The current approach to research and design of the artificial hip prosthesis: a review

One of the most successful techniques in restoration of degenerated joint functions is total hip replacement. This surgical approach includes removal of diseased cartilage and bone parts, and replacement by the corresponding joint prostheses. By using metal alloys, high quality plastic and polymer materials, orthopedic surgeons can reconstruct hip fractures, or replace a painful, dysfunctional joint with highly functional, long-lasting prostheses, enabling hundreds of thousands of people to live a more fulfilling and active life. However, most of these implants only last for 10-15 years, and one of the most common problems for both patients and doctors is implant failure. Observed in long-term, implant loosening is the main cause of failure. Occasionally, dislocation or bending of implants may occur. Fatigue fracture and wear were identified as the main problems related to loosening of implants, stress shielding, and final implant failure. There are several factors which contribute to implant integrity, including material and design, implant positioning, cementing technique and patient characteristics. To improve integrity and life of hip implant by using finite element analysis, two major factor should be considered, design and biomaterial. By using this method there are various parameters that should be define, including complex geometry of the bone and an implant, biomaterial properties, and specifics boundary conditions, i.e. contact between the hip prosthesis and the bone depending on fixation method. In orthopedic biomechanics finite element method was first used for the purpose of determining the stresses in human bones. Since then, this method has been more and more frequently applied in determining of stress state in bones and prostheses, as well as fracture fixation devices, including hip implants. This paper presents a review study of factors influencing design process and structural integrity of the hip implant. Correspondence to: K. Colic, University of Belgrade, Innovation Center, Faculty of Mechanical Engineering, Kraljice Marije 16, 11 000 Belgrade, Serbia, E-mail: kbojic@mas.bg.ac.rs

[1]  Karl Stoffel,et al.  Catastrophic failure of 4 cobalt-alloy Omnifit hip arthroplasty femoral components , 2008, Acta orthopaedica.

[2]  R. D. Mercado-Solís,et al.  Failure analysis of Co–Cr hip resurfacing prosthesis during solidification , 2013 .

[3]  G Bergmann,et al.  Determination of muscle loading at the hip joint for use in pre-clinical testing. , 2005, Journal of biomechanics.

[4]  Vanna Bottai,et al.  Total hip replacement in osteoarthritis: the role of bone metabolism and its complications. , 2015, Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases.

[5]  Tarun Goswami,et al.  Review of wear mechanisms in hip implants: Paper I – General , 2004 .

[6]  D. Arola,et al.  Fatigue of the bone/cement interface and loosening of total joint replacements , 2010 .

[7]  T. Goswami,et al.  Review of wear mechanisms in hip implants: Paper II: ceramics IG004712 , 2004 .

[8]  W. Gofton,et al.  Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty: protocol for a randomized, controlled study. , 2015, Annals of translational medicine.

[9]  T. Wallny,et al.  Thirteen year follow-up of a cementless femoral stem and a threaded acetabular cup in patients younger than fifty years of age , 2016, International Orthopaedics.

[10]  K. Kaneko,et al.  Midterm Outcome of Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis , 2016, Journal of orthopaedic surgery.

[11]  G. Ciapetti,et al.  Cytokines and osteolysis around total hip prostheses. , 2000, Cytokine.

[12]  Benedict U. Nwachukwu,et al.  Preoperative Hip Injections Increase the Rate of Periprosthetic Infection After Total Hip Arthroplasty. , 2016, The Journal of arthroplasty.

[13]  A. Sedmak,et al.  EXPERIMENTAL AND NUMERICAL RESEARCH OF MECHANICAL BEHAVIOUR OF TITANIUM ALLOY HIP IMPLANT , 2017 .

[14]  M. L. Le Duff,et al.  The Natural History of Osteoarthritis: What Happens to the Other Hip? , 2016, Clinical orthopaedics and related research.

[15]  Z. Feldbrin,et al.  Elevated ferritin and circulating osteoprotegerin levels as independent predictors of hip fracture in postmenopausal women admitted for fragility fracture: time for new screening strategies? , 2017, Immunologic research.

[16]  José A. Simões,et al.  Design of a composite hip femoral prosthesis , 2005 .

