Dr Randall on Advancing Prosthetic Embodiment in Sarcoma Amputation

"It’s [important] to raise awareness around [prosthetic] embodiment issues for patients who undergo amputation. Whether you’re a surgeon, medical oncologist, radiation therapist, or any allied oncologic provider, you will interface with these patients."

R. Lor Randall, MD, FACS, the David Linn Endowed Chair for Orthopedic Surgery, chair of the Department of Orthopedic Surgery, and a professor at UC Davis Comprehensive Cancer Center, shared insights into the evolving field of prosthetic embodiment for patients with sarcoma undergoing amputation.

Randall emphasized that prosthetic embodiment is a crucial factor in predicting both acceptance and sustained use of prosthetics. He noted that advancements in aesthetics, sensory feedback, surgical techniques, and skeletal integration are significantly transforming this area. However, Randall highlighted a substantial unmet need for rigorous research, stating that much of the current discussion is a review, with a scarcity of head-to-head studies and trials in the field.

Despite these challenges, progress is being made. Randall disclosed his involvement as an investigator at UC Davis in an ongoing phase 3 trial (NCT06134167) evaluating a compressive osseointegration device. Additionally, he mentioned the already FDA-approved OPRA Implant System, which has demonstrated a strong track record for osseointegration. However, Randall pointed out that other aspects beyond osseointegration remain largely understudied, often limited to small case series rather than stringent investigations.

Looking ahead, Randall stressed the critical need to continue advancing this research, particularly through more comparative studies. He also underscored the importance of raising awareness among all oncologic providers—including surgeons, medical oncologists, and radiation therapists—regarding the embodiment issues faced by patients undergoing amputation. Understanding these struggles is vital, as these professionals will invariably interface with such patients in their practice. These efforts aim to comprehensively define the optimal strategies for improving prosthetic outcomes and patient quality of life, he concluded.