“…Other research groups have found that lattice-based stem designs are effective for reducing strain shielding [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], with innovations including the inclusion of fatigue life constraints during the optimisation process [ 7 , 8 , 9 ]. The use of a trabecular-like stochastic porous structure in this study is potentially advantageous compared to more regular lattice designs as stochastic structures enable control of anisotropy [ 42 ], which may result in an implant that is more tolerant to unanticipated load cases. Other researchers have optimised the outer shape of hip implants [ 5 , 43 , 44 , 45 , 46 , 47 , 48 ], or optimised the modulus/density distribution within implants [ 49 , 50 ], with similar proposed benefits for preventing strain shielding.…”