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Open research questions in Orthopaedic implants and arthroplasty

131 unresolved questions extracted from the limitations and future-work sections of 495 Orthopaedic implants and arthroplasty papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Standardize instability reporting, - Evaluate the interactions among DDH severity, implant strategy, and long-term revision risk, - Investigate the effects of pregnancy on THA outcomes in women with DDH

    Long-Term Prosthesis Survival After Total Hip Arthroplasty in Young Women with Developmental Dysplasia of the Hip: A Narrative Review of Instability, Revision Risk, and Reproductive Health Considerations · 2026 · DOI

  • DDH severity is frequently underreported or unavailable, particularly in large registry datasets. Sex-and age-specific reporting remains limited. Instability is inconsistently defined and reported across studies.

    Long-Term Prosthesis Survival After Total Hip Arthroplasty in Young Women with Developmental Dysplasia of the Hip: A Narrative Review of Instability, Revision Risk, and Reproductive Health Considerations · 2026 · DOI

  • The extent to which the characteristics of ceramic materials are compromised in acidic oral environments remains to be fully elucidated. The chemical resistance of dental materials is a fundamental requirement for successful intraoral application.

    The effects of simulated gastric acid on the mechanical, optical, and physicochemical properties of different esthetic CAD-CAM materials · 2026 · DOI

  • Further research is needed to fully elucidate the extent to which the characteristics of ceramics are compromised in acidic oral environments. Research on the long-term durability and performance of restorative materials in patients with chronic reflux is needed. Studies on the effects of other types of acidic beverages on restorative materials are required.

    The effects of simulated gastric acid on the mechanical, optical, and physicochemical properties of different esthetic CAD-CAM materials · 2026 · DOI

  • The differential impact of robotic assistance on surgeons with varying levels of experience in total hip arthroplasty (THA) remains underexplored.

    Comparative study on the performance and early clinical outcomes of senior and junior orthopaedic surgeons in traditional versus robot-assisted total hip arthroplasty · 2026 · DOI

  • However, the effect of these characteristics on tissue mechanics within a collagenous matrix, has not been investigated experimentally.

    Investigating the impact of microcalcification size and volume on collagenous matrix and tissue mechanics using a tissue-engineered atherosclerotic cap model · 2025 · DOI

  • A lack of standardized outcome reporting and platform heterogeneity limits cross-study comparisons.

    Robotic total hip and knee arthroplasty: economic impact and workflow efficiency · 2025 · DOI

  • Postoperative complications, including nerve injury, hematoma, infection, and prosthesis dislocation. Limited number of studies reporting early postoperative PCS scores. Risk of bias due to small sample sizes in some studies.

    Early clinical efficacy and safety of different surgical approaches in total hip arthroplasty: a systematic review and network meta-analysis · 2026 · DOI

  • One study had a notable risk of bias due to an extremely small sample size. The study did not report randomization methods for five studies. The study had a limited number of studies reporting early postoperative PCS scores.

    Early clinical efficacy and safety of different surgical approaches in total hip arthroplasty: a systematic review and network meta-analysis · 2026 · DOI

  • The study aims to address the gap in knowledge regarding etiology-specific perioperative burden and early recovery after primary THA using AI-assisted 3D planning. The study investigates whether etiology still shapes outcomes under a unified planning pathway and single implant system.

    AI-assisted 3D preoperative planning in primary total hip arthroplasty for secondary hip osteoarthritis: etiology-specific perioperative burden and early recovery in DDH versus post-septic sequelae · 2026 · DOI

  • Instability or dislocation is a leading cause of revision after THA. The RHRS is a new design with limited clinical data. The study has a limited follow-up period.

    Reverse Hip Replacement System: Addressing Instability Concerns or Introducing New Risks? A Scoping Review · 2026 · DOI

  • The results published on the newly proposed RHRS are scarce and considered immature. The complication rate might be considered high. The study has a limited follow-up period.

    Reverse Hip Replacement System: Addressing Instability Concerns or Introducing New Risks? A Scoping Review · 2026 · DOI

  • There is a lack of research on ethnic-specific jumbo cup definitions for the Indian population. The current definition of jumbo acetabular cups may not be applicable to the Indian population.

    Jumbo Acetabular Cup in the Indian Population: Is It Time to Reconsider Existing Thresholds? · 2026 · DOI

  • Although the regression model identified age, sex, and etiology as significant predictors of acetabular cup size, the adjusted R2 of 0.30 indicates that a substantial proportion of variability remains unexplained. Important anthropometric and anatomical variables such as height, weight, body mass index, and pelvic morphometric parameters were not uniformly available across participating registry datasets and, therefore, could not be incorporated into the current analysis. Their omission may have introduced residual confounding and likely limited the explanatory power of the model. Future prospective studies with standardized anthropometric and radiographic data collection are warranted to refine prediction of population-specific acetabular component sizing. Furthermore, our study did not include long-term clinical outcomes following the use of jumbo cups, which could provide further insight into the durability and success of these implants over time. The strengths of this study include its large sample size of 2,372 patients, drawn from multiple high-volume centers, enhancing the generalizability of our findings across diverse patient populations. This multicentre approach allows us to account for regional variations and ensures robust data collection. Additionally, this study fills a critical gap in the literature by providing specific data on acetabular cup sizes for Indian patients, supporting the development of population-specific guidelines. However, this study also has some limitations. As a retrospective analysis, it is limited by the quality of data available in institutional registries, and variations in surgical technique across centers may influence component selection.

