N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector67858310.17816/vto678583BLZDPHReviewsОбзорыReview ArticlePotential use of SMART implants in traumatology and orthopedics: a reviewПерспективы применения «умных» имплантатов в травматологии и ортопедии. Обзор литературы5557-0572DontsovaOlga A.ДонцоваОльга Анатольевна
Russian Federation

Dr. Sci. (Chemistry), Academician of the Russian Academy of Sciences

д-р хим. наук, академик РАН

olga.a.dontsova@gmail.comhttps://orcid.org/0000-0003-1314-28871402-5186NazarenkoAnton G.НазаренкоАнтон Герасимович
Russian Federation

Corresponding Member of the Russian Academy of Sciences, MD, Dr. Sci. (Medicine), Professor of RAS

член-корреспондент РАН, д-р мед. наук, профессор РАН

nazarenkoag@cito-priorov.ruhttps://orcid.org/0000-0001-5582-52003671-5540KrupatkinAlexander I.КрупаткинАлександр Ильич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

krup.61@mail.ruhttps://orcid.org/0000-0002-9526-82747052-0220KuleshovAlexander A.КулешовАлександр Алексеевич
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

cito-spine@mail.ru2037-7164KleimyonovaElena B.КлеймёноваЕлена Борисовна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

KleymenovaEB@cito-priorov.ruhttps://orcid.org/0000-0001-6689-52209690-5117VetrileMarchel S.ВетрилэМарчел Степанович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

vetrilams@cito-priorov.ruhttps://orcid.org/0009-0002-3469-39448868-2577TairovGazinur N.ТаировГазинур Наильевич
Russian Federation

MD

gazinur.vezunchik@mail.ruhttps://orcid.org/0000-0001-5260-1973ZavyalovaElena G.ЗавьяловаЕлена Геннадиевна
Russian Federation
zlenka2006@gmail.comhttps://orcid.org/0000-0001-5892-6752AginaElena V.АгинаЕлена Валерьевна
Russian Federation
werdas@mail.ruKydralievaKamilya A.КыдралиеваКамиля Асылбековна
Russian Federation

Dr. Sci. (Chemistry), Academician of the Russian Academy of Sciences

д-р хим. наук, академик РАН

k_kamila@mail.ruSyrchenkoNikolay V.СырченкоНиколай Владимирович
Russian Federation
syrchenkonv@mai.ruKhudalovTaimuraz T.ХудаловТаймураз Таймуразович
Russian Federation

MD

khudalov@yandex.ruLomonosov Moscow State UniversityМосковский государственный университет им. М.В. ЛомоносоваPriorov National Medical Research Center of Traumatology and OrthopedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. ПриороваEnikolopov Institute of Synthetic Polymeric Materials Russian Academy of Sciences (ISPM RAS)Институт синтетических полимерных материалов им. Н.С. Ениколопова РАН (ИСПМ РАН)Moscow Aviation Institute (National Research University)Московский авиационный институт (национальный исследовательский университет)21062025220720253224935051504202517042025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://journals.eco-vector.com/0869-8678/article/view/678583

This review presents current scientific data on the use of biosensors in traumatology and orthopedics. Biosensors are specialized devices that detect various physicochemical parameters in the body. These parameters can be used to monitor, predict, and manage a variety of processes in orthopedic and trauma care. Technological advances enable the integration of biosensors and the development of customized implants. Their introduction has marked a significant breakthrough in trauma and orthopedic surgery, particularly with the emergence of SMART (Self-Monitoring Analysis and Reporting Technology) implants, which integrate microchips, wireless connectivity, and data analysis algorithms.

With the expected increase in surgeries and the growing need for implants, technological progress in this field is bound to continue and accelerate. Existing issues such as implant instability, infectious complications, and nonunions further underscore the relevance of this topic and the need for further research.

This analytical review was conducted using medical scientific databases and search engines, including PubMed (MEDLINE), Google Scholar, and eLibrary. The review addresses the following aspects: relevance, types of biosensors, their clinical applications, and prospects in traumatology and orthopedics. The review aims to improve understanding of biosensor uses in this medical field.

Представлен обзор литературы, посвящённой применению биосенсоров в травматологии и ортопедии. Биосенсоры — это специализированные устройства, которые могут воспринимать различные физико-химические показатели в организме. Данные показатели могут быть использованы для контроля, прогнозирования и управления различными процессами в травматологии и ортопедии. Развитие технологий позволяет интегрировать биосенсоры и создавать персонализированные имплантаты. В травматологии и ортопедии их внедрение стало прорывом, особенно с появлением SMART-имплантатов (Self-Monitoring Analysis and Reporting Technology), которые сочетают микрочипы, беспроводную связь и алгоритмы анализа данных.

