Implant failure is due to stress shielding and interface micromotion. The application of porous structures in the femoral implant has a great effect on reducing stress shielding and improving the stability of the bone-implant interface. The performance of femoral stems with triply periodic minimal surface (TPMS) structures, IWP, and Gyroid structures was evaluated using finite element analysis. We studied the stress shielding phenomenon of the porous femoral stem based on the ability of stress transfer to the femur. The micromotion at the bone-implant interface was explored for different porous femoral stems. The effect of gradient structure design was investigated in the axial direction of the stem. These gradient designs involved a stem with an increasing volume fraction in the axial direction (IAGS) and a decreasing volume fraction along the stem (DAGS). The results showed that the axial stiffness of the stem has a direct effect on stress shielding and an inverse relation to bone-implant micromotion. The finite element analysis results inferred that bone resorption is higher in the stems with IWP structure than in Gyroid at the same volume fraction. Axially graded stems transfer higher stress to the femur than homogenous porous stems. DAGS design of IWP and Gyroid and IAGS Gyroid increased the stress on the proximal-medial of the femur. Homogeneous porous stems with high porosity (80% porosity for IWP and 70% porosity for Gyroid) and DAGS design exhibited low stress shielding and controlled bone-implant interface micromotion within an acceptable range for bone ingrowth.

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http://dx.doi.org/10.1177/03913988231168158DOI Listing

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