Osseointegration Surgery: Procedure and Modern Surgical Techniques

Osseointegration is an advanced medical procedure that forms the foundation of modern implant-supported dentures. It involves inserting a specialized implant into the bone canal, which over time fuses permanently with the patient’s bone tissue, forming a single, solid unit. Thanks to extensive collaboration between doctors and engineers, this technology allows for the complete elimination of problems typical of traditional dentures, such as pain, sores, or instability in the mouth.

What will you read about?

• The surgical procedure
• Materials Technology and Safety

The surgical procedure

The surgery is typically performed under regional anesthesia—either epidural or spinal—which completely blocks pain and sensation from the waist down, leaving the patient in a state of sedation. The surgical procedure itself is extremely precise and begins with making an incision at the distal end of the stump to expose the remaining bone. A very important step is the removal of excess fat and subcutaneous tissue to minimize the distance between the bone and the skin, which is crucial for avoiding future complications.

In the next phase, the surgeon examines the stump for neuromas and removes them to reduce postoperative pain. The muscles are repositioned and attached directly to the bone using special sutures. This arrangement of muscle groups is intended not only to improve stability but also to enable future control of modern prostheses through muscle impulses. The bone canal is then sequentially expanded using special reamers until the desired shape and size are achieved.

The main focus of the procedure is the insertion of a titanium stem. The implant is carefully pressed into the prepared canal (press-fit technique), which ensures immediate primary stability and allows for a very rapid start to rehabilitation. Finally, a circular opening (stoma) is created in the skin at the base of the stump. An adapter passes through this opening, connecting the internal implant to the external components of the prosthesis.

Materials Technology and Safety

The success of the procedure is based on the use of biocompatible titanium, which is well tolerated by the body and promotes bone integration into the implant’s rough surface. The implant surface is coated with a highly porous layer that ensures immediate postoperative stability and enables durable, biological integration. The skin-penetrating adapter, in turn, has a highly polished surface to minimize soft tissue friction and is coated with an antimicrobial compound of niobium and titanium.

Thanks to such precise surgical techniques, the success rate is very high—in the case of femoral osseointegration, the revision rate is currently less than 2%. This surgery not only restores mechanical function to patients, but also, thanks to the phenomenon of osseoperception (deep sensation), allows them to feel contact with the ground once again. The completion of the procedure paves the way for intensive physical therapy, which often begins as early as the first or second day after surgery.