{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T21:54:44Z","timestamp":1770069284323,"version":"3.49.0"},"reference-count":78,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["POCI-01-0145-FEDER-031132"],"award-info":[{"award-number":["POCI-01-0145-FEDER-031132"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BPD\/117475\/2016"],"award-info":[{"award-number":["SFRH\/BPD\/117475\/2016"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UID\/EMS\/00481\/2019-FCT"],"award-info":[{"award-number":["UID\/EMS\/00481\/2019-FCT"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Musculoskeletal disorders are becoming an ever-growing societal burden and, as a result, millions of bone replacements surgeries are performed per year worldwide. Despite total joint replacements being recognized among the most successful surgeries of the last century, implant failure rates exceeding 10% are still reported. These numbers highlight the necessity of technologies to provide an accurate monitoring of the bone\u2013implant interface state. This study provides a detailed review of the most relevant methodologies and technologies already proposed to monitor the loosening states of endoprosthetic implants, as well as their performance and experimental validation. A total of forty-two papers describing both intracorporeal and extracorporeal technologies for cemented or cementless fixation were thoroughly analyzed. Thirty-eight technologies were identified, which are categorized into five methodologies: vibrometric, acoustic, bioelectric impedance, magnetic induction, and strain. Research efforts were mainly focused on vibrometric and acoustic technologies. Differently, approaches based on bioelectric impedance, magnetic induction and strain have been less explored. Although most technologies are noninvasive and are able to monitor different loosening stages of endoprosthetic implants, they are not able to provide effective monitoring during daily living of patients.<\/jats:p>","DOI":"10.3390\/s20010104","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T05:56:15Z","timestamp":1577166975000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Altering the Course of Technologies to Monitor Loosening States of Endoprosthetic Implants"],"prefix":"10.3390","volume":"20","author":[{"given":"Jo\u00e3o Henrique","family":"Cach\u00e3o","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-1263","authenticated-orcid":false,"given":"Marco P.","family":"Soares dos Santos","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Center for Mechanical Technology &amp; Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Associated Laboratory for Energy, Transports and Aeronautics (LAETA), 4150-179 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4642-1209","authenticated-orcid":false,"given":"Rodrigo","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Ant\u00f3nio","family":"Ramos","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Center for Mechanical Technology &amp; Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Rainer","family":"Bader","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University Medicine Rostock, 18057 Rostock, Germany"}]},{"given":"Jorge A. F.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Center for Mechanical Technology &amp; Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Ant\u00f3nio","family":"Torres Marques","sequence":"additional","affiliation":[{"name":"Associated Laboratory for Energy, Transports and Aeronautics (LAETA), 4150-179 Porto, Portugal"},{"name":"Mechanical Engineering Department, University of Porto, 4200-465 Porto, Portugal"}]},{"given":"Jos\u00e9 A. O.","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal"},{"name":"Center for Mechanical Technology &amp; Automation (TEMA), University of Aveiro, 3810-193 Aveiro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/S0140-6736(12)60607-2","article-title":"Hip arthroplasty","volume":"380","author":"Pivec","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/S0140-6736(11)60752-6","article-title":"Knee replacement","volume":"379","author":"Carr","year":"2012","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jmbbm.2008.02.005","article-title":"Pre-clinical validation of joint prostheses: A systematic approach","volume":"2","author":"Viceconti","year":"2009","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.berh.2014.08.002","article-title":"Burden of disability due to musculoskeletal (MSK) disorders","volume":"28","author":"March","year":"2014","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1302\/0301-620X.93B3.25467","article-title":"Revision rates after total joint replacement - cumulative results from worldwide joint register datasets","volume":"93-B","author":"Labek","year":"2011","journal-title":"J. Bone Joint Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.artd.2016.04.003","article-title":"Comparing