Reusing Implants: Is it Possible?

would you want a re-used implant placed in you???

I think that if the implant was used correctly ...... the question is difficult to resolve to one or to the other side. is it legal or not? I think that it depends by our personally experience in this special and also quite dangerous field. I sterilize the implant, commonly, with H2O2 130 volume, at first and then, after minutes, in another solution with H202 12 volume and for me is the best way also if for many collegues can be questionable. But i have 25 years back my shoulders of implantations of every kind of implant, experimentaly designered and produced, that i can be absolutely quite about this way of sterilization.

I would say ,in addition, that i commonly use implants gamma ray sterilized . ok it's all.

i only reuse implants for orthodontic purpose

Most companies take back their implant and give you another one but assuming that the company do not do so and you want to reuse an implant...How much are you sure about the result of your sterilisation and your implant is clean enough to heal correctly without any infection and peri implantitis? are you sure that your implant is good enoughy to take the occlusal stress, that your abutment is seated correctly and your hex is not damaged? Whatever the answer for these is...i will ask the following: Will you accept to do so for yourself, your mother or beloved one?if the answer is yes then it's ethical and you can do it...if not....you got the answer...

Why take the risk? If you are so worried about cost that you can not purchase another fixture, you should not be placing implants at all. Why compromise the patient as the reason for failure could be due to a manufacturing defect.

I know people that does it... furthermore they only use autoclave to sterilize the fixture. It is stupid, irresponsable and also shows an absolute lack of knowledge and class. I got nothing else to say about this

these responses amaze me. THE CORRECT ANSWSER IS NO! NEVER REUSE A FIXTURE. Think about it for one second. you have contimated an extremely rough somewhat porous surface with blood proteins which then get denatured but not removed when you autoclave or heat sterilize. you at the very least have permanent contaminants between implant and bone. not to mention cross contamination and disease transmission. if you decide to reuse, make sure your attorney is on a large retainer and readily available. use a new fixture if it is dropped, if it is contaminated by blood or saliva contact. most good companies with swap them out. gary

This re-use of a dental implant has serious medico-legal ramifications and consequences for the clinician. What is the position and recommendations of the ADA and insurance companies on this procedure? Are you covered ?. I would highly advise against this surgical procedure when a new implant can be placed at a very low cost compared to a potential long and costly litigation process.

reuse a failed implant???? unbelievable. what a concept! like feeding a guest somebody else's vomit without he or she knowing it. no less disgusting

Implant companies replace failed dental implants as long you send back the fixture either for free or a minimum processing charge. check out your providers warranty. Also from the risk management point of view if we need to buy back the implant to replace; what is a few hundred dollars compared to the moral responsibility and liability cost in any event.

never ever....EVER...reuse an implant. i agree with Gary and Dr Rav. the top companies will swap out failed fixtures. Dr Karateew DDS, Dip Perio, Dip Prosth

DO NOT REUSE IMPLANTS, CHARGE THE PATIENT FOR AN OTHER IMPLANT (FACTORY COST). EXPLAIN THE PATIENT THE RISKS AND FINANTIAL RESPONSABILITIES IN THE CASE OF FAILURE IF YOU ARE WORRY ABOUT THE EXTRA COST,OTHERWISE DO NOT PLACE THEM

NO!!! Once an implant comes in contact with body fluids, it is contaminated both with possible allergens and pathogens. Although resterilization by autoclave should reduce the microbes and pathogens, it is never 100% pathogen free. Autoclaving will NOT eliminate allergens. ALlergens can cause the loss of an implant by a host allergic response. Autoclaving can also contaminate the surface of the implant with whatever metals have been present in the autoclave previously. Some metals such as the heavier metals are toxic to tissues. These toxic metals can damage bone. Resterilzation by autoclaving is no guarantee that the implant is free of pathogens, allergens or other contaminants. You are asking for problems reusing a "re-sterilized" implant and would not have any defence should you be sued by a patient.

SB Oral Surgeon summed it up well.

I would never reuse an implant. How can you be sure that the etched surfaces are perfectly cleaned off? How can you be sure that the implant will remain sterile once you have sterilized it? How can you be sure that the surface of the implant will remain clean of any debris during and after sterilizing it? Having said this, I know that the old Imtec transitional implants came non-sterile, and we were required to autoclave them. The difference is that they were still new implants. I would think that implanting a used implant from another patient is illegal in the U.S. In any case, why open yourself up to litigation should the implant fail, or worse, the patient become septic? How would you defend yourself? With failure rates as low as they are, I don't think that reusing implants can be justified.

