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Prosthesis
Special Issues
Current and Emerging Concepts in Personalized Arthroplasty
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Current and Emerging Concepts in Personalized Arthroplasty

A Special Issue of Prosthesis (ISSN 2673-1592) belonging to the section "Orthopedics and Rehabilitation".

Deadline for manuscript submissions: 1 December 2026 | Viewed by 3700

Editor

Dr. George Mihai Avram

E-Mail Website
Guest Editor
1. Department of Clinical Research, Michael T. Hirschmann Research Group, Faculty of Medicine, University of Basel, Basel, Switzerland
2. Central Military University Emergency Hospital "Carol Davila", Bucharest, Romania
Interests: personalized arthroplasty; robotic-assisted surgery (imageless and image-based); 3D planning and custom-made arthroplasty; complex primary arthroplasty; knee and hip revision surgery

Special Issue Information

Dear Colleagues,

Rapid advances in recent years have brought knee phenotyping, laxity profiling, robotic-assisted surgery, modern alignment strategies, and ongoing developments in custom-made arthroplasty to the forefront of what is now considered personalized arthroplasty.

The current Special Issue aims to advance the concept of personalized arthroplasty by supporting authors in publishing current and beyond current concepts in the field.

Special focus will be dedicated to concepts related to robotic-assisted surgery, hip and knee phenotyping, laxity profiling of the knee, and technical aspects related to personalization in all its current variants.

In this Special Issue, original research articles, reviews, and advanced technical notes dedicated to personalization are welcome. Research areas may include (but are not limited to) the following:

  • Robotic-assisted hip and knee arthroplasty
  • Custom-made arthroplasty
  • 3D and 4D planning
  • Modern alignment strategies for hip and knee arthroplasty
  • Difficult primaries treated with personalized approaches
  • Gait analyses of the native, osteoarthritic, and implanted joint, as well as gait-based planning concepts for total joint arthroplasty

I look forward to receiving your contributions.

Dr. George Mihai Avram
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Prosthesis is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • personalized arthroplasty
  • robotic-assisted surgery
  • 3D/4D planning

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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12 pages, 1236 KB  
Article
Mixed Reality Guidance Improves Acetabular Component Positioning Accuracy During Simulated Total Hip Arthroplasty: A Prospective Pilot Study
by Javier Hernández-Balada, Damian Mifsut, M.-Carmen Juan and Alfonso Amador Valverde-Navarro
Prosthesis 2026, 8(7), 78; https://doi.org/10.3390/prosthesis8070078 - 21 Jul 2026
Viewed by 521
Abstract
Background: Accurate acetabular component positioning is critical to the success of total hip arthroplasty (THA). Mixed reality (MR)-based simulation offers a novel approach to surgical training by providing real-time feedback within immersive learning environments. This study evaluated the impact of an MR-based simulation [...] Read more.
Background: Accurate acetabular component positioning is critical to the success of total hip arthroplasty (THA). Mixed reality (MR)-based simulation offers a novel approach to surgical training by providing real-time feedback within immersive learning environments. This study evaluated the impact of an MR-based simulation on technical performance, as well as its usability and user experience. Methods: A prospective pre–post pilot educational study was conducted in a controlled simulation laboratory using a physical anatomical model. Forty-six final-year medical students with no prior experience in MR technology participated. Participants performed acetabular component positioning tasks before and after MR-assisted training. Technical accuracy was assessed by measuring deviations in inclination and anteversion. Usability, workload, presence, and cybersickness were evaluated using validated questionnaires. Results: MR-assisted training significantly improved technical accuracy. Median absolute deviation in inclination decreased from 1.0° (interquartile range [IQR], 1.0–3.5) to 0.5° (IQR, 0.0–2.0) (p = 0.0008, r = 0.56), while anteversion deviation decreased from 4.5° (IQR, 2.0–7.0) to 2.0° (IQR, 1.0–4.0) (p < 0.0001, r = 0.66). User experience scores ranked the application among top-performing systems in benchmark comparisons. Participants reported high levels of presence and usability, low workload (all NASA-TLX domains <36/100), and minimal cybersickness (mean Simulator Sickness Questionnaire score = 0.26). Conclusions: MR-assisted simulation significantly improved short-term technical performance in novice trainees and was associated with high user acceptance and minimal adverse effects. These findings support the use of MR as a promising adjunct in early surgical training, enabling integration of cognitive and psychomotor skills through real-time feedback. Further studies are warranted to evaluate skill retention and transfer to clinical practice. Full article
(This article belongs to the Special Issue Current and Emerging Concepts in Personalized Arthroplasty)
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19 pages, 3231 KB  
Article
Finite Element Analysis of Collared Hip Prosthesis Cross-Sections Under Dynamic Loading and Wear Conditions for Durable Orthopedic Implant Design
by Chethan K N, John Valerian Corda, Laxmikant G. Keni, M. Kalayarasan, Jonathan Reginald and Sudhir Jain Prathik
Prosthesis 2026, 8(4), 36; https://doi.org/10.3390/prosthesis8040036 - 3 Apr 2026
Cited by 1 | Viewed by 1590
Abstract
Background/Objective: Traditional hip implant evaluations often overlook patient-specific dynamic loadings. This study investigates the performance of novel collared hip implant designs under walking conditions, focusing on geometric profiles and two common stem materials: Ti-6Al-4V and CoCr alloy. Methods: Patient-specific dynamic forces were applied [...] Read more.
Background/Objective: Traditional hip implant evaluations often overlook patient-specific dynamic loadings. This study investigates the performance of novel collared hip implant designs under walking conditions, focusing on geometric profiles and two common stem materials: Ti-6Al-4V and CoCr alloy. Methods: Patient-specific dynamic forces were applied using commercial finite element analysis, adhering to ISO and ASTM standards. Four cross-sectional profiles—circular, elliptical, oval, and trapezoidal—were initially evaluated for induced stresses and displacements. Subsequently, wear characteristics at implant junctions were analyzed, comparing CoCr (MC 1) and Ti-6Al-4V (MC 2) stems. The study also assessed the impact of using Ultra-High Molecular Weight Polyethylene (UHMWPE) acetabular cups. Results: The elliptical (CS 2) cross-sectional profile demonstrated superior performance. Junction analysis revealed that the CoCr stem (MC 1) exhibited a stem-to-head sliding distance four times higher and contact pressure 5.5 times higher than the Ti-6Al-4V stem (MC 2). Specifically, MC 1 showed 82% higher contact pressure and 89% greater sliding distance at the stem–head junction compared to MC 2. Additionally, utilizing UHMWPE cups effectively eliminated squeaking sounds attributed to CoCr cups due to superior wear resistance. Conclusions: The combination of an elliptical (CS 2) cross-sectional profile with a Ti-6Al-4V stem and UHMWPE acetabular cup offers optimal performance. This configuration significantly reduces wear and contact pressure, suggesting enhanced functionality and durability for hip implants under dynamic loading conditions. Full article
(This article belongs to the Special Issue Current and Emerging Concepts in Personalized Arthroplasty)
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Review

