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Enthusiasm, concern, and controversy exist around the clinical application of porous materials for skeletal fixation of uncemented total joint replacements. The clinical and radiographic evaluations of such prosthetic components involve numerous measurements, which are necessary to communicate quantitative information on the patient's response, as well as the implant's performance. Just as communication requires a commonly accepted language for efficiency and effectiveness, clinical and radiographic analyses require commonly accepted criteria and terminology. The importance of radiography, the radiological factors influencing its interpretation, its evaluation methodology, and proposed criteria for sequential evaluation of the implant/bone interface and bone remodeling responses by using a zonal approach have been described to establish objectivity in the performance assessment of uncemented total joint replacements.
Porous implants, porous implant materials, total joint replacement, radiography, implant loosening, bone remodeling
Director, Institute for Bone and Joint Disorders, Phoenix, AZ