    Jumbo Acetabular Cup in the Indian Population: Is It Time to Reconsider Existing Thresholds? · 2026 · DOI

  • Acetabular component malpositioning is a significant challenge in THA. The Lewinnek safe zone is becoming less relevant. There is a need for personalized component positioning.

    Hip–Spine Evaluation: A Clinical Practice for Total Hip Arthroplasty in Indian Scenario · 2026 · DOI

  • There is a lack of studies evaluating spinopelvic parameters in Indian patients undergoing total hip arthroplasty (THA). There is a need to assess the role of functional component positioning in preventing dislocations in Indian THA patients.

    Hip–Spine Evaluation: A Clinical Practice for Total Hip Arthroplasty in Indian Scenario · 2026 · DOI

  • The study addresses the gap in knowledge regarding the comparison of the posterior and anterior approaches for hip resurfacing arthroplasty. The study investigates the potential benefits of using the anterior approach for hip resurfacing arthroplasty.

    NO ADVANTAGE TO ANTERIOR APPROACH DETECTED FOR HIP RESURFACING ARTHROPLASTY: A GAIT ANALYSIS STUDY · 2026 · DOI

  • The difficulty of removing the stem when well-fixed has led to a gap in knowledge regarding the effectiveness of stem retention in managing periprosthetic joint infections.

    LEAVE THE STEM! SURVIVORSHIP AND INFECTION MANAGEMENT WITH ONE TRIPLE-TAPERED COLLARED STEM IN THE FIRST DECADE OF USE · 2026 · DOI

  • There is a gap in understanding the predictors of risk beyond age in modern RTHA. Prior work has focused on chronological age as a limiting factor, but clinical experience suggests physiological status and frailty are more important.

    REVISING THE VERY ELDERLY: PREDICTORS OF RISK BEYOND AGE IN MODERN REVISION TOTAL HIP ARTHROPLASTY · 2026 · DOI

  • The variability in radiographic protocol can affect the accuracy of spinopelvic mobility classification. The lack of standardized protocols can lead to inconsistent results.

    THE EFFECT OF RADIOLOGICAL PROTOCOL ON SPINOPELVIC MOBILITY CLASSIFICATION IN TOTAL HIP ARTHROPLASTY: WHY ΔSS ALONE IS INSUFFICIENT WITHOUT ASSESSMENT OF SPINAL ALIGNMENT · 2026 · DOI

  • The lack of understanding of how radiographic protocol affects spinopelvic mobility classification. The need to quantify patient category migration across different classification systems.

    THE EFFECT OF RADIOLOGICAL PROTOCOL ON SPINOPELVIC MOBILITY CLASSIFICATION IN TOTAL HIP ARTHROPLASTY: WHY ΔSS ALONE IS INSUFFICIENT WITHOUT ASSESSMENT OF SPINAL ALIGNMENT · 2026 · DOI

  • The study identifies a gap in understanding how sex and age affect the risk of reoperation for PPFF.

    PERIPROSTHETIC FEMORAL FRACTURE AFTER PRIMARY HIP ARTHROPLASTY: SHOULD CHOICE OF STEM DESIGN AND FIXATION METHOD VARY BASED ON SEX AND AGE? DATA ON 187,576 CASES FROM THE NORWEGIAN ARTHROPLASTY REGISTER AND THE NORWEGIAN HIP FRACTURE REGISTER 2005–2023 · 2026 · DOI

  • Further studies are needed to evaluate the long-term outcomes of fourth-generation ceramic-on-ceramic THA. Studies should investigate the potential benefits and drawbacks of using fourth-generation bearings. Research should focus on improving the tribological properties and reducing the revision rates of ceramic-on-ceramic THA.

    Third- and fourth- generation ceramic-on-ceramic total hip arthroplasty: a ten- to sixteen year follow-up study · 2026 · DOI

  • Comparative clinical studies at a long-term are lacking. There is a need to evaluate the effectiveness of fourth-generation ceramic-on-ceramic THA. The study addresses the gap in knowledge by comparing third- and fourth-generation ceramic-on-ceramic THA.

    Third- and fourth- generation ceramic-on-ceramic total hip arthroplasty: a ten- to sixteen year follow-up study · 2026 · DOI

  • Pin-site complications and intraoperative navigation abandonment due to pin loosening. High acquisition and maintenance costs of existing computer-assisted systems. Limited resources in medical institutions.

    A novel pinless augmented reality-based navigation system for total hip arthroplasty in the supine position: a comparative study of acetabular cup angle accuracy · 2026 · DOI

Most-cited papers in Orthopaedic implants and arthroplasty

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131 open questions have been extracted from the limitations and future-work passages of 495 Orthopaedic implants and arthroplasty papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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