Osseointegration: All the information you need


What is osseointegration?

Osseointegration is a procedure that allows the direct connection of an external prosthesis to the skeleton through the surgical implantation of an intramedullary device..

Historically, osseointegration took place in two stages, with the insertion of an intramedullary component followed by a passive healing period of 6 to 8 weeks. A second surgery was then required to create an opening in the skin, or "stoma," followed by the insertion of external and dual components.

Since 2014, Dr Munjed al Muderis has modified the surgical technique and developed a new implant design that makes it easy to perform a single-stage surgery without compromising results. This has eliminated the need for a second operation and the associated risks, improved soft tissue management, accelerated rehabilitation, allowed for an earlier return to work, and reduced overall costs.


What is the OGAP - OPL implant?

‎The Osseointegration Group of Australia Prosthetic Limb (OGAP-OPL) is the osseointegration-based implant used in femur amputees.

It is composed of several components, which are divided into an internal module (endo) and an external module (exo)..

The endo module, a titanium stem, is implanted directly into the bone. The implant surface is made of highly porous titanium, allowing for initial stability and long-term osseointegration (growth). This technology has been successful in worldwide clinical use for over 30 years in joint replacement surgery. The biocompatibility of the titanium implant allows bone to grow into the surface of the prosthesis, making the bone and implant structure a solid unit. This is what is known as osseointegration.

The exo module uses a double adapter to connect to the internal implant. This adapter has a smooth, highly polished surface to minimize soft tissue friction. It is also coated with a titanium niobium, which has antibacterial properties. The double adapter passes through a small opening in the skin at the end of the stump known as the stoma. Externally, the adapter attaches to a torque control interlock that further engages with the prosthetic limb.

This device can be used with any type of knee prosthesis and lower extremity prosthetic components..

Graphic of the internal mechanism of osseointegration

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Advantages of the OGAP - OPL implant compared to a prosthesis

‎The OGAP-OPL (Osseointegration Group of Australia Prosthetic Limb) offers several advantages over classic leg prostheses:

The main advantage of the OGAP-OPL is that integrates directly with the bone of the patient's stump, rather than being attached to it by a strap or an adjustment at the top of the leg. This provides a much more solid and secure connection than classic leg prostheses..

Another important advantage of the OGAP-OPL is that it allows a greater freedom and range of motion. Classic leg prostheses are typically attached to the upper leg and can be bulky and heavy, limiting the patient's ability to move naturally. This allows the patient recover the sense of proprioception, which refers to the unconscious perception of the body's position, movement and spatial orientation in relation to the external environment. Also the ability to feel the ground and differentiate different types of surface is recovered, allowing for safe mobility in unfamiliar or dimly lit places.


Surgical procedure

The surgical procedure to implement the OGAP-OPL It can be done in two different ways, in two phases or in a single phase, depending on the patient's conditions.

The option of two-phase operation It is used when time is needed for the bone to fully integrate with the implant. In this option, An initial surgery is performed to place the implant in the patient's bone. The implant is a titanium structure that is inserted into the bone and allowed to integrate with the bone over a period of several months.. Once osseointegration has occurred, A second surgery is performed to attach the prosthesis to the implant.

The option of the operation in one phase is carried out when the prosthesis can be placed at the same time as the initial surgery. In this case, the surgeon inserts the implant into the patient's bone and then attaches the prosthesis to the implant during the same surgery.

In both options, a thorough evaluation of the patient is performed before surgery to make sure you are a suitable candidate for the procedure.



After the OGAP-OPL prosthesis implant surgery, Rehabilitation is a crucial process for the patient to recover their functional capacity and improve their quality of life.. The duration and extent of rehabilitation will depend on the patient's condition, age, and physical ability before surgery.

In the first days after surgery, the main objective is to control pain and inflammation, as well as ensure that the surgical wound is well closed and healing properly. Besides, The patient is encouraged to perform simple mobility exercises to prevent joint stiffness and improve blood circulation.

After receiving medical discharge, the patient continues rehabilitation at home or in a rehabilitation center. The goal in this phase is to develop strength and stability, so that the patient can walk with the prosthesis and recover their ability to perform daily activities.


Dr Munjed al Muderis, creator of the OGAP implant - OPL

Dr. Munjed Al Muderis is an Iraqi orthopedic surgeon and creator of the OGAP-OPL prosthesis. (Osseointegration Group of Australia Prosthetic Limb). The story of Al Muderis is impressive, since he began his career in Iraq as a doctor, but after refusing to work for Saddam Hussein's regime, He was forced to flee his country in 1999.

After arriving in Australia, Al Muderis had to start again from scratch, completing his medical training and specializing in orthopedic surgery. It was during his He worked in a Sydney hospital where he began researching and developing the OGAP-OPL prosthesis.

After its creation, Al Muderis has continued to work on improving prosthetics and has performed numerous successful surgeries on patients around the world.. In addition to his work as an orthopedic surgeon, Al Muderis is also an advocate for refugee rights and has used his story and experience to raise awareness about the challenges faced by refugees around the world.

Doctor Munjed Al Muderis