В связи с прогнозируемым увеличением оперативных вмешательств и ростом потребности в имплантатах развитие технологий в данной области, несомненно, будет продолжаться и набирать обороты. Существующие проблемы в виде нестабильности имплантатов, инфекционных осложнений и несращений также делают данный вопрос актуальным и требуют дальнейших исследований.

Обзор носит аналитический характер и проведён с использованием баз данных медицинской литературы и поисковых ресурсов PubMed (MEDLINE), Google Scholar и eLibrary. В обзоре затронуты следующие аспекты: актуальность, виды биосенсоров, область их применения и перспективы в травматологии и ортопедии. Целью обзора является углубление знаний о применении биосенсоров в травматологии и ортопедии.

SMART implantsbiosensorstraumatology and orthopedicsумные имплантатыбиосенсорытравматология и ортопедияRussian Science FoundationРоссийский научный фонд23-73-00103Gil B, Hall TAG, Freeman DME, et al. Wireless implantable bioelectronics with a direct electron transfer lactate enzyme for detection of surgical site infection in orthopaedics. Biosens Bioelectron. 2024;263:116571. doi: 10.1016/j.bios.2024.116571Lum ZC, Natsuhara KM, Shelton TJ, et al. Mortality During Total Knee Periprosthetic Joint Infection. J Arthroplasty. 2018;33(12):3783–3788. doi: 10.1016/j.arth.2018.08.021Karipott SS, Veetil PM, Nelson BD, Guldberg RE, Ong KG. An Embedded Wireless Temperature Sensor for Orthopedic Implants. IEEE Sens J. 2018;18(3):1265–1272. doi: 10.1109/JSEN.2017.2780226Shohat N, Goswami K, Tan TL, et al. Fever and erythema are specific findings in detecting infection following total knee arthroplasty. J Bone Jt Infect. 2019;4(2):92–98. doi: 10.7150/jbji.30088Gil B, Lo B, Yang GZ, Anastasova S. Smart implanted access port catheter for therapy intervention with pH and lactate biosensors. Mater Today Bio. 2022;15:100298. doi: 10.1016/j.mtbio.2022.100298Zargartalebi H, Mirzaie S, GhavamiNejad A, et al. Active-reset protein sensors enable continuous in vivo monitoring of inflammation. Science. 2024;386(6726):1146–1153. doi: 10.1126/science.adn2600Tan N, van Arkel RJ. Topology optimisation for compliant hip implant design and reduced strain shielding. Materials (Basel). 2021;14(23):7184. doi: 10.3390/ma14237184Khizriev UI, Besedin AD, Klishin IV. Биосенсоры и их применение в медицинской диагностике Biosensors and Their Application in Medical Diagnostics. Vestnik UGMU. 2024;(3):57–65. EDN: FJHZRKNielsen K, Yu WL, Kelly L, et al. Development of a lateral flow assay for rapid detection of bovine antibody to Anaplasma marginale. J Immunoass Immunochem. 2008;29(1):10–8. doi: 10.1080/15321810701734693Kuleshov BS, Zavyalova EG, Poymanova EYu, et al. Multisensors based on electrolyte-gated organic field-effect transistors with aptamers as recognition elements: current state of research. Russ Chem Rev. 2024;93(4):RCR5116. doi: 10.59761/RCR5116 EDN: GZWUBNGupta U, Gupta V, Arun RK, Chanda N. Recent advances in enzymatic biosensors for point-of-care detection of biomolecules. Biotechnol Bioeng. 2022;119(12):3393–3407. doi: 10.1002/bit.28251Seshadri P, Manoli K, Schneiderhan-Marra N, et al. Low-picomolar, label-free procalcitonin analytical detection with an electrolyte-gated organic field-effect transistor based electronic immunosensor. Biosens Bioelectron. 2018;104:113–119. doi: 10.1016/j.bios.2017.12.041Adachi T, Nakamura Y. Aptamers: A review of their chemical properties and modifications for therapeutic application. Molecules. 