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25 pages, 1474 KB  
Review
Return to Play After Total Hip Arthroplasty: What Do Instrumented Hip Implants Teach Us? A Scoping Review
by Vasileios Giannatos, Sofia A. Xergia, Irini Tatani, Panagiotis Antzoulas, Charis Tsarbou, Nikolaos I. Liveris, Michalis Kroustalakis, Riccardo Giorgino, Konstantinos Kafchitsas and Andreas Panagopoulos
Prosthesis 2026, 8(6), 61; https://doi.org/10.3390/prosthesis8060061 - 16 Jun 2026
Viewed by 958
Abstract
Background: Return to play (RTP) after total hip arthroplasty (THA) is increasingly expected by younger and more physically active patients. Current activity recommendations remain heterogeneous and are largely derived from expert opinion and indirect biomechanical modelling approaches, rather than direct in vivo biomechanical [...] Read more.
Background: Return to play (RTP) after total hip arthroplasty (THA) is increasingly expected by younger and more physically active patients. Current activity recommendations remain heterogeneous and are largely derived from expert opinion and indirect biomechanical modelling approaches, rather than direct in vivo biomechanical evidence. The aim of this article is to systematically map and synthesize the evidence from instrumented hip implant studies and to clarify how direct in vivo telemetry data can inform RTP counselling after THA. Methods: A scoping review was conducted according to a predefined Open Science Framework protocol and reported following PRISMA-ScR guidelines. MEDLINE (PubMed) and Scopus were searched from inception. Peer-reviewed clinical studies reporting direct in vivo biomechanical measurements obtained from instrumented hip implants were included. Conference proceedings, technical notes, reviews, and in vitro or computational-only studies were excluded. Data were extracted and synthesized descriptively according to activity domain, biomechanical variables, and implant technology. Results: Fifty studies met the inclusion criteria. Early investigations established feasibility and evolved from wired strain-gauge systems to fully implantable telemetric prostheses capable of measuring three-dimensional forces, moments, and friction-related parameters. Across cohorts, level walking consistently produced peak hip contact forces of approximately 2–3 times body weight, serving as a clinically meaningful reference loading envelope. Several recreational activities—including cycling, aquatic exercise, Nordic walking, and most gym-machine exercises—generally remained within or close to this range when performed with controlled technique. In contrast, certain rehabilitation tasks, forward-bent postures, lifting maneuvers, and perturbation events generated loads equal to or exceeding those observed during walking. Importantly, frictional moments and load direction showed substantial variability and may be more relevant to implant fixation than peak force magnitude alone. Conclusions: Instrumented hip implants provide objective biomechanical benchmarks that support principle-based and individualized RTP counselling, grounded in directly measured mechanical exposure rather than sport classification alone. Full article
(This article belongs to the Special Issue Current and Emerging Concepts in Personalized Arthroplasty)
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