Orthopaedic osseointegration: Implantology and future directions

Archie L. Overmann, Conrado Aparicio, John T. Richards, Isha Mutreja, Nicholas G Fischer, Sean M. Wade, Benjamin K. Potter, Thomas A. Davis, Joan E Bechtold, Jonathan A. Forsberg, Devaveena Dey

Research output: Contribution to journalReview articlepeer-review

70 Scopus citations


Osseointegration (OI) is the direct anchorage of a metal implant into bone, allowing for the connection of an external prosthesis to the skeleton. Osseointegration was first discovered in the 1960s based on the microscopic analysis of titanium implant placed into host bone. New bone was observed to attach directly to the metal surface. Following clinical investigations into dentistry applications, OI was adapted to treat extremity amputations. These bone anchored implants, which penetrate the skin and soft tissues, eliminate many of the challenges of conventional prosthetic sockets, such as poor fit and suspension, skin breakdown, and pain. Osseointegrated implants show promise to improve prosthesis use, pain, and function for amputees. The successful process of transcutaneous metal integration into host bone requires three synergistic systems: the host bone, the metal implant, and the skin-implant interface. All three systems must be optimized for successful incorporation and longevity of the implant. Osseointegration begins during surgical implantation of the metal components through a complex interplay of cellular mechanisms. While implants can vary in design—including the original screw, press fit implants, and compressive osseointegration—they face common challenges to successful integration and maintenance of fixation within the host bone. Overcoming these challenges requires the understanding of the complex interactions between each element of OI. This review outlines (a) the basic components of OI, (b) the science behind both the bone-implant and the skin-implant interfaces, (c) the current challenges of OI, and (d) future opportunities within the field.

Original languageEnglish (US)
Pages (from-to)1445-1454
Number of pages10
JournalJournal of Orthopaedic Research
Issue number7
StatePublished - Jul 1 2020

Bibliographical note

Publisher Copyright:
© 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.


  • amputation
  • military
  • osseointegration
  • trauma


Dive into the research topics of 'Orthopaedic osseointegration: Implantology and future directions'. Together they form a unique fingerprint.

Cite this