I love to hear so many opinions based on individual conceptions of what is or what should be the norm. What happened to the scientific process of conducting research on the matter? I guess restaurants should stop using non disposable dishes, silverware and glasses because someone thinks it would be better for everyone.

NO, send it back and get another one, or clean it up and sterilize it and use it as a demo.

Basic knowledge of implant surface treatment procedures, would in itself answer the question, with a resounding NO! I wonder if anyone has ever asked the question of what happens to this highly specialized surface,once it is sterilized in an autoclave that has processed instruments contaminated with amalgam(thus mercury as well) and oil from handpieces. Once in contact with any biological material, certainly this surface would be forever ruined, although, in situ treatment of exposed threads with chemicals and laser are done to try and avoid implant loss and further surgery for the patient.

Most of the dentists are not in favour of Re-using of failed implant. Several arguments were raised, of those, issue of sterilization, allergic reactions, litigation, insurance and cost-effective issues including the clinical problem of the distorted implant fixtures, etc. are mentioned in their say. So far I know anecdotally, and by literature search, I could not find any case report and outcome of a clinical trail on re-use of failed implants. However, in clinical practice nothing is impossible. It keeps on changing, but, the changes need to be tested and evidence based. There are clinical practitioners and researchers coming up with new solutions of the need. But we should have better understanding on how frequently our dentists are experiencing implant failures, and what are the reasons for such failures. If the host tissue is acceptable for re-fixing, and the used implant is not distorted, sterilized, non-allergic, and importantly, if the preparation/procedure is cost-effective- that way, there will be no wrong to re-use it. Nevertheless, in my opinion, first we should look into the following issue, if at all we need to re-use of implants. For that, we must need strong scientific evidence (published case reports, clinical trials) based on the following: 1. Status of the host tissue, supporting areas, overall patents compliance, anticipated occlusion aesthetics for re-implantation of an implant. 2. Condition of the implant components will be re-used. 3. Infection control by employing appropriate method of sterilization (autoclaving ensure 100% sterilization including embedded tissues in an implant component, but, we may need to know whether any structural changes occur in the components of the implants after autoclaving, will be re-used. 4. Patients’ compliance, ethical-litigation issues, cost-effectiveness and insurance etc are dependent on how you are ensuring a quality clinical outcome with the re-used implant. I suggest to test it, and validating it for a cost-effective practice both for the dentists and patients. Anyway, the following published report by Pekka Laine et al of the Department of Oral and Maxillofacial Surgery (Chair: Prof. C. Lindqvist), Helsinki University Central Hospital of Finland may give you an idea on the few issues discussed. Abstract: “Most patients did not have any symptom indicating failure; hence, the failures were noticed mainly by the clinicians when instability of the fixture or of the prosthetic reconstruction became obvious. Radiolucency around the fixture was the most frequent radiological finding. Twenty per cent of the fixtures were located in insufficient bone. Ninety seven per cent of the bacterial cultures were positive, Streptococcus milleri being the most commonly identified aerobic and Fusobacterium nucleatum the most commonly anaerobic bacteria. Conclusion The most critical time for success is immediately after prosthetic loading. Hence, implants should be placed in the optimal position to facilitate prosthetic reconstruction and loading. Ref. Journal of Cranio-Maxillofacial Surgery Volume 33, Issue 3, June 2005, Pages 212-217 You may visit http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJ1-4G1GFCG-2&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=52fdf2fafae33dfda53897aba16354c0 - Chitta R Choudhury, PhD, FFDRCS, BDS Poole NHS Hospital Dept of Maxillofacial Surgery & Bournemouth University, England

if you are a clinician then-NO,Send it back to the company ,explain it to the patient about the cost involved (if any). if you want to do research and donot do practice post your address online people will send you all the failed implant;;; enjoy your research.