2019;24(23):4229. doi: 10.3390/molecules24234229Araujo-Rocha M, Piro B, Noël V, Barbault F. Computational studies of a DNA-based aptasensor: toward theory-driven transduction improvement. J Phys Chem B. 2021;125(33):9499–9506. doi: 10.1021/acs.jpcb.1c05341Berto M, Vecchi E, Baiamonte L, et al. Label Free Detection of Plant Viruses with Organic Transistor Biosensors. Sens Actuators B Chem. 2019;281:150–156.Ricci S, Casalini S, Parkula V, et al. Label-free immunodetection of α-synuclein by using a microfluidics coplanar electrolyte-gated organic field-effect transistor. Biosens Bioelectron. 2020;167:112433. doi: 10.1016/j.bios.2020.112433Macchia E, Manoli K, Holzer B, et al. Single-molecule detection with a millimetre-sized transistor. Nat Commun. 2018;9(1):3223. doi: 10.1038/s41467-018-05235-zMa F, Li Y, Tang B, Zhang CY. Fluorescent biosensors based on single-molecule counting. Acс Chem Res. 2016;49(9):1722–30. doi: 10.1021/acs.accounts.6b00237Zhang K, Liu G, Goldys EM. Robust immunosensing system based on biotin-streptavidin coupling for spatially localized femtogram mL−1 level detection of interleukin-6. Biosens Bioelectron. 2018;102:80–86. doi: 10.1016/j.bios.2017.11.023Cho IH, Kim DH, Park S. Electrochemical biosensors: Perspective on functional nanomaterials for on-site analysis. Biomater Res. 2020;24:6. doi: 10.1186/s40824-019-0181-yPoimanova EY, Kretova EA, Keshek AK, et al. Universal approach to fabrication of reusable egofet-based aptasensors with track-etched membranes for biorecognition layer. J Mater Chem B. 2025;13(15):4681–4692. doi: 10.1039/d4tb02536aPoimanova EY, Zavyalova E, Kretova EA, et al. Quantitative detection of the influenza a virus by an EGOFET-based portable device. Chemosensors. 2023;11(8):464. doi: 10.3390/chemosensors11080464Sequeira-Antunes B, Ferreira HA. Nucleic acid aptamer-based biosensors: a review. Biomedicines. 2023;11(12):3201. doi: 10.3390/biomedicines11123201Chow AW. Lab-on-Chip: Opportunities for chemical engineering. Am Inst Chem Eng AIChE J. 2002;48(8):1590.,Sun C, Feng G, Song Y, et al. Single molecule level and label-free determination of multibiomarkers with an organic field-effect transistor platform in early cancer diagnosis. Anal Chem. 2022;94(17):6615–6620. doi: 10.1021/acs.analchem.2c00897Casalini S, Leonardi F, Cramer T, Biscarini F. Organic field-effect transistor for label-free dopamine sensing. Org Electron. 2013;14(1):156–163. doi: 10.1016/j.orgel.2012.10.027Sawayama J, Okitsu T, Nakamata A, Kawahara Y, Takeuchi S. Hydrogel glucose sensor with in vivo stable fluorescence intensity relying on antioxidant enzymes for continuous glucose monitoring. iScience. 2020;23(6):101243. doi: 10.1016/j.isci.2020.101243Zhao C, Man T, Cao Y, et al. Flexible and implantable polyimide aptamer-field-effect transistor biosensors. ACS sensors. 2022;7(12):3644–3653. doi: 10.1021/acssensors.2c01909Edward R, Priefer R. A comparison of continuous glucose monitors (CGMs) in diabetes management: A systematic literature review. Prim Care Diabetes. 2023:S1751-9918(23)00178-X. doi: 10.1016/j.pcd.2023.10.009Nicholson JA, Makaram N, Simpson A, Keating JF. Fracture nonunion in long bones: A literature review of risk factors and surgical management. Injury. 2021;52 Suppl 2:S3–S11. doi: 10.1016/j.injury.2020.11.029Ledet EH, Liddle B, Kradinova K, Harper S. Smart implants in orthopedic surgery, improving patient outcomes: a review. Innov Entrep Health. 2018;5:41–51. doi: 10.2147/ieh.s133518Morshed S, Corrales L, Genant H, Miclau T 3rd. Outcome assessment in clinical trials of fracture-healing. J Bone Joint Surg Am. 2008;90 Suppl 1:62–7. doi: 10.2106/JBJS.G.01556Davis BJ, Roberts PJ, Moorcroft CI, et al. Reliability of radiographs in defining union of internally fixed fractures. Injury. 