Orthopaedic osseointegration: Implantology and future directions.

Autor: Overmann AL; Orthopaedics, USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Aparicio C; MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics and Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota., Richards JT; Orthopaedics, USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Mutreja I; MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics and Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota., Fischer NG; MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics and Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota., Wade SM; Orthopaedics, USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Potter BK; Orthopaedics, USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Davis TA; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Bechtold JE; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota.; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota.; Hennepin Healthcare Research Institute, Minneapolis, Minnesota., Forsberg JA; Orthopaedics, USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland., Dey D; USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2020 Jul; Vol. 38 (7), pp. 1445-1454. Date of Electronic Publication: 2020 Jan 13.
DOI: 10.1002/jor.24576
Abstrakt: Osseointegration (OI) is the direct anchorage of a metal implant into bone, allowing for the connection of an external prosthesis to the skeleton. Osseointegration was first discovered in the 1960s based on the microscopic analysis of titanium implant placed into host bone. New bone was observed to attach directly to the metal surface. Following clinical investigations into dentistry applications, OI was adapted to treat extremity amputations. These bone anchored implants, which penetrate the skin and soft tissues, eliminate many of the challenges of conventional prosthetic sockets, such as poor fit and suspension, skin breakdown, and pain. Osseointegrated implants show promise to improve prosthesis use, pain, and function for amputees. The successful process of transcutaneous metal integration into host bone requires three synergistic systems: the host bone, the metal implant, and the skin-implant interface. All three systems must be optimized for successful incorporation and longevity of the implant. Osseointegration begins during surgical implantation of the metal components through a complex interplay of cellular mechanisms. While implants can vary in design-including the original screw, press fit implants, and compressive osseointegration-they face common challenges to successful integration and maintenance of fixation within the host bone. Overcoming these challenges requires the understanding of the complex interactions between each element of OI. This review outlines (a) the basic components of OI, (b) the science behind both the bone-implant and the skin-implant interfaces, (c) the current challenges of OI, and (d) future opportunities within the field.
(© 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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