Steel is still the standard for implants. It is very stable, easy to sterilise and cheap to produce. However it creates a bio film which can lead to implant failure and has negative effects with imaging and allergies. Titanium is half the weight of steel, a little more rigid, but has osteoinductive capacity. Since it is completely inert, the surrounding bone will integrate the screw entirely without biofilm.
There is a certain learning curve handling titanium screws. Metallic screws tend to squeak before they break, titanium does not. The torsion resistance of a screw needs between 5-7 Nm. Our titanium screw holds up to 12 Nm torsional strength.
Standard sterilisation procedures all work for titanium screws and the therasys equipment. After contact with air i.e. oxygen, the screw turns a little darker due to oxidisation. This improves osseous integration.
In fact all orthobiologics available can be injected with a syringe or through the connector kit in to the target area. Only bone fillers which are too pasty have to be adapted into the process before fitting in the screw. Meaning, after drilling a cyst in lag technique a switching stick or Steinmann Pin will be inserted into the cyst. If you use Innotere (Arthrex), the plastic tube coming along will be applied over the pin into the cyst and connected to the syringe. After deploying the cement into the cyst the Therasys screw is inserted.
The insertion of the screw is as described in the video. A standard plastic tubing can be cut with a scissor and applied to the head of the screw and fixed using the tube adapter and tube fixator. Skin and subcutus are closed either with suture material or staples and the infusion tubing is integrated in the bandage. Through the tubing liquid materials like antibiotics can be introduce into the bone as often as needed. Once the therapy is finished by simply pulling the tubing the infusion line is removed.
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