I cannot believe someone in this forum suggested we do clinical research on re-using failed implants. I have been on more than one FDA panel for implant research and I can gaurantee you the concept would never get past the application process. But I have a suggestion. For everyone who thinks such a practice might be a good idea, go do implants in all the staff and patientws in an AIDS clinic. The patients are HIV positive, the staff is not. REmember, we never know what our patients are carriers of, that is why we use universal precautions. Make it a double blind study so the clinician has no way of knowing which implants are HIV contaminated. Make sure to use implants with extrememly porous microtexture such as TiUnite. Sterilize them in an autoclave and then implant them in your mother and children. Does ANYONE in this forum care to take me up on the offer? By the way Dr. P, if you are truly on the implant lecture circuit and did not know the answer to this question kindly retire or at least practive in California where I do a lot of medico-legal work. My attorney friends need the business.

It's hard to believe we're discussing this in this forum! There is absolutely no realistic way you could decontaminate or sterilize a rough surface implant.

Purely anecdotal, not a recomendation and I personally would not do it, But I have seen this done sistematically, but only with Nobel Branemark machined implants, I think it would not work on rough surfaces. No problems with osseointegration, y suppose that Oxide layer was augmented imporving surface topography. Simply if your are a teacher, it is easier to say dont do it. Greetings

I would not do it. However one may be able to remove the organic debris with organic solvents and plasma glow discharge. I do question this with the microtextured surfaces.

Reusing an implant is like using an directimplant, never compromise and give your patients such poor quality for the sake of money, think about ethics and longevity. Will this implant be in the mouth in 10 or 15 years. Of course never reuse or replant an implant.

This can not be a doctor asking the question, it is someone on the forum getting us all fired up, no real doctor in their right mind would ever do such a thing, with the exception of replant of an implant. The question is have you ever during surgery ever over prepped an osteotomy and placed say a 4.3 taken it out because fixation was not ideal and used this implant in a different osteotomy during the same surgery. The implant is contaminated with patients own blood and the forces have been applied to the threads of the implant, of course you would irrigate the implant and then would you use it in a different osteotomy in a different location during the same surgery and obviously the same patient.

The question is: if the implantes can be reused.The answer is "YES".The question is not about economical or oral matters. that is other thig. Some titanium hip protesis and other implements are taken out from deth humans and are reuse. Of course i depends of the implant treated surface and the way you use to serilize it. It also have to be free of contaminated particuls. Again I´m anly talking of biological possibilities and not moral or economical.

I never reused a failed implant and I do not consider it an acceptable solution at the moment. However if further studies validated predictable in-office procedures for decontaminating implant surfaces, I would consider reusing an implant in case of early failure (before loading) on the same patient. Recent animal studies show that dental implants previously affected by periimplantitis can be successfully reused. Moreover, if grafting a bone defect caused by periimplantitis is considered a feasible treatment, why reusing a failed implant (on the same patient) should not? The same biological principles are involved. At last it is likely that in a few years the advance in implant-science and the spreading of implant therapy will make the implant an inexpensive commodity, so that recycling of dental implants will be a nonsense.

I know of three pioneers and giants in the field of oral implantology that have done this . The US FDA could answer this question for US docs. Blades and the early Core Vents were modified and steralized. I guess you have to stop and THINK, do I trust the steralization methods in my office and do I TRUST and BELIEVE in the science that I have learned and am I not reacting with emmotions.

I agree with Richard. Of course dental implants can be reused if the question is a purely hypothetical one. Practically, and generally it should not be reused. Ideally, return it to the manufacturer for a new one. However in certain circumstances when one is left with little choice but to reuse it, with our knowledge of the science of implant materials and sterilization, it should not be too much trouble to sandblast it and acid etch it and then autoclave it and then reuse it. Back to the basics and cheers!

at least i read the many opinions about the question: yes i do or no i do it not. i read too, that the many "no" or "not" are very questionable and emotional but not scientific. i read too that" reusing implant i like using a direct implant. for me is a great compliment because i use direct implants ( like Pasqualini, Tramonte, Muratori, Pierazzini, Garbaccio,the great italians who ideated,designed and experimented with certified foolow up of 30 o more years , before the war 1939-45) since 1980 and only theese, with great satisfaction. Linkow and other great americans did the same with their direct designed direct implants. however the question , for me is only scientific and not etically.

Have you ever heard of orthopedic surgeons or neurosurgeon re-using their hardware? I don't think so!!!!!!!!!!!!!!!!

