Cementing Osseointegration Implants Results in Loosening: Case Report and Review of Literature.

Jason S Hoellwarth,Munjed Al Muderis,S Robert Rozbruch

doi:10.7759/cureus.7066

Jason S Hoellwarth, Munjed Al Muderis + Show 1 more

Open Access

https://doi.org/10.7759/cureus.7066

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Abstract

Skeletal transcutaneous osseointegration was performed on a 54-year-old female transfemoral amputee. None of the available osseointegration implants achieved press-fit stability, so an implant was cemented in position. Although initially stable, by six months the patient reported painful loading and radiographs revealed cement mantle lucency. The osseointegration implant was removed, antibiotics were delivered via implanted spacer and intravenously, and revision osseointegration three months later achieved appropriate immediate press-fit stability. Cemented transcutaneous osseointegration implants loosen within one year. Osseointegration is only successful when bone grows directly onto the implant.

Highlights

The most common rehabilitation solution for lower extremity amputation is a skin suspension suction socket
For fractures occurring around press-fit osseointegration implants, routine fracture management with implant retention has been uniformly successful, and patients remain more active after recovery than before osseointegration [4,5]
She desired a future attempt at osseointegration, so the recommendation was made to obtain intraoperative cultures, place an antibiotic spacer to empirically treat any potential bacterial colonization, and consider staged revision osseointegration based on her recovery

Summary

Introduction

The most common rehabilitation solution for lower extremity amputation is a skin suspension suction socket. Eight weeks after the first stage, the dual cone (the component which connects the internal implant to an external prosthetic limb) was inserted through a transcutaneous stoma On both the anterior-posterior (A) and lateral (B) views, there is a uniform cement mantle between the implant and the cortical bone with proximal uniformity of the cement indicating the restrictor helped pressurize the cement during insertion. She desired a future attempt at osseointegration, so the recommendation was made to obtain intraoperative cultures, place an antibiotic spacer to empirically treat any potential bacterial colonization, and consider staged revision osseointegration based on her recovery. Three weeks following revision osseointegration, she is loading 40 kg without pain and radiographs reveal a stable implant (Figure 5). The distal collar is highly polished niobium oxynitride to prevent skin adhesion. 1, proximal cap screw. 2, OPL body. 3, safety screw. 4, dual cone abutment adapter. 5, permanent locking propeller screw. 6, proximal connector. 7, prosthetic connector

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