When the Total Hip Replacement Fails: A Review on the Stress-Shielding Effect

Total hip arthroplasty is one of the most common and successful orthopedic surgeries. Sometimes, periprosthetic osteolysis occurs associated with the stress-shielding effect: it results in the reduction of bone density, where the femur is not correctly loaded, and in the formation of denser bone, wh...

Full description

Saved in:
Bibliographic Details
Published in:Processes 2022-03, Vol.10 (3), p.612
Main Authors: Savio, Davide, Bagno, Andrea
Format: Article
Language:English
Subjects:
Adaptation
Arthritis
Biomaterials
Biomedical materials
Bone density
Bone growth
Bone surgery
Bones
Design criteria
Femur
Functionally gradient materials
Hip
Hip joint
Joint replacement surgery
Joint surgery
Literature reviews
Materials selection
Medical research
Orthopaedic implants
Orthopedics
Osseointegration
Osteoarthritis
Osteolysis
Prostheses
Stress shielding
Titanium alloys
Total hip arthroplasty
Transplants & implants
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Total hip arthroplasty is one of the most common and successful orthopedic surgeries. Sometimes, periprosthetic osteolysis occurs associated with the stress-shielding effect: it results in the reduction of bone density, where the femur is not correctly loaded, and in the formation of denser bone, where stresses are confined. This paper illustrates the stress shielding effect as a cause of the failing replacement of the hip joint. An extensive literature survey has been accomplished to describe the phenomenon and identify solutions. The latter refer to the design criteria and the choice of innovative materials/treatments for prosthetic device production. Experimental studies and numerical simulations have been reviewed. The paper includes an introduction to explain the scope; a section illustrating the causes of the stress shielding effect; a section focusing on recent attempts to redefine prosthetic device design criteria, current strategies to improve the osteointegration process, and a number of innovative biomaterials; functionally graded materials are presented in a dedicated section: they allow customizing prosthesis features with respect to the host bone. Conclusions recommend an integrated approach for the production of new prosthetic devices: the “engineering community” has to support the “medical community” to assure an effective translation of research results into clinical practice.
ISSN:2227-9717
2227-9717
DOI:10.3390/pr10030612