Implantable antennas are mandatory to transfer data from implants to the external world wirelessly. Smart implants can be used to monitor and diagnose the medical conditions of the patient. The dispersion of the dielectric constant of the tissues and variability of organ structures of the human body absorb most of the antenna radiation. Consequently, implanting an antenna inside the human body is a very challenging task. The design of the antenna is required to fulfill several conditions, such as miniaturization of the antenna dimension, biocompatibility, the satisfaction of the Specific Absorption Rate (SAR), and efficient radiation characteristics. The asymmetric hostile human body environment makes implant antenna technology even more challenging. This paper aims to summarize the recent implantable antenna technologies for medical applications and highlight the major research challenges. Also, it highlights the required technology and the frequency band, and the factors that can affect the radio frequency propagation through human body tissue. It includes a demonstration of a parametric literature investigation of the implantable antennas developed. Furthermore, fabrication and implantation methods of the antenna inside the human body are summarized elaborately. This extensive summary of the medical implantable antenna technology will help in understanding the prospects and challenges of this technology.

Total hip replacement (THR) is a common orthopedic surgery technique that helps thousands of individuals to live normal lives each year. A hip replacement replaces the shattered cartilage and bone with an implant. Most hip implants fail after 10–15 years. The material selection for the total hip implant systems is a major research field since it affects the mechanical and clinical performance of it. Stress shielding due to excessive contact stress, implant dislocation due to a large deformation, aseptic implant loosening due to the particle propagation of wear debris, decreased bone remodeling density due to the stress shielding, and adverse tissue responses due to material wear debris all contribute to the failure of hip implants. Recent research shows that pre-clinical computational finite element analysis (FEA) can be used to estimate four mechanical performance parameters of hip implants which are connected with distinct biomaterials: von Mises stress and deformation, micromotion, wear estimates, and implant fatigue. In vitro, in vivo, and clinical stages are utilized to determine the hip implant biocompatibility and the unfavorable local tissue reactions to different biomaterials during the implementation phase. This research summarizes and analyses the performance of the different biomaterials that are employed in total hip implant systems in the pre-clinical stage using FEA, as well as their performances in in vitro, in vivo, and in clinical studies, which will help researchers in gaining a better understanding of the prospects and challenges in this field.

With an expectation of an increased number of revision surgeries and patients receiving orthopedic implants in the coming years, the focus of joint replacement research needs to be on improving the mechanical properties of implants. Head-stem trunnion fixation provides superior load support and implant stability. Fretting wear is formed at the trunnion because of the dynamic load activities of patients, and this eventually causes the total hip implant system to fail. To optimize the design, multiple experiments with various trunnion geometries have been performed by researchers to examine the wear rate and associated mechanical performance characteristics of the existing head-stem trunnion. The objective of this work is to quantify and evaluate the performance parameters of smooth and novel spiral head-stem trunnion types under dynamic loading situations. This study proposes a finite element method for estimating head-stem trunnion performance characteristics, namely contact pressure and sliding distance, for both trunnion types under walking and jogging dynamic loading conditions. The wear rate for both trunnion types was computed using the Archard wear model for a standard number of gait cycles. The experimental results indicated that the spiral trunnion with a uniform contact pressure distribution achieved more fixation than the smooth trunnion. However, the average contact pressure distribution was nearly the same for both trunnion types. The maximum and average sliding distances were both shorter for the spiral trunnion; hence, the summed sliding distance was approximately 10% shorter for spiral trunnions than that of the smooth trunnion over a complete gait cycle. Owing to a lower sliding ability, hip implants with spiral trunnions achieved more stability than those with smooth trunnions. The anticipated wear rate for spiral trunnions was 0.039 mm3, which was approximately 10% lower than the smooth trunnion wear rate of 0.048 mm3 per million loading cycles. The spiral trunnion achieved superior fixation stability with a shorter sliding distance and a lower wear rate than the smooth trunnion; therefore, the spiral trunnion can be recommended for future hip implant systems.

Radiographic images are commonly used to detect aseptic loosening of the hip implant in patients with total hip replacement (THR) surgeries. These techniques of manual assessment by medical professionals can suffer from the drawback of low accuracy, poor inter-observer reliability, delays due to the unavailability of experienced clinicians. Thus, the paper provides a reliable Deep Convolutional Neural Networks (DCNNs) based novel stacking approach (HipXNet) for detecting loosening of the hip implant using X-ray images. Two major investigations were done in this study. Firstly, the performance of four different state-of-the-art object detection YOLOv5 models was evaluated to detect the implant region from the hip X-ray images. Secondly, the study developed a stacking classifier using three different Convolutional neural networks (CNN) models to classify aseptic hip loosening and compared the performance with eight different state-of-the-art CNN networks. Moreover, one publicly accessible dataset with two sub-sets was created for these two experiments, where 200 hip implant X-ray images were collected and annotated by two expert radiologists for implant detection and 206 hip implant X-ray images were collected for loosening detection. YOLOv5m model outperformed the other variants of YOLOv5 to detect the implant region with the precision, recall, mean average precision (mAP)0.5, mAP0.5-0.95 of 100%, 100%, 100%, and 87.8%, respectively. Densenet201 CNN model outperformed other CNN models with the accuracy, precision, sensitivity, F1 score, and specificity of 94.66%, 94.66%, 94.66%, 94.66%, and 94.5%, respectively while the stacking technique with Random Forest meta learner classifier produced the best performance with the accuracy, precision, sensitivity, F1 score and specificity of 96.11%, 96.42%, 96.42%, 96.42%, and 96.74% respectively for loosening detection. The reliability of the performance was confirmed by the popular Score-CAM visualization. This study can help in the early and fast identification of hip implant loosening with the help of simple X-ray images and computed aided diagnosis.

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