CNRS, Laboratoire Modélisation et Simulation Multi Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010 Créteil cedex, France.
Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, People's Republic of China.
J R Soc Interface. 2019 Jul 26;16(156):20190259. doi: 10.1098/rsif.2019.0259. Epub 2019 Jul 31.
In recent decades, cementless implants have been widely used in clinical practice to replace missing organs, to replace damaged or missing bone tissue or to restore joint functionality. However, there remain risks of failure which may have dramatic consequences. The success of an implant depends on its stability, which is determined by the biomechanical properties of the bone-implant interface (BII). The aim of this review article is to provide more insight on the current state of the art concerning the evolution of the biomechanical properties of the BII as a function of the implant's environment. The main characteristics of the BII and the determinants of implant stability are first introduced. Then, the different mechanical methods that have been employed to derive the macroscopic properties of the BII will be described. The experimental multi-modality approaches used to determine the microscopic biomechanical properties of periprosthetic newly formed bone tissue are also reviewed. Eventually, the influence of the implant's properties, in terms of both surface properties and biomaterials, is investigated. A better understanding of the phenomena occurring at the BII will lead to (i) medical devices that help surgeons to determine an implant's stability and (ii) an improvement in the quality of implants.
近几十年来，无水泥植入物已广泛应用于临床实践，以替代缺失的器官，替代受损或缺失的骨组织，或恢复关节功能。然而，仍然存在着失败的风险，这些风险可能会产生戏剧性的后果。植入物的成功取决于其稳定性，而稳定性取决于骨-植入物界面（BII）的生物力学特性。本文的目的是提供更多的深入了解目前的技术水平，涉及 BII 的生物力学特性的演变，作为植入物环境的函数。首先介绍了 BII 的主要特征和决定植入物稳定性的因素。然后，将描述用于得出 BII 的宏观特性的不同机械方法。还回顾了用于确定假体周围新形成的骨组织的微观生物力学特性的实验多模态方法。最终，研究了植入物特性（包括表面特性和生物材料）的影响。对 BII 中发生的现象的更好理解将导致（i）有助于外科医生确定植入物稳定性的医疗设备，以及（ii）提高植入物的质量。