[17]  W. Winkelmann,et al.  The influence of the alloy of megaprostheses on infection rate. , 2008, The Journal of arthroplasty.

[18]  J. Kärrholm,et al.  Early Subsidence Predicts Failure of a Cemented Femoral Stem With Minor Design Changes , 2016, Clinical orthopaedics and related research.

[19]  J. Gelin,et al.  Composite based on polyetheretherketone reinforced with carbon fibres, an alternative to conventional materials for femoral implant: Manufacturing process and resulting structural behaviour , 2012 .

[20]  Klaus-Dieter Kühn,et al.  Bone Cements: Up-to-Date Comparison of Physical and Chemical Properties of Commercial Materials , 2000 .

[21]  W. Jiranek,et al.  Acetabular Dysplasia in Middle-Aged Patients: Periacetabular Osteotomy or Total Hip Arthroplasty? , 2016, The Journal of arthroplasty.

[22]  Jianning Zhao,et al.  Automatic extraction of 3D anatomical feature curves of hip bone models reconstructed from CT images. , 2015, Bio-medical materials and engineering.

[23]  H. Owaki,et al.  Changes in axial alignment of the ipsilateral hip and knee after total hip arthroplasty. , 2016, The bone & joint journal.

[24]  F. Pozzi,et al.  Sit-To-Stand Biomechanics Before and After Total Hip Arthroplasty. , 2015, The Journal of arthroplasty.

[25]  K. Kaneko,et al.  Cementless total hip arthroplasty for patients with rheumatoid arthritis: a more than 10-year follow-up , 2016, European Journal of Orthopaedic Surgery & Traumatology.

[26]  E. Pyburn,et al.  Finite element analysis of femoral components paper III: hip joints , 2004 .

[27]  E. P. Silva,et al.  Design aspects involved in a cemented THA stem failure case , 2009 .

[28]  R Pietrabissa,et al.  Improved mathematical model of the wear of the cup articular surface in hip joint prostheses and comparison with retrieved components , 2001, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[29]  Sergej Hloch,et al.  Numerical Simulation of Fatigue Crack Growth in Hip Implants , 2016 .

[30]  M. Manley,et al.  Bearings of the future for total hip arthroplasty. , 2008, The Journal of arthroplasty.

[31]  Tarun Goswami,et al.  Finite element analysis of hip stem designs , 2008 .

[32]  Katarina Čolić,et al.  Finite Element Modeling of Hip Implant Static Loading , 2016 .

[33]  Stanley A. Brown,et al.  Distribution of cobalt chromium wear and corrosion products and biologic reactions. , 1996, Clinical orthopaedics and related research.

[34]  W. Healy,et al.  HIP REPLACEMENT: CHOOSING AN IMPLANT , 2000 .

[35]  Peter Greil,et al.  Functionally graded materials for biomedical applications , 2003 .

[36]  Farzam Farahmand,et al.  Aseptic loosening of femoral components – A review of current and future trends in materials used , 2012 .

[37]  P. Prendergast,et al.  An analysis of crack propagation paths at implant/bone-cement interfaces. , 1996, Journal of biomechanical engineering.

[38]  U. Wyss,et al.  Hip stem fatigue test prediction , 2009 .

[39]  T. V. Vliet Vlieland,et al.  Preoperative predictors for outcomes after total hip replacement in patients with osteoarthritis: a systematic review , 2016, BMC Musculoskeletal Disorders.

[40]  Derek J Donegan,et al.  Diagnosing Infection in Patients Undergoing Conversion of Prior Internal Fixation to Total Hip Arthroplasty. , 2017, The Journal of arthroplasty.

[41]  M. Niinomi,et al.  Development of new metallic alloys for biomedical applications. , 2012, Acta biomaterialia.

[42]  E. Pakos,et al.  Custom-Made Femoral Implants in Total HIP Arthroplasty Due to Congenital Disease of the HIP: A Review , 2016, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[43]  Yunhua Luo,et al.  Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling. , 2016, Bone.

[44]  Marco Viceconti,et al.  Primary stability of an anatomical cementless hip stem: a statistical analysis. , 2006, Journal of biomechanics.

