Osseointegration of cemented and noncemented implants in artificial hip replacement: Long-term findings in man

Implant fixation is of utmost importance for pain-free function of endopros theses. Primary fixation is achieved during implantation, whereas secondary fixation is a result of repair and bone remodelling during the healing pro cess comparable to fracture healing. The chronologic course of the healing process follows three overlapping phases: (i) an initial phase with destruc tion and necroses of bone, (ii) a phase of repair with integration of the i mplant into the bone, and (iii) a phase of stabilization of the permanent i mplant bed with adaptation to load transfer and possible reactions to irrit ations of the interface like sepsis, mechanical instability, corrosion and degradation of implant materials, and wear products from articulating and a nchoring surfaces.