Joint replacement enabling below knee amputees with knee arthritis or short residual bone to walk without needing a socket prosthesis. Dr. Al Muderis was portrayed on 60 Minutes Australia showing the failures from his surgeries, there in the USA, and in his native Iraq. He did not contact patients who had issues from hypergranulosis, maggots, infections, over charging of procedure. Lack of follow up for complications, cause many patients to have the implants removed. On December 7, 2015, two Operation Iraqi Freedom/Operation Enduring Freedom veterans, Bryant Jacobs and Ed Salau, became the first in America to get a percutaneous osseointegrated prosthesis. In the first stage, doctors at Salt Lake Veterans Affairs Hospital embedded a titanium stud in the femur of each patient. About six weeks later, they went back and attached the docking mechanism for the prosthesis. Mechanism Osseointegration is a dynamic process in which characteristics of the implant (i.e. macrogeometry, surface properties, etc.) play a role in modulating molecular and cellular behavior. While osseointegration has been observed using different materials, it is most often used to describe the reaction of bone tissues to titanium, or titanium coated with calcium phosphate derivatives. It was previously thought that titanium implants were retained in bone through the action of mechanical stabilization or interfacial bonding. Alternatively, calcium phosphate coated implants were thought to be stabilized via chemical bonding. It is now known that both calcium phosphate coated implants and titanium implants are stabilized chemically with bone, either through direct contact between calcium and titanium atoms, or by the bonding to a cement line-like layer at the implant/bone interface. While there are some differences (e.g. like the lack of chondrogenic progenitors), osseointegration occurs through the same mechanisms as bone fracture healing. Technique For osseointegrated dental implants, metallic, ceramic, and polymeric materials have been used, in particular titanium. To be termed osseointegration the connection between the bone and the implant need not be 100%, and the essence of osseointegration derives more from the stability of the fixation than the degree of contact in histologic terms. In short it is a process where clinically asymptomatic rigid fixation of alloplastic materials is achieved, and maintained, in bone during functional loading. Implant healing time and initial stability are a function of implant characteristics. For example, implants using a screw-root form design achieve high initial mechanical stability through the action of their screws against bone. Following placement of the