Lately, more and more people have some type of implant. From head to toe implants are used to stabilize fractures, replace joints, fuse bones and support dental crowns. Surgical technology has progressed leaps and bounds because of the ability to find an anchor point for both simple plates for fractures and elaborate spine hardware for fusions. However, anchoring into bone requires one very important ingredient: good quality bone stock. Mushy osteoporotic bone just does not provide a good foothold for implants. The poor bone stock quality found in the elderly, post-menopausal woman, or unhealthy individual challenges surgeons around the world.
Building a scaffolding of hardware in the body is challenging enough even with good bone. Imagine trying to place a screw into a jello-like surface. That screw is very likely to pull-out, shift, and loosen. Implant failure leads to the need for more surgery-revision surgery. And more surgery increases the likelihood of infection, pain, and other complications. When the bone and the implant are unable to integrate, implant failure is highly likely. Because of poor bone quality, osteoporosis does threaten the success of implants.
Without good quality bone as a foundation, total joints can fail. Without solid, healthy bone, fractures are less likely to fuse even with internal hardware fixation. All this fancy surgical technology is nearly worthless in those with osteoporosis. Thus, special preparation must be made in order to avoid implant failure. With proper prior planning, implants are a viable option in those with osteoporosis.
Many types of solutions to poor bone stock quality have been devised. Some innovative hardware helps to improve the chances of the bone interlocking with the implant. A solid abutment connection is critical for implant success. Other technologies increase the chance of the success like bone substitutes, bone cement, and bone grafts. Probably the most interesting and futuristic prevention strategy for implant failure in those with osteoporosis is gene therapy. Wouldn't it be nice to force bone cells to make stronger bone? Someday, that possibility will be a reality. But until then, those with osteoporosis need to be very cautious about opting for implants.
Better yet, before the need for an implant arises, an individual should start working on improving bone health now. Beginning with calcium and vitamin D early in life will minimize the threats to implants in the future. Building a solid foundation now will provide strong anchor points for everything from screws to total joints in the future. Ultimately, preventing osteoporosis is the key to preventing potential implant failure.
Published On: April 13, 2011