A composite fixation principle for modular segmental defect replacement (SDR) prostheses.

A composite fixation concept for porous-coated modular segmental bone and joint replacement prostheses was developed. Bone cement will provide immediate intramedullary stem stability, whereas autogenous bone grafts are applied over the porous-coated segmental shoulder region to achieve extracortical bone bridging and ingrowth for long-term biologic fixation. Bench tests, theoretical analyses, and animal experiments were performed to validate such a concept. Preliminary clinical trials have demonstrated extraordinary results as well as several limiting factors. Additional effort is required to perfect this innovative concept for prosthetic implant fixation.