I would tell any individual contemplating re-use of a dental implant in the U.S. that federal law requires them to register as a “Reprocessor of single use devices” (see the link below; this requirement applies even if the “reprocessor” is a private clinician), list with FDA the device(s) they reprocess, and pay the FY2009 establishment registration fee of US$1,851. Failure to do so would be a federal crime. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/RegistrationandListing/ucm053165.htm

Dr. Romano, I too, use the Pasqualini blade. I love this implant. I was mentored by Dr. Linkow, he and other giants had a huge influence on me and my approach to oral implantology. Yes, the Italian implantologist have made significant contrabutions to oral implantology.

reuse implants? 0$ cost 100% risky!!!! No matter the way you sterelize your implants.... the company will give a new one to you! what about reuse washed condoms?!?!?! Pablo. DDS, OMS. Argentina

Of course it is outlandish to contemplate reusing an implant for all the reasons stated.But if you wanted to clean an implant ( glove contaminated etc) never autoclave ( liqiud only) and then blast it clean after to re-prepare the surface.( unless the implant surface is chemically treated)

What about cover screws, healing caps, healing abutments? Do you think they can be re-used? Whilst some healing caps come with fixtures, the Straumann ones don't.

NEVER reuse an implant that was in place and failed. Use this in a laboratory procedure or send back to manufacturer for full/partial refund. If you have good relations with your supplier they take care of you!

I am a regular Straumann user. The cover screws, healing caps abutments , even drills, are reusable after a close inspection and sterilisation in autoclave. Elie

First I didn't believed the question but then , no question is bad or wrong , just the answers, I feel relived that almost everyone here have objection about the reusing implants and I agree with Dr. Willardsen and others, yes you can think about it but its not an option. If your supplier don't change it for a new one, change supplier.

Legally, the implant needs to be sterile. Clinically, the implant needs to be pure. Technically, if you had the materials at hand to clean the implant to the requisite purity properly then you could sterilize it in pure ethanol, dry it and use it. Although whether its worth while doing it is ethically, legally or even worth wasting time over is debatable. I think Jerry probably has data on the success rate of hand modified and re-etched corevents in the field. :)

Interestingly everyone assumed that the used implant would be placed in a different individual at a future date. Therefore all the concerns for contamination and sterilization. How about removing an implant and use it on the same person either at a different site or the same site at a future date? Lets not get emotional about this and approach it like scientists that we are. Unless the implant is coated by a sensitive material like HA, most of the implants' surfaces are simply roughened surfaces made by either acid etching or blasting with an abrasive. To achieve cleanliness, alternate submersion in 3% H2O2 and 5% NaHCl3 (bleach)for a total time of 15 mts followed by thorough rinsing is sufficient and dissolves and removes all the organic matters that may have been trapped in the roughness. This treatment would make it good enough for the implant to be used on the same patient on the same date. For future date use or use in a different individual, it should be dried and sterilized and stored in a sealed bag. If you recall, the original Branamark screw implants that showed 20 and 30 year success tracks did not have ANY surface treatment. Ossiointegration takes place just as well on plane Titanium. So, the surface treatment of the bone surface of the implant is more a bonus on the total surface area than a necessity for success. We can also conclude that how this roughness is achieved is inconsequential as long as there remain no residue of the abrasive on the implant surface preventing close contact of the Titanium to bone. I would be comfortable totally scraping the original rough surface of the old implant by a diamond or carbide leaving it grossly roughed up by my rotary instrument. Scientifically, the cleanig/sterilization and/or re-roughing of the surface will work without any safety or success concerns. However, we invest tens of thousands of dollars in decorations, disposables and technologies that do not contribute one bit to the safety or success of our procedures, because they make us and our patients "feel good" about what we are doing. Therefore, spending a few hundred dollars extra for a new fixture eventhough is not scientifically warranted,is emotionally desirable for a first class operation that all of us claim to have.

I will answer the question by asking another questions 1-is osseointegration an acceptable terminology in dentistry? :No 2-What is the structure of intermediate tissue between bone and implant?:connective tissue 3-What kind of material will irritate connective tissues?:allergens,foreign bodies,electropositive and electronegatve metals,trauma 4-what is the mechanisem and cause of ossteoclastic activity in the bone?:cell mediated response,necrosis due to overheating,pathogens So as you see insertion and retention of an implant in bone structure is a physically phenomen and insertion of our fixture in the bone will fabricate a path that is inherently retentive and lock and embedded the fixture in the bone,and the delicate connective tissue in the interface is responsible for any body reaction. the problem with reused implants are : 1-because of thread corrosion(when the fixture threads are sharp it will penetrate easily with minimum heat generating and the bone will lock better the fixture. 2-possible transmitted pathogens so if i want to reuse an implant i should carefully check the threads for any unsharpness of the thread surface,and proper autoclaving to remove the pathogens.

fyi, implant direct will NOT reimburse for 'failed' implants

Most implants that I know of are sold as single-use devices. The "2" with the circle/slash through it indicates this. The FDA mandates this needs to be on the packaging. Therefore, reusing the implant could have legal ramifications.

