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 endoprostheses. Primary fixation is achieved during implantation, whereas secondary fixation is a result of repair and bone remodelling during the healing process comparable to fracture healing. The chronologic course of the healing process follows three overlapping phases: (i) an initial phase with destruction and necroses of bone, (ii) a phase of repair with integration of the implant into the bone, and (iii) a phase of stabilization of the permanent implant bed with adaptation to load transfer and possible reactions to irritations of the interface like sepsis, mechanical instability, corrosion and degradation of implant materials, and wear products from articulating and anchoring surfaces.