Bone Loss and Reduced Bone Quality of the Human Femur after Total Hip Arthroplasty under Stress-Shielding Effects by Titanium-Based Implant

Abstract

The present work was aimed at clarifying the stress-shielding effect caused by hip-joint implantation into a femur by using a human cadaver with a cementless hip implant. In particular, bone quality was assessed from the standpoint of preferential c-axis orientation of biological apatite (BAp). Comparing the implanted side to the non-implanted side, a finite element analysis (FEA) indicated that artificial hip-joint implantation had a significant stress-shielding effect on the femur. The results also showed a marked decrease in the degree of preferential BAp orientation as well as bone loss in the medial-proximal femur. This is the first report showing a reduction in the degree of preferential BAp orientation due to a stress-shielding effect after artificial hip-joint implantation. Since preferential BAp orientation is an important index for determining bone mechanical function, these findings should be taken into account in future artificial hip-joint designs, especially those involving the stem component.

Crystallographic Orientation Control of 316L Austenitic Stainless Steel via Selective Laser Melting

“…23) However, the use of stiff metal implants induces stress shielding, in which stresses placed on the bone are supported by the stiff metal implant, leading to insufficient physiological loading on the bone. 24,25) Sound loading plays an important role not only in the maintenance of bone mass but also in that of bone quality, 26,27) therefore, the stress shielding should be avoided. 28,29) Polycrystalline-form 316L SS shows the Young's modulus of ~200 GPa, 30) which is much higher than the modulus of bone (~30 GPa).…”

A paradigm shift for bone quality in dentistry: A literature review

“…With the use of metallic implants, the stress shielding phenomenon due to the large difference in Young's moduli between bone and implant materials is a great problem [97]. Stress shielding induces significant bone loss and disruption of bone quality [98,99], leading to an increased fracture risk. An optimally oriented groove structure on the implant surface is a promising method to overcome the stress shielding phenomenon and achieve bone tissue with appropriate bone quality.…”

A novel cytocompatible, hierarchical porous Ti6Al4V scaffold with immobilized silver nanoparticles

“…Mechanical properties and biological inertness endow titanium-based implants with advantages in orthopedic applications including bone substitution and total joint replacement surgeries [1]. However, biomechanical mismatch associated with their excessively high elastic modulus unfortunately leads to stress shielding effect and therefore aseptic loosening, osteopenia, and eventually revision surgery [1,2].…”

“…However, biomechanical mismatch associated with their excessively high elastic modulus unfortunately leads to stress shielding effect and therefore aseptic loosening, osteopenia, and eventually revision surgery [1,2]. With tunable mechanical properties, porous titanium has emerged as a promising solution, and their optimized cellular structures are supposed to provide an extended framework for osteointegration.…”