contemporary revision burden among hip and knee joint replacement registries","volume":"2","author":"McGrory","year":"2016","journal-title":"Arthroplast. Today"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: Total hip replacement","volume":"370","author":"Learmonth","year":"2007","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.pmatsci.2017.04.002","article-title":"Advances in metals and alloys for joint replacement","volume":"88","author":"Kocich","year":"2017","journal-title":"Prog. Mater Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.biomaterials.2016.01.016","article-title":"Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants","volume":"84","author":"Raphel","year":"2016","journal-title":"Biomaterials"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.msec.2016.11.011","article-title":"Mediating bone regeneration by means of drug eluting implants: From passive to smart strategies","volume":"71","author":"Bagherifard","year":"2017","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J. Bone Joint Surg."},{"key":"ref_12","unstructured":"(2018). Norwegian National Advisory Unit on Arthroplasty and Hip Fractures, Helse Bergen HF, Department of Orthopaedic Surgery, Haukeland University Hospital. Technical Report."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1007\/s11999-009-0834-6","article-title":"Future young patient demand for primary and revision joint replacement\u2014National projections from 2010 to 2030","volume":"467","author":"Kurtz","year":"2009","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1007\/s00264-011-1235-5","article-title":"International survey of primary and revision total knee replacement","volume":"35","author":"Kurtz","year":"2011","journal-title":"Int. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.joca.2014.04.009","article-title":"Utilization rates of hip arthroplasty in OECD countries","volume":"22","author":"Pabinger","year":"2014","journal-title":"Osteoarthr. Cartil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3070","DOI":"10.1007\/s11999-010-1399-0","article-title":"Risk of subsequent revision after primary and revision total joint arthroplasty","volume":"468","author":"Ong","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1007\/s11999-015-4245-6","article-title":"Do rerevision rates differ after first-time revision of primary THA with a cemented and cementless femoral component?","volume":"473","author":"Gromov","year":"2015","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_18","first-page":"1","article-title":"New cosurface capacitive stimulators for the development of active osseointegrative implantable devices","volume":"6","author":"Marote","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1007\/s11999-013-2941-7","article-title":"A review of current fixation use and registry outcomes in total hip arthroplasty: The uncemented paradox","volume":"471","author":"Troelsen","year":"2013","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jbiomech.2014.12.021","article-title":"Long-term implant fixation and stress-shielding in total hip replacement","volume":"48","author":"Sumner","year":"2015","journal-title":"J. Biomech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1586\/17434440.2014.946695","article-title":"Instrumented hip joint replacements, femoral replacements and femoral fracture stabilizers","volume":"11","author":"Ferreira","year":"2014","journal-title":"Expert Rev. Med. Devices"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.1016\/j.actbio.2014.06.004","article-title":"Bone and metal: An orthopaedic perspective on osseointegration of metals","volume":"10","author":"Goriainov","year":"2014","journal-title":"Acta Biomater."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.biomaterials.2010.09.011","article-title":"The correlation between gene expression of proinflammatory markers and bone formation during osseointegration with titanium implants","volume":"32","author":"Omar","year":"2011","journal-title":"Biomaterials"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.clinbiomech.2013.04.003","article-title":"Estimation of change of bone structures after total hip replacement using bone remodeling simulation","volume":"28","author":"Kwon","year":"2013","journal-title":"Clin. Biomech."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.actbio.2013.10.008","article-title":"The effects of pulsed electromagnetic field on the functions of osteoblasts on implant surfaces with different topographies","volume":"10","author":"Wang","year":"2014","journal-title":"Acta Biomater."},{"key":"ref_26","unstructured":"Mj, P., and Ks, G. (2010). Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Collab."