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Archives of Orthopaedic and Trauma Surgery

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01-09-2016 | Handsurgery

Osteointegration of a modular metal-polyethylene surface gliding finger implant: a case report

Authors: Stephan F. Schindele, Christoph M. Sprecher, Stefan Milz, Stefanie Hensler

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2016

Abstract

Introduction

Primary press fit and secondary osteointegration is a precondition for component anchoring in articular surface replacements, also in the case of proximal interphalangeal (PIP) joint. Nevertheless, many existing prostheses for the PIP joint have failed to show sufficient osteointegration. CapFlex-PIP^© implant is a modular metal-polyethylene surface replacement for the PIP joint consisting of a proximal and distal component each having a titanium pore backside, which allows secondary osteointegration at the bone-implant interface. To evaluate osseous integration of this implant, we report a histological analysis of an explantation of a CapFlex-PIP^© finger implant.

Case presentation

We present a case of a removed CapFlex-PIP^© implant due to a soft tissue complication in an 84-year-old woman. The patient received bisphosphonate medication as treatment for osteoporosis. For the histological analysis, the bone-implant contact (BIC) was measured on all stained sections using a Zeiss Axioplan microscope. The summated BIC was 40.7 % for the proximal component and 46.5 % for the distal component of the implant. Histology showed that the implant was in direct contact with the bone at various locations, with no signs of wear or degradation.

Conclusions

This case demonstrates successful osteointegration of the CapFlex-PIP^© implant. Both components of the investigated implant show osseous integration to an extent which is comparable to that of other load-bearing and articulating implants at different locations in the human body.

Agarwal R, García AJ (2015) Biomaterial strategies for engineering implants for enhanced osseointegration and bone repair. Adv Drug Deliv Rev 94:53–62CrossRefPubMed

Braunstein V, Sprecher CM, Gisep A, Benneker L, Yen K, Schneider E, Heini P, Milz S (2008) Long-term reaction to bone cement in osteoporotic bone: new bone formation in vertebral bodies after vertebroplasty. J Anat 212(5):697–701CrossRefPubMedPubMedCentral

Castagna A, Randelli M, Garofalo R, Maradei L, Giardella A, Borroni M (2010) Mid-term results of a metal-backed glenoid component in total shoulder replacement. J Bone Joint Surg Br 92-B(10):1410–1415CrossRef

Daecke W, Veyel K, Wieloch P, Jung M, Lorenz H, Martini AK (2006) Osseointegration and mechanical stability of pyrocarbon and titanium hand implants in a load-bearing in vivo model for small joint arthroplasty. J Hand Surg Am 31(1):90–97CrossRefPubMed

Finnilä S, Moritz N, Svedström E, Alm JJ, Aro HT (2016) Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density. Acta Orthop 87(1):48–54CrossRefPubMed

Gahlert M, Rohling S, Wieland M, Sprecher CM, Kniha H, Milz S (2009) Osseointegration of zirconia and titanium dental implants: a histological and histomorphometrical study in the maxilla of pigs. Clin Oral Implants Res 20(11):1247–1253CrossRefPubMed

Giro G, Chambrone L, Goldstein A, Rodrigues JA, Zenóbio E, Feres M, Figueiredo LC, Cassoni A, Shibli JA (2015) Impact of osteoporosis in dental implants: a systematic review. World J Orthop 6(2):311–315CrossRefPubMedPubMedCentral

Herren DB, Schindele S, Goldhahn J, Simmen BR (2006) Problematic bone fixation with pyrocarbon implants in proximal interphalangeal joint replacement: short-term results. J Hand Surg Br 31(6):643–651CrossRefPubMed

Hohendorff B, Zhang W, Burkhart KJ, Müller LP, Ries C (2015) Insertion of the Ascension PyroCarbon PIP total joint in 152 human cadaver fingers: analysis of implant positions and malpositions. Arch Orthop Trauma Surg 135(2):283–290CrossRefPubMed

10.

Reissner L, Schindele S, Hensler S, Marks M, Herren DB (2014) Ten year follow-up of pyrocarbon implants for proximal interphalangeal joint replacement. J Hand Surg Eur 39(6):582–586CrossRef

11.

Schenk RK, Buser D (1998) Osseointegration: a reality. Periodontol 2000 17(1):22–35CrossRefPubMed

12.

Schindele SF, Hensler S, Audigé L, Marks M, Herren DB (2015) A modular surface gliding implant (CapFlex-PIP) for proximal interphalangeal joint osteoarthritis: a prospective case series. J Hand Surg Am 40(2):334–340CrossRefPubMed

13.

Schmidutz F, Sprecher CM, Milz S, Gohlke F, Hertel R, Braunstein V (2015) Resurfacing of the humeral head: an analysis of the bone stock and osseous integration under the implant. J Orthop Res 33(9):1382–1390CrossRefPubMed

14.

Schüttrumpf JP, Balcarek P, Sehmisch S, Frosch S, Wachowski MM, Stürmer KM, Walde H-J, Walde TA (2012) Navigated cementless total knee arthroplasty—medium-term clinical and radiological results. Open Orthop J 6:160–163CrossRefPubMedPubMedCentral

15.

Shibli JA, Aguiar KCDS, Melo L, d’Avila S, Zenóbio EG, Faveri M, Iezzi G, Piattelli A (2008) Histological comparison between implants retrieved from patients with and without osteoporosis. Int J Oral Maxillofac Surg 37(4):321–327CrossRefPubMed

16.

Sprecher CM, Gahlert M, Röhling S, Kniha H, Gueorguiev B, Milz S (2013) Comparison of imaging methods used for dental implant osseous integration assessment. J Mater Sci Mater Med 24(9):2195–2200CrossRefPubMed

17.

Streit M, Innmann M, Merle C, Bruckner T, Aldinger P, Gotterbarm T (2013) Long-term (20- to 25-year) results of an uncemented tapered titanium femoral component and factors affecting survivorship. Clin Orthop Relat Res 471(10):3262–3269CrossRefPubMedPubMedCentral

18.

Wesemann A, Flugel M, Mamarvar M (2008) Moje prosthesis for the proximal interphalangeal joint. Handchir Mikrochir Plast Chir 40(3):189–196CrossRefPubMed

19.

Weycker D, Macarios D, Edelsberg J, Oster G (2007) Compliance with osteoporosis drug therapy and risk of fracture. Osteoporos Int 18(3):271–277CrossRefPubMed

Title: Osteointegration of a modular metal-polyethylene surface gliding finger implant: a case report
Authors: Stephan F. Schindele
Christoph M. Sprecher
Stefan Milz
Stefanie Hensler
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 9/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2526-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Osteointegration of a modular metal-polyethylene surface gliding finger implant: a case report

Abstract

Introduction

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusions

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