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However, although there seems to be consensus that un-tethered implants elicit a smaller tissue reaction than tethered ones, it is still unclear if the actual neuronal numbers differ between the two fixation modes.
Taken together, these findings underscore the need for a study systematically comparing the two fixation modes by evaluating the overall elicited tissue reactions and specifically addressing in quantitative terms the issue of neuronal numbers close to the implants over rather long evaluation periods.
Since changes over time are important to consider when systematically evaluating how the characteristics of the implant influence the tissue, we here focused on establishing and quantifying the relative importance and potential interactions between implant size and fixation modes over time.
Hybrid fixation modes including one cemented and one uncemented component (hybrids, reversed hybrids, resurfacings) were less frequently used and therefore classified into one group ("other", Table 1).
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This means that un-tethered fixation mode resulted in fewer activated astrocytes and microglia.
Fixation mode did not affect the density of neurons (Figure 2 and Table 1).
Since the aim was to investigate the impact of size and fixation mode of the implant on the tissue response, we compared a 200 µm to a 50 µm implant diameter, and a tethered to an un-tethered fixation mode.
The present study focused on basic properties of implanted electrodes, and could demonstrate that both size and fixation mode of the implant influence tissue trauma and healing.
Also the shapes and sizes of the cavities made by the implants demonstrated different characteristic properties depending on implant fixation mode.
Since there was no significant difference in cavity size when comparing 6 weeks and 12 weeks after implantation, we investigated fixation mode regardless of time point.
Notably, the relative importance of implant size and fixation mode, and the possible interplay between the two factors have not been established or quantified.
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