2004;35(6):557–61. doi: 10.1016/S0020-1383(03)00262-6McClelland D, Thomas PB, Bancroft G, Moorcraft CI. Fracture healing assessment comparing stiffness measurements using radiographs. Clin Orthop Relat Res. 2007;457:214–9. doi: 10.1097/BLO.0b013e31802f80a8Mills LA, Aitken SA, Simpson AHRW. The risk of non-union per fracture: current myths and revised figures from a population of over 4 million adults. Acta Orthop. 2017;88(4):434–439. doi: 10.1080/17453674.2017.1321351Iyengar KP, Kariya AD, Botchu R, Jain VK, Vaishya R. Significant capabilities of SMART sensor technology and their applications for Industry 4.0 in trauma and orthopaedics. Sensors Int. 2022;3:100163. doi: 10.1016/j.sintl.2022.100163Bizzoca D, Vicenti G, Caiaffa V, et al. Assessment of fracture healing in orthopaedic trauma. Injury. 2023;54 Suppl 1:S46–S52. doi: 10.1016/j.injury.2020.11.014Kienast B, Kowald B, Seide K, et al. An electronically instrumented internal fixator for the assessment of bone healing. Bone Jt Res. 2016;5(5):191–7. doi: 10.1302/2046-3758.55.2000611McGilvray KC, Unal E, Troyer KL, et al. Implantable microelectromechanical sensors for diagnostic monitoring and post-surgical prediction of bone fracture healing. J Orthop Res. 2015;33(10):1439–46. doi: 10.1002/jor.22918Borchani W, Aono K, Lajnef N, Chakrabartty S. Monitoring of Postoperative Bone Healing Using Smart Trauma-Fixation Device with Integrated Self-Powered Piezo-Floating-Gate Sensors. IEEE Trans Biomed Eng. 2016;63(7):1463–72. doi: 10.1109/TBME.2015.2496237Arciola CR, Campoccia D, Montanaro L. Implant infections: Adhesion, biofilm formation and immune evasion. Nat Rev Microbiol. 2018;16(7):397–409. doi: 10.1038/s41579-018-0019-yYocum D, Housholder E, Yergler J. Manipulation under Anesthesia Following TKA with Persona IQ: A Case Series. J Orthop Case Rep. 2023;13(8):127–131. doi: 10.13107/jocr.2023.v13.i08.3844Kelmers E, Szuba A, King SW, et al. ‘Smart Knee Implants: An Overview of Current Technologies and Future Possibilities’. Indian J Orthop. 2022;57(5):635–642. doi: 10.1007/s43465-022-00810-5Zimmer Biomet. Persona IQ Brochure: Robotic-assisted solutions for knee replacement. Internal document, n.d.Yocum D, Elashoff B, Verta P., et al. Patient reported outcomes do not correlate to functional knee recovery and range of motion in total knee arthroplasty. J Orthop. 2023;43:36–40. doi: 10.1016/j.jor.2023.07.009Schumacher N, Geiger F, Spors S, et al. Detection of Total Hip Replacement Loosening Based on Structure-Borne Sound: Influence of the Position of the Sensor on the Hip Stem. Sensors. 2024;24(14):4594. doi: 10.3390/s24144594Mohammadbagherpoor H, Ierymenko P, Craver MH, et al. An implantable wireless inductive sensor system designed to monitor prosthesis motion in total joint replacement surgery. IEEE Trans Biomed Eng. 2020;67(6):1718–1726. doi: 10.1109/TBME.2019.2943808Liao YS, Benya PD, McKellop HA. Effect of protein lubrication on the wear properties of materials for prosthetic joints. J Biomed Mater Res. 1999;48(4):465–73. doi: 10.1002/(sici)1097-4636(1999)48:4<465::aid-jbm10>3.0.co;2-yBergmann G, Graichen F, Dymke J, et al. High-tech hip implant for wireless temperature measurements in vivo. PLoS One. 2012;7(8):e43489. doi: 10.1371/journal.pone.0043489Ibrahim A, Jain M, Salman E, Willing R, Towfighian S. A smart knee implant using triboelectric energy harvesters. Smart Mater Struct. 2019;28(2):025040. doi: 10.1088/1361-665X/aaf3f1Rohlmann A, Bergmann G, Graichen F. A spinal fixation device for in vivo load measurement. J Biomech. 1994;27(7):961–7. doi: 10.1016/0021-9290(94)90268-2Kim SJ, Wang T, Pelletier MH, Walsh WR. ‘SMART’ implantable devices for spinal implants: a systematic review on current and future trends. J Spine Surg. 2022;8(1):117–131. doi: 10.21037/jss-21-100Viswanathan VK, Jain VK, Sangani C, et al. SMART (self-monitoring analysis and reporting technology) and sensor based technology applications in trauma and orthopaedic surgery. J Orthop. 