone agonists (LHRH agonists) or antiandrogens to stop testosterone production in men who have advanced prostate cancer. The goal of hormonal treatment is to reduce levels of testosterone circulating in the bloodstream so that tumors do not grow as quickly as they would if testosterone levels were normal. 

Chemotherapy may be used alone or in combination with other treatments, such as surgery or radiation therapy, to treat advanced prostate cancer that has spread beyond its primary location (metastatic).

Surgery for Prostate Cancer

Surgery for prostate cancer involves removing the prostate gland or part of it. This surgery is called radical prostatectomy (RP). There are two types of RPs: open and robotic-assisted laparoscopic. The type of surgery you have depends on your tumor size and location, age, and other factors.

Radical prostatectomy is a surgical procedure to remove the prostate gland, including some surrounding tissue and lymph nodes. The surgeon makes an incision in the lower abdomen and removes the prostate gland through that opening. A catheter may be inserted into the urethra so urine can flow freely afterward. The surgeon then repairs any damage done during surgery, closes the incision, and stitches up any remaining skin openings on each side of the scrotum (in males).

At Burjeel Medical City, Abu Dhabi, we are dedicated to providing the best possible care for patients with prostate cancer. Our experienced team of uro-oncologists is committed to providing the highest quality of care and treatment for our patients. We understand the importance of providing comprehensive care for prostate cancer and are dedicated to providing the best possible outcomes for our patients. With our cutting-edge technology and expertise, we strive to provide the best possible care for our patients and ensure that they have the best chance.