Experimental studies of bone remodeling in total hip arthroplasty.

Experimental studies of bone remodeling after total hip arthroplasty are reviewed. Most of the studies have been motivated by the introduction of cementless hip replacements in which porous coatings are used to provide fixation by bone ingrowth. Stress shielding is thought to be the main factor responsible for bone loss after hip replacement. Experimentally, design features related to (1) the nature of the bone-implant interface and (2) stem stiffness have been tested to determine if the effects of stress shielding can be decreased. The dominant long-term design feature controlling bone remodeling in hip replacement appears to be stem stiffness.