title: Bone and metal: an orthopaedic perspective on osseointegration of metals.
abstract: The area of implant osseointegration is of major importance, given the predicted significant rise in the number of orthopaedic procedures and an increasingly ageing population. Osseointegration is a complex process involving a number of distinct mechanisms affected by the implant bulk properties and surface characteristics. Our understanding and ability to modify these mechanisms through alterations in implant design is continuously expanding. The following review considers the main aspects of material and surface alterations in metal implants, and the extent of their subsequent influence on osseointegration. Clinically, osseointegration results in asymptomatic stable durable fixation of orthopaedic implants. The complexity of achieving this outcome through incorporation and balance of contributory factors is highlighted through a clinical case report.
authors.affiliation: Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Institute for Developmental Sciences, University of Southampton, MP887, Institute of Development Science Building, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. Electronic address: vitaligoriainov@hotmail.com.
authors.forename: Vitali
authors.initials: V
authors.lastname: Goriainov
authors.affiliation: National Centre for Advanced Tribology at Southampton (nCATS), Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Cook
authors.affiliation: Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: M Latham
authors.affiliation: Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: Douglas
authors.initials: D
authors.lastname: G Dunlop
authors.affiliation: Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Institute for Developmental Sciences, University of Southampton, MP887, Institute of Development Science Building, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: Richard O C
authors.initials: RO
authors.lastname: Oreffo
mesh_terms: D000375:Aging; D000818:Animals; D006801:Humans; D016268:Internal Fixators; D008670:Metals; D009983:Orthopedic Equipment; D016348:Osseointegration; D019736:Prostheses and Implants
chemical_list: D008670:Metals
keywords: Biocompatibility; Material bulk characteristics; Orthopaedic metal implants; Osseointegration; Surface characteristics