Abstract
Various concepts and parameters have been addressed in the literature for the evaluation and assessment of integration between the bone and the implant for implantation of orthopedic implants to the bone tissue. In order to treat the severe bone injuries, losses, fractures, and even deformities, it would be inevitable to use internal implantation of orthopedic implants. Therefore the integration of bone tissue to/through the implant surface is the main concern that is currently being investigated by the researchers and product developers in the development of new generation of orthopedic implants. In this chapter, history of osseointegration concept was first reviewed, and then the effective parameters on integration of bone to the implant were discussed in view of biological and mechanobiological aspects. Poor osseointegration of orthopedic implant is associated with loosening of the implant after implantation to the bone. There would be some factors which originate from the implant that would have significant effect on osseointegration such as contact wear particles, bone loss during implantation, implant design, implant surface roughness, early mechanical integration to the cortical and trabecular bones, etc. It was observed that contact wear particles would induce expression of macrophages to phagocytosis the contact wear particles or any released particles from the implant, from which bone remodeling process is affected. Likewise, damage to the bone tissue during bone drilling and insertion of implant to the bone has been found to be effective parameter in early osseointegration. Furthermore, design feature for early mechanical integration to the bone was reported to influence the early biological integration of bone to the implant. In this chapter, the fundamentals of osseointegration in orthopedic implants and loosening of the implant are deeply reviewed. Reading of this chapter is recommended for effective pursuing of the reviewed contents in the following chapters.
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