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"M\u00e4kel\u00e4, K.T., Matilainen, M., Pulkkinen, P., Fenstad, A.M., Havelin, L., Engesaeter, L., Furnes, O., Pedersen, A.B., Overgaard, S., and K\u00e4rrholm, J. (2014). Failure rate of cemented and uncemented total hip replacements: Register study of combined Nordic database of four nations. Br. Med. J.","DOI":"10.1136\/bmj.f7592"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ruther, C., Timm, U., Ewald, H., Mittelmeier, W., Bader, R., Schmelter, R., Lohrengel, A., and Kluess, D. (2012). Current Possibilities for Detection of Loosening of Total Hip Replacements and How Intelligent Implants Could Improve Diagnostic Accuracy. Recent Advances in Arthroplasty, IntechOpen. Chapter 17.","DOI":"10.5772\/25772"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.jfranklin.2014.11.005","article-title":"Active orthopaedic implants: Towards optimality","volume":"352","author":"Ferreira","year":"2015","journal-title":"J. Frankl. Inst."},{"key":"ref_30","first-page":"1","article-title":"Capacitive technologies for highly controlled and personalized electrical stimulation by implantable biomedical systems","volume":"9","author":"Coutinho","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1016\/j.jbiomech.2013.08.002","article-title":"Instrumented hip implants: Electric supply systems","volume":"46","author":"Ferreira","year":"2013","journal-title":"J. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0268-0033(01)00002-X","article-title":"Accurate diagnosis of hip prosthesis loosening using a vibrational technique","volume":"16","author":"Georgiou","year":"2001","journal-title":"Clin. Biomech."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.medengphy.2015.05.012","article-title":"Development of a non-invasive diagnostic technique for acetabular component loosening in total hip replacements","volume":"37","author":"Alshuhri","year":"2015","journal-title":"Med. Eng. Phys."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.medengphy.2017.06.037","article-title":"Non-invasive vibrometry-based diagnostic detection of acetabular cup loosening in total hip replacement (THR)","volume":"48","author":"Alshuhri","year":"2017","journal-title":"Med. Eng. Phys."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.medengphy.2012.05.007","article-title":"A vibrational technique for diagnosing loosened total hip endoprostheses: An experimental sawbone study","volume":"35","author":"Rieger","year":"2013","journal-title":"Med. Eng. Phys."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.medengphy.2014.11.011","article-title":"Loosening detection of the femoral component of hip prostheses with extracorporeal shockwaves: A pilot study","volume":"37","author":"Rieger","year":"2015","journal-title":"Med. Eng. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.medengphy.2006.09.011","article-title":"Intra- operative evaluation of cementless hip implant stability: A prototype device based on vibration analysis","volume":"29","author":"Lannocca","year":"2007","journal-title":"Med. Eng. Phys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.sna.2010.08.029","article-title":"Assessment of implant stability of cementless hip prostheses through the frequency response function of the stem\u2013bone system","volume":"163","author":"Varini","year":"2010","journal-title":"Sens. Actuators A"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1749-799X-4-10","article-title":"In vivo evaluation of a vibration analysis technique for the per-operative monitoring of the fixation of hip prostheses","volume":"4","author":"Pastrav","year":"2009","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1109\/10.821764","article-title":"Vibration Arthrometry in the Patients with Failed Total Knee Replacement","volume":"47","author":"Jiang","year":"2000","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.medengphy.2013.06.004","article-title":"Investigation of an acoustic-mechanical method to detect implant loosening","volume":"35","author":"Ruther","year":"2013","journal-title":"Med. Eng. Phys."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ruther, C., Timm, U., Fritsche, A., Ewald, H., Mittelmeier, W., Bader, R., and Kluess, D. (2013). A New Approach for Diagnostic Investigation of Total Hip Replacement Loosening. Biomedical Engineering Systems and Technologies, Springer.","DOI":"10.1007\/978-3-642-29752-6_6"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jbiomech.2009.10.005","article-title":"A non-invasive acoustic and vibration analysis technique for evaluation of hip joint conditions","volume":"43","author":"Glaser","year":"2010","journal-title":"J. Biomech."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/s130100001","article-title":"Investigation of a passive sensor array for diagnosis of loosening of endoprosthetic implants","volume":"13","author":"Ruther","year":"2013","journal-title":"Sensors"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/S0268-0033(03)00051-2","article-title":"How much can a vibrational diagnostic tool reveal in total hip arthroplasty loosening?","volume":"18","author":"Qi","year":"2003","journal-title":"Clin. Biomech."