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Total joint replacement: where are we today, and where are we headed?
1Section of Orthopedic Surgery, Arizona Health Sciences Center, Tucson 85724.
Southern Medical Journal
|February 1, 1989
Summary
Newer biologically fixed implants for joint replacement show poor performance, causing longer recovery and pain. Current research aims to improve these devices, but a perfect total joint prosthesis is still distant.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device engineering
Background:
- The introduction of noncemented total joint prostheses has raised questions regarding the performance of biologically fixed implants.
- Current data on biologically fixed implants have not demonstrated improved performance metrics.
Purpose of the Study:
- To evaluate the predictability and performance of newer biologically fixed implants in joint replacement surgery.
- To identify and discuss the challenges and concerns associated with current noncemented joint prostheses.
Main Methods:
- Review of reported clinical experience with noncemented total joint prostheses.
- Analysis of material properties and their impact on implant performance.
- Examination of potential complications and adverse effects.
Main Results:
- Reported experiences indicate prolonged convalescence and increased postoperative pain with biologically fixed implants.
- Difficulties in revision procedures have been noted.
- Concerns include ion leaching, stress shielding, and stress overload due to material properties.
Conclusions:
- Current biologically fixed implants present significant challenges in terms of patient recovery and long-term performance.
- Material limitations contribute to adverse biomechanical effects.
- Ongoing research shows promise, but a truly optimal total joint prosthesis has yet to be developed.