3D-printed hip prostheses with regenerative integration: a state-of-the-art comprehensive review

This article offers an in-depth review of the design and modeling of 3D-printed hip prostheses, emphasizing the integration of regenerative medicine, especially in the context of custom Rapidly Destructive Osteoarthritis implants. It traces the history of Total hip arthroplasty and current implant materials, along with recent advances in tissue engineering strategies and biofunctionalization methods to enhance biological integration. Computational processes are examined, including segmentation, image processing, computer-aided design, finite element analysis, and CAE simulations. It also discusses techniques in additive manufacturing that control porosity and stiffness, as well as strategies for recruiting host stem cells. The overall performance of existing THA approaches, combined with reliance on outdated surgical workflows and the complexity of clinical standards, creates challenges for the adoption of innovative implant research and limits broader application. International standards (ISO/ASTM), regional regulations (MDR, FDA), ethical considerations, and professional design guidelines are crucial components of this review, guiding safety, reproducibility, and the clinical impact of next-generation THA solutions. Finally, this review proposes a novel 'regenerative design' paradigm. Distinct from traditional biointegration methods, this framework integrates patient-specific imaging, mechanobiology-based architecture optimization, and biologically calibrated simulation to direct endogenous cell recruitment and vascularized healing explicitly.