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/1350-4533(96)00004-5","article-title":"Vibration analysis in the detection of total hip prosthetic loosening","volume":"18","author":"Li","year":"1996","journal-title":"Med. Eng. Phys."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1243\/PIME_PROC_1989_203_014_01","article-title":"The differentiation of loose and secure femoral implants in total hip replacement using a vibrational technique: An anatomical and pilot clinical study","volume":"203","author":"Rosenstein","year":"1989","journal-title":"Proc. Inst. Mech. Eng. Part H J. Eng. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.medengphy.2007.04.017","article-title":"Bone vibration measurement using ultrasound: Application to detection of hip prosthesis loosening","volume":"30","author":"Rowlands","year":"2008","journal-title":"Med. Eng. Phys."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.medengphy.2017.08.007","article-title":"Vibration-based fixation assessment of tibial knee implants: A combined in vitro and in silico feasibility study","volume":"49","author":"Leuridan","year":"2017","journal-title":"Med. Eng. Phys."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10439-017-1941-2","article-title":"Knee Implant Loosening Detection: A Vibration Analysis Investigation","volume":"46","author":"Arami","year":"2018","journal-title":"Ann. Biomed. Eng."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0924-4247(00)00320-4","article-title":"Telemetry system for the detection of hip prosthesis loosening by vibration analysis","volume":"85","author":"Puers","year":"2000","journal-title":"Sens. Actuators A"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.sna.2009.08.025","article-title":"Integration of a wireless lock-in measurement of hip prosthesis vibrations for loosening detection","volume":"156","author":"Marschner","year":"2009","journal-title":"Sens. Actuators A"},{"key":"ref_53","unstructured":"Sauer, S., Marschner, U., Gratz, H., and Fischer, W.J. (2012, January 19\u201324). Medical wireless vibration measurement system for hip prosthesis loosening detection. Proceedings of the Third International Conference on Sensor Device Technologies and Applications Applications (SENSORDEVICES 2012), Rome, Italy."},{"key":"ref_54","first-page":"1022","article-title":"A finite element analysis of the vibration behaviour of a cementless hip system","volume":"16","year":"2011","journal-title":"Comput. Meth. Biomech. Biomed. Eng."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/2047-783X-14-6-264","article-title":"Acoustic monitoring (RFM) of total hip arthroplasty results of a cadaver study","volume":"14","author":"Unger","year":"2009","journal-title":"Eur. J. Med. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.medengphy.2017.07.006","article-title":"Development of an acoustic measurement protocol to monitor acetabular implant fixation in cementless total hip Arthroplasty: A preliminary study","volume":"49","author":"Goossens","year":"2017","journal-title":"Med. Eng. Phys."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"112","DOI":"10.2106\/JBJS.H.00627","article-title":"Clicking and squeaking: In vivo correlation of sound and separation for different bearing surfaces","volume":"90","author":"Glaser","year":"2008","journal-title":"J. Bone Joint Surg. Ser. A"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Ewald, H., Timm, U., Bader, R., and Kluess, D. (December, January 28). Acoustic sensor system for loosening detection of hip implants. Proceedings of the 2011 Fifth International Conference on Sensing Technology, Palmerston North, The New Zealand.","DOI":"10.1109\/ICSensT.2011.6137029"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ewald, H., Ruther, C., Mittelmeier, W., and Bader, R. (2011, January 28\u201331). A novel in vivo Sensor for Loosening Diagnostics in Total Hip Replacement. Proceedings of the 2011 IEEE SENSORS, Limerick, Ireland.","DOI":"10.1109\/ICSENS.2011.6127166"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1016\/j.jbiomech.2010.02.019","article-title":"The efficacy of using vibrometry to detect osteointegration of the Agility total ankle","volume":"43","author":"Reinhall","year":"2010","journal-title":"J. Biomech."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/S0883-5403(96)80115-X","article-title":"Monitoring the integrity of the cement-metal interface of total joint components in vitro using acoustic emission and ultrasound","volume":"11","author":"Davies","year":"1996","journal-title":"J. Arthroplast."