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Background: Total joint replacements are an established treatment for patients suffering from reduced mobility and pain due to severe joint damage. Aseptic loosening due to stress shielding is currently one of the main reasons for revision surgery. As this phenomenon is related to a mismatch in mechanical properties between implant and bone, stiffness reduction of implants has been of major interest in new implant designs. Facilitated by modern additive manufacturing technologies, the introduction of porosity into implant materials has been shown to enable significant stiffness reduction; however, whether these devices mitigate stress-shielding associated complications or device failure remains poorly understood.
Methods: In this systematic review, a broad literature search was conducted in six databases (Scopus, Web of Science, Medline, Embase, Compendex, and Inspec) aiming to identify current design approaches to target stress shielding through controlled porous structures. The search keywords included 'lattice,' 'implant,' 'additive manufacturing,' and 'stress shielding.'
Results: After the screening of 2530 articles, a total of 46 studies were included in this review. Studies focusing on hip, knee, and shoulder replacements were found. Three porous design strategies were identified, specifically uniform, graded, and optimized designs. The latter included personalized design approaches targeting stress shielding based on patient-specific data. All studies reported a reduction of stress shielding achieved by the presented design.
Conclusion: Not all studies used quantitative measures to describe the improvements, and the main stress shielding measures chosen varied between studies. However, due to the nature of the optimization approaches, optimized designs were found to be the most promising. Besides the stiffness reduction, other factors such as mechanical strength can be considered in the design on a patient-specific level. While it was found that controlled porous designs are overall promising to reduce stress shielding, further research and clinical evidence are needed to determine the most superior design approach for total joint replacement implants.
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http://dx.doi.org/10.1186/s13018-022-03492-9 | DOI Listing |
Neurochem Res
December 2024
Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
The central nervous system (CNS) comprises membranes and barriers that are vital to brain homeostasis. Membranes form a robust shield around neural structures, ensuring protection and structural integrity. At the same time, barriers selectively regulate the exchange of substances between blood and brain tissue, which is essential for maintaining homeostasis.
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Department of Pomology, Faculty of Agriculture, Assiut University, Assiut, 71526, Egypt; Biology Research & Studies Institute, Assiut University, Assiut, 71526, Egypt. Electronic address:
Smart nanohybrid technology with potential advantages to plants has recently been developed formanaging the widespread pollution of heavy metals. Herein, we disclose a novel strategy to combat Pb stress in strawberry (Fragaria spp. cv.
View Article and Find Full Text PDFBiomed Mater
December 2024
Department of Chemical Engineering, Indian Institute of Technology - Bombay, Powai, Mumbai 400 076, Mumbai, Maharastra, 400076, INDIA.
Mechanical non-conformance of conventionally used transvaginal non-degradable meshes has led to complications like organ perforation, dyspareunia caused by mesh stiffness, and stress shielding. In this study, we have solved the dire need of mimicking the mechanical properties of vaginal wall by designing and developing a soft and elastic mesh made of polycaprolactone (PCL), citric acid modified polyethylene glycol (PEGC) and zinc oxide (ZnO) prepared through electrospinning and is tested in-vitro and in-vivo. Mesh containing 90:10:0.
View Article and Find Full Text PDFJ Gerontol A Biol Sci Med Sci
December 2024
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Biomarkers of ageing serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of ageing for use in intervention studies via the Delphi method.
View Article and Find Full Text PDFEpigenomics
December 2024
Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Aim: Investigate associations between religion and spirituality (R&S) and DNA methylation of four HPA-axis genes (i.e. 14 CpG sites) among 992 adults from the Hispanic Community Health Study/Study of Latinos cohorts.
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