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Compressive osseointegration for endoprosthetic reconstruction.
Parlee, Lindsay; Kagan, Ryland; Doung, Yee-Cheen; Hayden, James B; Gundle, Kenneth R.
Affiliation
  • Parlee L; Department of Orthopedics and Rehabilitation, Oregon Health and Science University.
  • Kagan R; Department of Orthopedics and Rehabilitation, Oregon Health and Science University.
  • Doung YC; Department of Orthopedics and Rehabilitation, Oregon Health and Science University.
  • Hayden JB; Department of Orthopedics and Rehabilitation, Oregon Health and Science University.
  • Gundle KR; Department of Orthopedics and Rehabilitation, Oregon Health and Science University.
Orthop Rev (Pavia) ; 12(3): 8646, 2020 Nov 24.
Article in En | MEDLINE | ID: mdl-33312488
This review summarizes the biomechanical concepts, clinical outcomes and limitations of compressive osseointegration fixation for endoprosthetic reconstruction. Compressive osseointe - gration establishes stable fixation and integration through a novel mechanism; a Belleville washer system within the spindle applies 400-800 PSI force at the boneimplant interface. Compressive osseointegration can be used whenever standard endoprosthetic reconstruction is indicated. However, its mode of fixation allows for a shorter spindle that is less limited by the length of remaining cortical bone. Most often compressive osseointegration is used in the distal femur, proximal femur, proximal tibia, and humerus but these devices have been customized for use in less traditional locations. Aseptic mechanical failure occurs earlier than with standard endoprosthetic reconstruction, most often within the first two years. Compressive osseointegration has repeatedly been proven to be non-inferior to standard endoprosthetic reconstruction in terms of aseptic mechanical failure. No demographic, device specific, oncologic variables have been found to be associated with increased risk of aseptic mechanical failure. While multiple radiographic parameters are used to assess for aseptic mechanical failure, no suitable method of evaluation exists. The underlying pathology associated with aseptic mechanical failure demonstrates avascular bone necrosis. This is in comparison to the bone hypertrophy and ingrowth at the boneprosthetic interface that seals the endosteal canal, preventing aseptic loosening.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Orthop Rev (Pavia) Year: 2020 Document type: Article Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Orthop Rev (Pavia) Year: 2020 Document type: Article Country of publication: United States