[45]  V. Good,et al.  Oxidized zirconium : a potentially longer lasting hip implant , 2005 .

[46]  Stuart B. Goodman,et al.  Bearing Surfaces for Joint Replacement: New Materials or New Problems , 2014 .

[47]  Hasan Kurtaran,et al.  Static, dynamic and fatigue behavior of newly designed stem shapes for hip prosthesis using finite element analysis , 2007 .

[48]  J. Fisher,et al.  The effect of cup outer sizes on the contact mechanics and cement fixation of cemented total hip replacements. , 2015, Medical engineering & physics.

[49]  M. Parker,et al.  Total hip replacement for hip fracture: Surgical techniques and concepts. , 2016, Injury.

[50]  M. Figgie,et al.  Implant Survival and Patient-Reported Outcomes after Total HIP Arthroplasty in Young Patients with Developmental Dysplasia of the HIP , 2016, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[51]  E. Salvati,et al.  The modern, hybrid total hip arthroplasty for primary osteoarthritis at the Hospital for Special Surgery. , 2016, The bone & joint journal.

[52]  I. Heger,et al.  The mechanism of loosening in cemented hip prostheses determined from long-term results , 2004, Archives of Orthopaedic and Trauma Surgery.

[53]  M. Jordan,et al.  Comparison of open reduction and internal fixation and primary total hip replacement for osteoporotic acetabular fractures: a retrospective clinical study , 2017, International Orthopaedics.

[54]  M. Santare,et al.  Analysis of a femoral hip prosthesis designed to reduce stress shielding. , 2000, Journal of biomechanics.

[55]  Zohar Yosibash,et al.  Toward verified and validated FE simulations of a femur with a cemented hip prosthesis. , 2013, Medical engineering & physics.

[56]  P. Vestergaard,et al.  Epidemiology of Fractures in Diabetes , 2017, Calcified Tissue International.

[57]  O. Reikerås,et al.  Changes of center of rotation and femoral offset in total hip arthroplasty. , 2015, Annals of translational medicine.

[58]  J. Katz,et al.  Total joint replacement in osteoarthritis. , 2006, Best practice & research. Clinical rheumatology.

[59]  S. Inouye,et al.  Sex Differences in Hip Fracture Surgery: Preoperative Risk Factors for Delirium and Postoperative Outcomes , 2016, Journal of the American Geriatrics Society.

[60]  Possible Solutions Joon B. Park.  Hip Joint Prosthesis Fixation: Problems and Possible Solutions , 2002 .

[61]  Young-Hoo Kim,et al.  Ultrashort versus Conventional Anatomic Cementless Femoral Stems in the Same Patients Younger Than 55 Years , 2016, Clinical orthopaedics and related research.

[62]  Arthur L. Malkani,et al.  Instability after Total Hip Replacement , 2005 .

[63]  Sergej Hloch,et al.  THERMAL MANIFESTATIONS AND NANOINDENTATION OF BONE CEMENTS FOR ORTHOPAEDIC SURGERY , 2014 .

[64]  Buddy D. Ratner,et al.  Biomaterials Science: An Introduction to Materials in Medicine , 1996 .

[65]  Sukumar Mishra,et al.  Classification of Biomaterials used in Medicine , 2012 .

[66]  Mel S. Lee.  Minimally invasive total hip arthroplasty. , 2012, Clinical privilege white paper.

[67]  A. Malcolm,et al.  The mechanism of loosening of cemented acetabular components in total hip arthroplasty. Analysis of specimens retrieved at autopsy. , 1992, Clinical orthopaedics and related research.

[68]  J. Aurégan,et al.  Contra-lateral hip fracture in the elderly: are decreased body mass index and skin thickness predictive factors? , 2017, International Orthopaedics.

[69]  A. Wang,et al.  Three-body wear of UHMWPE acetabular cups by PMMA particles against CoCr, alumina and zirconia heads in a hip joint simulator , 2001 .

[70]  H. Gill,et al.  Biomechanics in orthopaedics:Considerations of the hip and knee , 2010 .

[71]  Rui B Ruben,et al.  On the optimal shape of hip implants. , 2012, Journal of biomechanics.