History of Osseointegration
In 1990 first implantations of osseointegrated, percutaneous (skin perforating) femoral prostheses was performed by R. BRANEMARK, who provided a bilateral above knee amputee with an intramedullar (inside the bone) force carrier to which the conventional exo-prostheses could be attached. This idea derived from findings made with tooth-implants. BRANEMARK’s father had invented tooth-implants, which are also directly attached to the bone to allow fixation of an artificial tooth. This system has found worldwide appreciation and is nowadays performed very often.
In 1999 the first so-called Endo-Exo-Femurprosthesis, which had been developed by Dr. Hans GRUNDEI, was implanted to a young motorbike rider after he suffered from a traumatic above knee amputation of the left leg.
At the ISPO World Congress 2010 in Leipzig, Germany BRANEMARK reported by now more than 200 patients who had received his osseointegrated system mainly after traumatic amputations at above-knee, above- and below-elbow as well as thumb level.
The group in Lübeck, Germany around Dr. ASCHOFF can look at more than 100 patients that have been operated in Lübeck itself and other patients in different places in Germany and other European countries as well as Australia.
Lübeck is the place with the highest amount of EEP - patients, there are also more than ten patients that have been provided with Endo-Exo-Tibia-Implants after below-knee amputation. A third group in England has less clinical experience but intensely works on the problem of chronic soft tissue infection at the site of skin-penetration of the implant, which has not been completely solved by now. A successful emulation of the biologic model of deer antlers is pursued. However, a closed system with a smooth transition from vital skin and soft tissue layers to the metal surface of the implant has not been achieved by now. The group in Lübeck around Dr. ASCHOFF therefore counts on a potential epithelialization (tissue growing) of the channel between outer skin and the distal (away from the body) end of the bone. This thought is empirically driven due to the findings that in case of a complete skin-growth inside of this channel an ascending infection is only theoretically possible between bone and implant. This is not obligatory but constitutes an absolute exception.
