Osseointegration in skeletal reconstruction and rehabilitation: a review.

The loosening of implants from bone tissues has been a cause of problems in reconstructive surgery and joint replacement. The thought for decades has been that the layer of fibrous tissue that develops around the implant diminishes the integrity and mechanical stability of the implant/bone interface (1). During the 1950s it had been shown by Brånemark that chambers made of the metal titanium could become permanently incorporated with bone. That is, the living bone could become so fused with the titanium oxide layer of the implant that the two could not be separated without fracture (2). Brånemark introduced the term “osseointegration” to describe this modality for stable fixation of titanium to bone tissue.