PATIENT-SPECIFIC BIOMECHANICAL MODELING FOR OPTIMIZING IMPLANT ALIGNMENT AND LONGEVITY IN TOTAL HIP ARTHROPLASTY

Abstract

Background: Total hip arthroplasty (THA) is a highly effective procedure for relieving pain and restoring mobility in patients with advanced hip disease, but implant longevity remains influenced by alignment accuracy, bone quality, joint loading, soft-tissue balance, wear, instability, and patient-specific anatomical variation. Conventional implant positioning strategies often rely on generalized alignment targets and static radiographic parameters, which may not fully account for differences in femoral offset, acetabular version, pelvic tilt, spinopelvic mobility, gait mechanics, and functional activity. Patient-specific biomechanical modeling offers a precision-based approach for optimizing implant alignment by integrating imaging-based reconstruction, finite element analysis, musculoskeletal simulation, wear prediction, and functional assessment of hip-spine mechanics. These models can support individualized prediction of stress distribution, implant fixation, impingement risk, joint loading, edge loading, and postoperative instability. Robotic-assisted surgery, navigation-guided systems, artificial intelligence, digital twins, and three-dimensional printing may further enhance the translation of computational planning into surgical execution. This review discusses the biomechanical principles, modeling techniques, clinical applications, limitations, and future directions of patient specific biomechanical modeling in THA. Although broader clinical adoption requires standardized workflows, prospective validation, cost-effectiveness analysis, and long-term outcome data, individualized biomechanical planning may improve implant positioning, reduce mechanical complications, and support more durable precision arthroplasty.