Osseointegration

What is Osseointegration?

Osseointegration refers to the integration of a metal (titanium) implant into a bone. The  anchored implant protrudes through the skin creating an interface where an arm or leg prostheses  can be attached. This can provide a more stable and functional prostheses connection than  traditional socket-based systems.

Importance and Benefits

Osseointegration can benefit those with the following issues

• Ill-fitting socket protheses that cause skin sores and pressure spots
• Nerve pain or neuromas
• Abnormal contours of a residual limbs
• Patients who want increased control of their prosthesis

Osseointegration Procedures

• Preoperative Considerations

Before surgery, a thorough medical history, physical exam, and imaging are  performed to make sure patients are a good candidate for osseointegration. Medical  and physical factors play a part in the successful outcome of the surgery.

• Surgical Process

Osseointegration surgery is typically done in a single stage – where the soft tissue is  recontoured and the metal implant is inserted in the same surgery. If that patient is  having nerve related issues, these problems can be addressed during the same or  separate procedure.

• Postoperative

A progressive loading protocol is initiated several weeks after surgery, but in most  cases, patients can attach their prosthesis iin as soon as six weeks post-operatively.

Advantages of Osseointegration

There are multiple advantages of osseointegration. These include:

• Avoidance of socket related issues related to skin sores and neuroma type  pain
• Improved function and ambulation with decreased energy expenditure o Improved proprioception (sense of spatial awareness of their extremity) o Faster donning and doffing of a prosthesis
• Increased bone density as the bone is directly loaded with weight bearing

Potential Risks and Challenges

Every surgery has its risks. Infection around the skin-implant interface is a risk of  osseointegration. With advanced soft tissue closure, an antibacterial metal coating, these risks  are minimized. Another postoperative risk is a fracture around the implant. This risk is  decreased with a progressive loading protocol that increases bone mineral density. Fail-safes  within the prosthesis connectors are also installed to decrease this risk.

 

FAQs

What is osseointegration?

Osseointegration refers to the integration of a metal (titanium) implant into a bone. The anchored implant protrudes through the skin creating an interface where an arm or leg prostheses can be attached. This can provide a more stable and functional prostheses connection than traditional socket-based systems.

How does osseointegration work?

After the device is placed during surgery, the body builds new bone around the implant that “integrates” with the porous titanium surface. This integration is a close bond that anchors the implant to the bone

Is osseointegration FDA approved?

The “press-fit” implants that I use are not fully FDA approved for standard use in the United States. Currently, we apply for FDA approval on a case-by case basis. As this procedure becomes more common in the US, we hope to gain fully FDA approval

What are the benefits of osseointegration compared to traditional methods?

Osseointegration can benefit those with the following issues:

• Ill-fitting socket protheses that cause skin sores and pressure spots
• Nerve pain or neuromas
• Abnormal contours of a residual limbs
• Patients who want increased control of their prosthesis

Who is a good candidate for osseointegration?

Osseointegration can benefit those who are having problems with their socket prothesis or for those who wish to gain mobility with the current prosthesis.

What is the typical recovery time after an osseointegration procedure?

A progressive loading protocol is initiated several weeks after surgery, but in most cases, patients can attach their prosthesis in as soon as six weeks post-operatively.

Are there any risks or complications associated with osseointegration?

Every surgery has its risks. Infection around the skin-implant interface is a risk of osseointegration. With advanced soft tissue closure, an antibacterial metal coating, these risks are minimized. Another postoperative risk is a fracture around the implant. This risk is decreased with a progressive loading protocol that increases bone mineral density. Fail-safes within the prosthesis connectors are also installed to decrease this risk.

How long do osseointegration implants last?

Osseointegration implants are expected to last a lifetime. There are certain components on the outside that need to be tightened or replaced at regular intervals. These are typically done in a clinic setting.

What kind of maintenance is required for osseointegration implants?

Regular care of the skin-implant interface (aperture) is required while the skin matures. This is typically done with saline and gauze.

How much does an osseointegration procedure costs?

The cost of the implant and procedure are dependent on insurance.

Will my insurance cover the osseointegration procedure?

Insurance may cover the osseointegration implant and procedure.

What should I expect during the initial consultation with Dr. Wallace?

During initial consultation, Dr. Wallace will take a thorough medical history and physical exam. Radiographs are typically taken in clinic and a CT scan will be obtained to custom size the implant and plan the osseointegration surgery

How do I prepare for an osseointegration surgery?

Before surgery, a thorough medical history, physical exam, and imaging are performed to make sure patients are a good candidate for osseointegration. Medical and physical factors play a part in the successful outcome of the surgery.

What is the success rate of osseointegration procedures?

Most patients achieve successful osseointegration with the implant that allows them to have increased control of their prothesis with decreased socket related issues.

Can osseointegration be done for both lower and upper limbs?

Yes. Osseointegration is typically done both the lower and upper limbs. The most common devices are implanted into the femur, tibia, humerus, and radius.

Orthopedic osseointegration refers to the integration of an implant with bone tissue specificallyin the field of orthopedics. This process is often used in prosthetics, where implants are designedto be anchored directly into the bone, providing a morestable and functional connection thantraditional socket-based systems.

Here’s how it generally works:

1. Implant Placement: An orthopedic implant, often made of titanium or another biocompatible material, is surgically placed into the bone. The implant might be a part of a limb prosthesis or used to stabilize a joint or fracture.
2. Bone Integration: Over time, the bone grows around and bonds with the surface of the implant. This biological process creates a stable and durable interface between the bone and the implant.
3. Functional Restoration: Once the osseointegration process is complete, the implant provides a solid base for attaching prosthetic limbs or other orthopedic devices. This can lead to improved functionality, comfort, and stability compared to traditional prosthetic  sockets that rest on the surface of the limb.

Orthopedic osseointegration can be particularly beneficial for individuals who need prosthetic  limbs, as it allows for a more natural and secure attachment. It can also be used in procedures  like bone-anchored hearing aids or certain types of joint replacements.

The success of orthopedic osseointegration depends on several factors, including the quality of  the bone, the design of the implant, and the surgical technique used.