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S0142-9612(03)00581-7","article-title":"Investigation of fatigue crack growth in acrylic bone cement using the acoustic emission technique","volume":"25","author":"Roques","year":"2004","journal-title":"Biomaterials"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/jbm.a.30133","article-title":"3D real time methodology monitoring cement failures in THA","volume":"71","author":"Qi","year":"2004","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Fokter, S.K. (2012). Acoustic Emission Studies in Hip Arthroplasty\u2014Peak Stress Impact In Vitro Cemented Prosthesis. Recent Advances in Arthroplasty, IntechOpen.","DOI":"10.5772\/1445"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.medengphy.2010.10.025","article-title":"Medical Engineering & Physics Real time monitoring of progressive damage during loading of a simplified total hip stem construct using embedded acoustic emission sensors","volume":"33","author":"Mavrogordato","year":"2011","journal-title":"Med. Eng. Phys."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/jor.1100130306","article-title":"In vitro evaluation of bonding of the cement-metal interface of a total hip femoral component using ultrasound","volume":"13","author":"Davies","year":"1995","journal-title":"J. Orthop. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.conengprac.2016.09.013","article-title":"Signal processing and event detection of hip implant acoustic emissions","volume":"58","author":"Rodgers","year":"2017","journal-title":"Control Eng. Pract."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.bspc.2016.12.011","article-title":"Biomedical Signal Processing and Control Development and validation of an acoustic emission device to measure wear in total hip replacements in-vitro and in-vivo","volume":"33","author":"Fitzpatrick","year":"2017","journal-title":"Biomed. Signal Process. Control"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1109\/TIM.2007.894170","article-title":"Low-invasive diagnosis of metallic prosthesis osseointegration by electrical impedance spectroscopy","volume":"56","author":"Arpaia","year":"2007","journal-title":"IEEE Trans. Instrum. Meas."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Arpaia, P., Clemente, F., and Romanucci, C. (2007, January 1\u20133). In-vivo test procedure and instrument characterization for EIS-based diagnosis of prosthesis osseointegration. Proceedings of the 2007 IEEE Instrumentation & Measurement Technology Conference IMTC 2007, Warsaw, Poland.","DOI":"10.1109\/IMTC.2007.379446"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"104503","DOI":"10.1115\/1.4005222","article-title":"A novel sensor concept for optimization of loosening diagnostics in total hip replacement","volume":"133","author":"Ruther","year":"2011","journal-title":"J. Biomech. Eng."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Burton, A.R., Sun, P., and Lynch, J.P. (2019). Bio-compatible wireless inductive thin-film strain sensor for monitoring the growth and strain response of bone in osseointegrated prostheses. Struct. Health Monit., 1\u201319.","DOI":"10.1177\/1475921719831452"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1002\/jor.22918","article-title":"Implantable microelectromechanical sensors for diagnostic monitoring and post-surgical prediction of bone fracture healing","volume":"33","author":"McGilvray","year":"2015","journal-title":"J. Orthop. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2147\/IEH.S133518","article-title":"Smart implants in orthopedic surgery, improving patient outcomes: A review","volume":"5","author":"Ledet","year":"2018","journal-title":"Innov. Entrep. Health"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1586\/17434440.2015.1068114","article-title":"Instrumented knee joint implants: Innovations and promising concepts","volume":"12","author":"Ferreira","year":"2015","journal-title":"Expert Revi. Med. Devices"},{"key":"ref_76","first-page":"1","article-title":"Clinical potential of implantable wireless sensors for orthopedic treatments","volume":"15","author":"Karipott","year":"2018","journal-title":"Expert Revi. Med. Devices"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Varga, M., and Wolter, K.J. (2014, January 23\u201326). Sensors and imaging methods for detecting loosening of orthopedic implants. Proceedings of the IEEE 20th International Symposium for Design and Technology in Electronic Packaging (SIITME), Bucharest, Romania.","DOI":"10.1109\/SIITME.2014.6966990"},{"key":"ref_78","first-page":"1","article-title":"Wireless Sensors for Smart Orthopedic Implants","volume":"3","author":"Kiourti","year":"2017","journal-title":"J. Bio-Tribo-Corros."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/1\/104\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:44:56Z","timestamp":1760190296000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/1\/104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,23]]},"references-count":78,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["s20010104"],"URL":"https:\/\/doi.org\/10.3390\/s20010104","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,23]]}}}