[Biomechanical aspects of loosening of hip prostheses]

The central problem of endoprosthetics that still needs to be solved is aseptic loosening of a prosthesis. The various efforts toward solving this problem have also included optimization of design so as to minimize remodelling and to include adaptation to the performance of the bone-supporting tissue. In this respect, special kinds of surface structures using biomaterials similar to the bone matrix have also been developed. These materials are optimized by means of the latest morphometric analytical devices. Another goal in this respect is to analyze the reactions of the bone implant to mechanical stimuli. Finally, prospective multicentric studies should be carried out to evaluate the various anchoring methods such as cement, cementless or custom-made methods.