I was approached by a local veterinary hospital and subsequently have donated used implants to them for a trial for cosmetic work on show dogs. They apparently receive ex-planted pacemakers as well for use in animals with rhythm disturbances. The only other use is to stick them in a jar for educational purposes- all my patients want to see what I am about to implant.

Les qualités de surface d'implant sont critiques dans la détermination de la configuration absorbée du premier biofilms pendant la guérison après le traitement de péri-implant. L'énergie de surface, la charge et la texture de la surface d'implant dentaire peuvent influencer la différentiation de tissu et affecter osseointegration/reosseointegration. Le bioactivite d'un biomatériau est associé à son énergie de surface, sous l'influence de la pureté de la matière et est un critère important pour la détermination de bioacceptabilite. La contamination de la surface biomatériau avec les hydrocarbures et d'autres molécules et les éléments peut réduire l'énergie de surface et le potentiel bioacceptabilite de la surface d'implant dentaire. L'analyse de couche d'oxyde a démontré l'incorporation de quelques polluants dans la surface d'implant dentaire. Les événements critiques différents pourraient déclencher l'incompatibilité d'implant dentaire. Par exemple, les polluants inorganiques comme C, Ca, Na et P étaient probablement pertinents au mécanisme d'absorption d'ions solvates qui se produisent naturellement dans les liquides de corps. En plus, le contrôle des caractéristiques de surface de cpTi dentaire implante est considéré comme un facteur important pour la réalisation d'une réponse de tissu optimale pendant la guérison d'os et de tissus mous. Le degré de contamination de la surface de titane de récupéré implante a montré pour avoir un effet direct sur la stabilité mécanique et les qualités osseoinduction .

what about implants that i opened the box not the cover cylinder? can i use them?

Oui monsieur, vous pouvez les utiliser.

to cut discussion about sterilization of a discharged but perfect direct implant (i use only different kinds of direct implants)i will show you what i perform to determinate the best polishing and sterilization of an implant or more implants that i discharged only why not suited for horizzotal or vertical dimension. after discharged, full immersion in H2O2 32% and not 3% or 5 %, for five-ten minutes. then full immersion in warm whater and NaCl 6% or 15% for ten or more minutes. then full immersion in an electronic ultrasonic tank with warm whater, NaCl 6% or more for 10-15 minutes. then sterilization at 140°C for circa 120 min. in a inoxidable steel box sigillated. then before to make any new use of any of theese, can we say recycled, implants, i begin from the first step i described earlier. All of this i described is a fruit of my personal experience in a dimension where the failure and personal errors can carry we to fall into an ambush whether legal or moral. tahnk Alessandro

a correction is a duty NOT NaCl BUT NaClO .

I would not recommend re-using a dental implant. If it fails again and the patient decides to sue you, this is something the patient can use against you.

I have a question regarding dental implants that have been touched by a metalic instrument or gloves accidentally during surgery .. Could we place it directly or later after treatment of the titanium surface? Does lack of titanium oxide layer (because of this contact)affect the bone graft material ?

I do not think it's a big deal if an implant is touched with sterile gloves or a sterile metal instrument.

titanium oxide layer is the biocompattible layer of the implant & it is formed very fast on exposure of titanium to air.touching an instrument as long as it is sterile , well not affect the oseointegration,the point of touching the gloves is more critical espicially cos if the gloves still keeping the it's powder or any isolating material ,this might work as separating media for osteointegration at the area of touch.to be on the save side don't touch the implant.

Thanks Prof Husam .. We are discussing accidental touch of metalic instruments or gloves..Don't you think that this will remove the titanium oxide layer? What is your recommendation if that happenned? Do you recommend discarding the implant? Do you recommend keeping such implant to support graft material?

