Reactions of surrounding tissue to the cementless hip implant Ti-6Al-4V after an implantation period of several years. Autopsy studies in three cases.

Three femoral endoprosthetic stems implanted without cement, made of Ti-6Al-4V alloy, with implantation periods of between 2 and 4 years were examined histologically in the form of undecalcified thin ground sections after having been split into segments and embedded in plastic. During the implantation period total osseointegration in the metadiaphyseal region takes place, while in the proximal area reaction forms with direct contact between metal and bone on the one hand and with an interposed membrane of connective tissue and adjacent secondary bony shell on the other must be distinguished. The osseointegration of the stem is the result of a primary healing of the bone and is due to the biocompatibility of the metal alloy and to the primary stability obtained by the press-fit method.