Evaluation of Osseointegration and Secondary Stability

Abstract

Evaluation, on an a/p radiograph (classical and negative) at the last follow-up, of a radiolucent line which is taken into account independent of its thickness.

Note: Eliminate all criteria that do not clearly indicate a deficit of osseointegration such a “reactive” line or a reduction of the density of the cortical bone in the contact with the implant.

Two femoral zones are identified: the proximal femur corresponding to Gruen zones 1, 2 and 6 and the distal femur corresponding to zones 3 and 5. The radiolucent line is:

• Quantified at the level of every femoral zone , depending on its extent, from 10 to 4 points: The total of the two zones leads to a score of osseointegration so-called “raw” score on 20 points with a distribution in four stages: very good (20); good (17); average (14); poor (11–8).

• Qualified to define the type of secondary stability, depending of the location of the radiolucent line, to obtain a so-called “weighted” final score, also done on the basis of 20 points with a distribution in four stages: very good (20–18); good (14); average (11); poor (5–8).

Results secondary stability (weighted score) (n 150): very good n = 83 (20–18); good n = 41 (14); average n = 19 (11); poor n = 7 (8–5). The numerical scores obtained decrease in progressive and logical manner, which tends to validate the method. There is no significant association between secondary stability, as previously defined, and the value of secondary bone stock (p = 0.1)

An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-3-319-03614-4_21