2023;44:113–118. doi: 10.1016/j.jor.2023.09.006Boutry CM, Kaizawa Y, Schroeder BC, et al. A stretchable and biodegradable strain and pressure sensor for orthopaedic application. Nat Electron. 2018;1(5):314–321. doi: 10.1038/s41928-018-0071-7Saini N, Kundnani V, Patni P, Gupta S. Outcome of early active mobilization after flexor tendons repair in zones II–V in hand. Indian J Orthop. 2010;44(3):314–21. doi: 10.4103/0019-5413.65155Bogaerts S, Desmet H, Slagmolen P, Peers K. Strain mapping in the Achilles tendon — A systematic review. J Biomech. 2016;49(9):1411–1419. doi: 10.1016/j.jbiomech.2016.02.057Dzhardimalieva GI, Kydralieva KA, Uflyand IE. Bioinspired and biomimetic self-healing materials. 10 breakthrough ideas in the energy sector for the next 10 years. Global’naya energiya. 2023:63–85. (in Russ.).Baimuratova RK, Dzhardimalieva GI, Vaganov EV, et al. Novel Self-Healing Metallocopolymers with Pendent 4-Phenyl-2, 2': 6', 2 "-Terpyridine Ligand: Kinetic Studies and Mechanical Properties. Polymers (Basel). 2021;13(11):1760. doi: 10.3390/polym13111760Tan YJ, Wu J, Li H, Tee BCK. Self-healing electronic materials for a smart and sustainable future. ACS Appl Mater Interfaces. 2018;10(18):15331–15345. doi: 10.1021/acsami.7b19511Han L, Lu X, Wang M, et al. A mussel-inspired conductive, self-adhesive, and self-healable tough hydrogel as cell stimulators and implantable bioelectronics. Small. 2017;13(2). doi: 10.1002/smll.201601916Dzhardimalieva GI, Yadav BC, Singh S, Uflyand IE. Self-healing and shape memory metallopolymers: state-of-the-art and future perspectives. Dalt Trans. 2020;49(10):3042–3087. doi: 10.1039/c9dt04360hLai Y, Wu H, Lin H, et al. Entirely, intrinsically, and autonomously self-healable, highly transparent, and superstretchable triboelectric nanogenerator for personal power sources and self-powered electronic skins. Adv Funct Mater. 2019;29(40):1904626. doi: 10.1002/adfm.201904626Irzhak VI, Uflyand IE, Dzhardimalieva GI. Self-healing of polymers and polymer composites. Polymers (Basel). 2022;14(24):5404. doi: 10.3390/polym14245404Kratasyuk VA. The principle of luciferase biotesting. Proceeding of the First International School ‘Biological Luminescence’; 1990. 550 р. (in Russ.).Esimbekova EN, Kalyabina VP, Kopylova KV, Torgashina IG, Kratasyuk VA. Design of bioluminescent biosensors for assessing contamination of complex matrices. Talanta. 2021;233:122509. doi: 10.1016/j.talanta.2021.122509Esimbekova EN, Kalyabina VP, Kratasyuk VA. Enzymatic Biotesting: Scientific Basis and Application. Contemporary Problems of Ecology. 2021;14(3):290–302. doi: 10.1134/s1995425521030069Deeva AA, Zykova EA, Nemtseva EV, Kratasyuk VA. Functional divergence between LuxG and Fre oxidoreductases. Proteins. 2019;87(9):723–729. doi: 10.1002/prot.25696Kratasyuk VA, Gigelzon II. The use of luminous bacteria in bioluminescent analysis. Uspekhi mikrobiologii. 1987;21(1):3–30. (in Russ.). EDN: WZHDKHRimashevskaya AA, Muchkina EY, Sutormin OS, et al. Bioluminescence Inhibition Bioassay for Snow Cover Estimation. Forests. 2024;15(8):1325. doi: 10.3390/f15071325Kratasyuk VA, Kolosova EM, Sutormin OS, et al. Software for Matching Standard Activity Enzyme Biosensors. Sensors. 2021;21(3):1017. doi: 10.3390/s21031017Esimbekova EN, Kalyabina VP, Kopylova KV, Torgashina IG, Kratasyuk VA. Design of bioluminescent biosensors for assessing contamination of complex matrices. Talanta. 2021;233:122509. doi: 10.1016/j.talanta.2021.122509