Forearm bone-anchored amputation prosthesis: A case study on the osseointegration

Abstract

Background and purpose Bone-anchored titanium implants have been used for anchorage of amputation prostheses for more than one and a half decades. Histo-logical and ultrastructural analyses were performed on a forearm amputation prosthesis after being in use for more than 11 years. Material, methods and results The implant was retrieved from the ulnar bone after a fatigue fracture of the titanium implant, and was clinically stable at the time of removal. The histological findings showed a large amount of bone within the threads and a high degree of apposition of mineralized bone to the implant surface. Ultrastructural analysis of thin samples prepared by focused ion-beam microscopy revealed an electron-dense layer at the interface and direct apposition of crystalline hydroxyapatite at the implant surface. Interpretation Our observations in this retrieval study provide a structural correlate to the functional properties and clinical results of amputation prostheses.