History of Osseointegration

A Brief Osseointegration Timeline

Socket use first recorded
Enter the socket

In the 1500's, Ambroise Paré designed one of the first reported traditional socket prosthesis which could be considered a predecessor of the current socket-base prosthesis, the worldwide standard of care. 

Post 1500s
Socket developed

Since then, different designs based on the traditional socket prosthesis have been produced to support patients perform different daily activities with greater functionality.

Nevertheless, skin irritation, ulcers, and problems with the fitting of the prosthesis are common issues with these socket-based prostheses.

First steps
Osseointegration first attempts

The first attempts towards osseointegration occurred in the 1940´s. Several surgeons and researchers began studies around transcutaneous osseointegration for amputees (TOFA). This procedure refers to metal prosthesis that is implanted in the body, passes through the skin, and connects with an external prosthesis.

Major strides
Titanium screws first used

In the 1980s, Per-Ingvar Brånemark presented work that had begun 15 years earlier in Gothenburg using titanium in rabbit bones. Brånemark's investigations into the phenomenon of osseointegration, or the biological fusion of bone to a foreign material, resulted in a revolution in dentistry and dental implants. 

Applied to amputees
First human patient

Building on his father's success, Rickard Brånemark worked towards the first osseointegration procedure using a titanium fixture in a human in 1990. The patient was able to walk with crutches. The implants had to be removed after 23 years due to problems with the soft tissue

Improvement over socket

Clinical investigation into osseointegration continued during the 1990s. Several studies confirmed that osseointegration avoided some of the skin problems caused by socket-based prosthesis, improved the range of motion, added control over the artificial limb, and enhanced sensory perception

Implant development

In 1998, the OPRA procedure (Osseointegrated Prostheses for the Rehabilitation of Amputees) was defined. This procedure is based on the use of screw-like implants, which were first used in dentistry. The main disadvantage of screw-like implants is the lower initial rotational stability compared to other implant types.

Implant development

In 1999, a new type of “press-fit" implants was first used on an amputee in Germany. The new type of implants had a porous surface that aimed to achieve fixation with the bone. This concept was different from the screw-type design that had been previously used in the OPRA procedure. The new implant-type surgery was called Integral Leg Prosthesis (ILP)

Implant Refined

A new technique called OPL was developed in the last decade by Dr. Al Muderis and his colleagues. OPL is a single stage procedure compared to other techniques like OPRA, ILP or POP, which require 2 operations to be performed. In addition, OPL shows promising clinical results. OPL has more than 800 implantations world-wide in recent years and has faster rehabilitation times than OPRA.

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