I do not think that touching an implant with an instrument or gloved gand will make the world come to an end. In theory it may make a difference but clinically, no big deal. Unless it's gross niglect.

I buy Imtec implants for under $160 and charge about $2000 for a single tooth. Why would I risk the legal ramifications of trying to save $160? If you are considering re-using implants, you are paying too much and letting emotion and money affect clinical judgement. Change brands and be a better dentist.

Not recommended

this is a very interesting discussion about instrumentation and sterilization. I have worked with sterilization and othopedics for a long time and I do not recall the surgeons I consult for having this detailed of a conversation, it is nice to see. there is one thing I did not see in this discussion though. In the united States the the manufactuer of the an implant generally must submit the implant for 510K approval to offer the product in the US. If a implantable Class II device is designed to be reused then that manufactuer must provide validated reprocessing and sterilization instructions for the user to follow.The FDA will not give approval for the device unless it is satisfied that the manufactuer has given the user a way to make the reprocessable implant safe for patient use. So in other words, in the US at least - if there are no manufactuer VALIDATED and FDA approved instructions for reprocessing and sterilization of the fDA approve device then it should not be reused!! In fact it is against the law to do so, because you are using a medical device in a way that it is not designed or approved to be used in the course of patient care. FDA, Joint commision, CDC,WHO,ADA and all other standards groups for healthcare in this country have always stated that the manufactuers instructions MUST be followed for reprocessing and sterilization and they should be kept on file for reference and be produced in case of inspection, multiple infections and or legal action for malpractice. The bottom line is that the manufactuer must be able to give you documentation in writing that states it is an approved medical device whichcan be placed in a patients body and that you CAN or CANNOT reprocess it. the device manufatuer is required to give you decontamination and cleaning instructions to prepare it for sterilization, as well as specific sterilization methods (like steam sterilization,Gas or Plasma)and the exposer times for the sterilant (for steam it would be the exposer time, at a specific temperature in a prevacuum or gravity autoclave)and the packaging to keep it steril until it can be implanted in the body. It also is stated in the standards that you must use Biological indicators with every implantable to assure that the sterilization cycle was succesful. If you cannot produce that documentation and an infection occurs or the patients lawyer can prove you did not follow the instructions or use the device in an unapproved manor you wil have major malpractice issues. Really patient safety is the issue, please follow the instructions it is in your best interest - and the patients. Hope his helps.

Can You reuse a disposable prophy cup? Can You refill a lidocaine cartrige? Can you reuse a disposable suction tip? Can you wash a paper patient bid and reuse it? Can I re use a failed Implant? Yes, you can , but you should'nt

I am not concerned about the structural strength of the implant but the surface contamination is a big concern. I do not feel we can clean the implants surface adequately to be able to reuse a failed implant. What if the reused implant causes a failure again and worse case a large amount of bone loss results or other issue? If this were to become litiganous you would have no defense reusing an implant. Spending another $2-300 is better insurance to a success then reusing one to save a few $

if we can make sure that the surface of free of blood proteins, allergens, etc, and if we can follow the above mentioned procedure like h2o2, nacl etc,i feel in certain selected cases, we might be able to reuse the implant in the same patient, provided the patient has signed a consent form. Its not a matter of class, litigation or whatever and certainly not research. no offense pls this is only a personal thought.....thank you

If you could confirm the implant surface is not altered, and is free of pathogens, chemical contamination and tissue debris after sterilization and decontamination methods, I guess it could be re-used. I personally would NOT re-use implants because confirming the above would be very expensive, and research hasn't been done in this particular area. Someone above said that doing this would be risky for the patients. Very true, but, then using homologous bone or tissues for regeneration or transplants would also be out of question. Even high quality bone and tissue processing companies warn you about the risks involved in using transplanted tissues. What I'm trying to say is, if matters such as these were never brought up for discussion, I guess transplants would have never occured in the first place.

The design of a prosthetic implant especially hip, is nodular. Most failure occurs due to asceptic loosening of the acetabular cup while the femoral component is always intact and may be re-used. The re-use would occur during remanufacturing after it is thoroughly sterilised, inspected and treated by the manufacturer or an independent remanufacturer.

there is another question which by itself will eliminate a lot of issues like alergen cross contamination ,or even implant and accessories ciclic fatigue, what if we sterilise anduse a failed implant which has failed before loading and for the same patient in the same socket