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March 26, 1982

Bony ingrowth holds new 'joints' in place

JAMA. 1982;247(12):1680-1685. doi:10.1001/jama.1982.03320370004002

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Methyl methacrylate, introduced to the orthopedic surgical world in the late 1950s by John Charnley, MB, FRCS, of the University of Manchester, England, revolutionized joint replacement because it provided a quick-drying cement as well as a cushion between bone and prosthesis. Still, most surgeons agree that the best bond between bone and implant is a biologic one, and this is the goal of several prosthetic devices on the market today—to achieve permanent bone ingrowth into an implant.

"Over the past ten to 20 years it has evolved that the major problem with artificial joints of all types is the fixation of the joint to the bone, which tends to work loose over time," says Kenenth A. Krakow, MD, assistant professor of orthopedic surgery at The Johns Hopkins University School of Medicine and chief of orthopedic surgery at Loch Raven Veterans Administration Hospital, Baltimore. "You can imagine how it would feel