Understanding The Causes Of Implant Failure

The success of an orthopedic implant depends on multiple factors, such as surgical technique, implant (mechanical properties of implant material, shape, and size), and patient factors (such as adjacent bone quality).1 However, some patients may encounter implant failure.2 Orthopedic implant failure occurs when the implant bonds poorly to the bone cells.2 Implant failure can potentially increase the morbidity rate, delay the healing process, and increase the hospital stay and health-cost burden.3

Your orthopedic surgeon will inform you about the possible implant-related complications before you undergo the procedure.  

The demand for better orthopedic implants has caused significant advances in the field, resulting in implants with better performance and novel properties.8

Some of the common challenges include:

Bone implant infection icon

Implant Infection:

Implant infections are a major concern in orthopedic surgery. The bacteria residing on the skin and inside the body can lead to infection after implant surgery.4

A bone implant icon

Implant Breakage:

Implant breakage or fracture can be caused due to non-union of a fractured bone, failure to comply with prescribed post-operative instructions, recurring trauma, and bacterial infections at the surgical site.5

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Implant Loosening:

Implant loosening can be caused due to bearing of excessive weight before the fracture has healed completely.6 The other causes include surgical technique, lower bone quality, lesser biocompatibility of implant, inadequate bone remodeling, and infection.7 


1. Grzeskowiak  RM., Schumacher J, Dhar MS., et al. Bone and Cartilage Interfaces With Orthopedic Implants: A Literature Review. Frontiers in Surgery. Vol.7.2020 www.frontiersin.org   
2. S. Minagar, Y. Li, C.C. Berndt, C. Wen, 9 - The bioactivity and bone cell attachment of nanotubular layers anodized in aqueous and nonaqueous electrolytes, Editor(s): Cuie Wen, Metallic Foam Bone, Woodhead Publishing, 2017, Pages 217-239.
3. Kumar S, Kumar D, Gill S.P.S, et al., Evaluation of Implant Failure in Long Bones Fractures – A Retrospective Study, Indian Journal of Orthopaedics Surgery, 2016;2(1):64-68
4. Ribeiro M, Monteiro FJ, Ferraz MP. Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions. Biomatter. 2012;2(4):176-94. 
5. Patil RR, Badole CM, Mote GB, et al. Why do orthopedic implants break?: A retrospective analysis of implant failures at a rural tertiary care centre in central India. J Mahatma Gandhi Inst Med Sci 2020;25:95-8
6. Ogbemudia A, Umebese P, Implant failure in osteosynthesis of fractures of long bones. JMBR: A Peer-review Journal of Biomedical Sciences. 2006 Vol. 5 No.2 pp-75-78
7. Apostu D, Lucaciu O, Berce C, et al. Current methods of preventing aseptic loosening and improving osseointegration of titanium implants in cementless total hip arthroplasty: a review. J Int Med Res. 2018;46(6):2104-2119. 
8. Jin W, Chu PK. Orthopedic implants. Encyclopedia of Biomedical Engineering. 2019;1:3. Available at: www.cityu.edu.hk [Accessed on 27th Feb 2022]