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Bian Y, Wang H, Huang A. Finite Element Analysis of Acetabulum Prosthesis' Lining Damage Zone with Different Implanting Angle. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:9350474. [PMID: 37304323 PMCID: PMC10256448 DOI: 10.1155/2023/9350474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 06/13/2023]
Abstract
Objective Research the acetabular component's construction method of a three-dimensional finite element model in THA with different angles and study the influence of polyethylene liner wearing with finite element analysis. Methods Build a model in the 3D modeling software system HyperMesh according to the artificial hip joint prosthesis' entities and data. Using a finite element analysis system, ABAQUS 6.11 reconstitute acetabular prosthesis after hip replacement joints under different implanting position angles. Simulation and load the joint load when sheet foot touchdown state. Calculate the plastic volume strain and fatigue fracture. Results The two groups of combinations of abduction angle 50° vs. anteversion angle 10° and abduction angle 55° vs. anteversion angle 15° have been found to have relatively smaller interface plastic strain and fatigue fracture volume value (2.241 × 10-7 m3, 2.443 × 10-7 m3), respectively. Conclusion The groups of combinations of abduction angle 50° vs. anteversion angle 10° have been found to have relatively smallest interface plastic strain and fatigue fracture volume value in the total hip arthroplasty.
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Affiliation(s)
| | - Hao Wang
- Liaocheng Traditional Chinese Medicine Hospital, China
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2
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Soleymani Eil Bakhtiari S, Karbasi S, Toloue EB. Modified poly(3-hydroxybutyrate)-based scaffolds in tissue engineering applications: A review. Int J Biol Macromol 2020; 166:986-998. [PMID: 33152357 DOI: 10.1016/j.ijbiomac.2020.10.255] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/09/2020] [Accepted: 10/30/2020] [Indexed: 01/13/2023]
Abstract
As a member of the polyhydroxyalkanoate (PHAs) family, Poly(3-hydroxybutyrate) (PHB) has attracted much attention for a variety of medical applications because of its desirable properties such as high biocompatibility, nontoxic degradation products and high mechanical strength in comparison to other polymers in different fields including tissue engineering. There are different approaches such as making PHB alloy scaffolds, using PHB as a coating for ceramic-based scaffolds and producing composite scaffolds by using a mixture of PHB with ceramic particles utilized to improve hydrophobicity, degradation rate and brittleness. In this review, different applications of PHB, its alloys and composites in tissue engineering are explained based on the common methods of fabrication such as polymeric sponge replication, electrospinning and salt leaching.
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Affiliation(s)
- Sanaz Soleymani Eil Bakhtiari
- Advanced Materials Research Center, Department of Materials Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Saeed Karbasi
- Biomaterials and Tissue Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Elahe Bahremandi Toloue
- Biomaterials and Tissue Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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3
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Hallab NJ, Jacobs JJ. Orthopedic Applications. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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4
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Pulley BR, Trinh TQ, Bentley JC, Politi JR. Adverse reaction to metal debris in a patient with acetabular shell loosening 8 years after ceramic-on-metal total hip arthroplasty. Arthroplast Today 2015; 1:93-98. [PMID: 28326381 PMCID: PMC4958114 DOI: 10.1016/j.artd.2015.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/19/2015] [Accepted: 07/21/2015] [Indexed: 11/07/2022] Open
Abstract
A 41-year-old woman presented 8 years after a left total hip arthroplasty. She complained of progressive groin pain for several months. Radiographs demonstrated a hard-on-hard bearing surface combination and radiolucent lines surrounding the acetabular shell. Laboratory analysis revealed a mild leukocytosis, a normal erythrocyte sedimentation rate, and a mildly elevated C-reactive protein. Serum cobalt and chromium levels were markedly elevated. Aspiration of the hip joint was negative for infection. Magnetic resonance imaging failed to demonstrate a pseudotumor. Revision total hip arthroplasty was performed, and a ceramic-on-metal bearing surface combination was explanted. Significant intraoperative findings included dark gray synovial fluid, metal transfer onto the ceramic femoral head, and a grossly loose acetabular shell pivoting about a single well-fixed screw. The explanted components otherwise appeared normal macroscopically. Histologic analysis of the capsular tissue demonstrated aseptic lymphocyte-dominated vasculitis-associated lesion and inclusion bodies consistent with third-body wear. Revision arthroplasty to a ceramic-on-polyethylene bearing surface combination was performed with a good clinical result and laboratory normalization at 9-month follow-up.
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Affiliation(s)
- Benjamin R Pulley
- Department of Orthopaedic Surgery, Mount Carmel Health System, Columbus, OH, USA
| | - Thai Q Trinh
- Department of Orthopaedic Surgery, Mount Carmel Health System, Columbus, OH, USA
| | - Jared C Bentley
- Department of Orthopaedic Surgery, Mount Carmel Health System, Columbus, OH, USA
| | - Joel R Politi
- Department of Orthopaedic Surgery, Mount Carmel Health System, Columbus, OH, USA; Orthopedic ONE, Columbus, OH, USA
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Ching HA, Choudhury D, Nine MJ, Abu Osman NA. Effects of surface coating on reducing friction and wear of orthopaedic implants. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2014; 15:014402. [PMID: 27877638 PMCID: PMC5090599 DOI: 10.1088/1468-6996/15/1/014402] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 01/07/2014] [Accepted: 09/10/2013] [Indexed: 05/05/2023]
Abstract
Coatings such as diamond-like carbon (DLC) and titanium nitride (TiN) are employed in joint implants due to their excellent tribological properties. Recently, graphite-like carbon (GLC) and tantalum (Ta) have been proven to have good potential as coating as they possess mechanical properties similar to bones-high hardness and high flexibility. The purpose of this systematic literature review is to summarize the coating techniques of these four materials in order to compare their mechanical properties and tribological outcomes. Eighteen studies published between January 2000 and February 2013 have met the inclusion criteria for this review. Details of their fabrication parameters, material and mechanical properties along with the tribological outcomes, such as friction and wear rate, were identified and are presented in a systematic way. Although experiment conditions varied, we conclude that Ta has the lowest wear rate compared to DLC, GLC and TiN because it has a lower wear rate with high contact pressure as well as higher hardness to elasticity ratio. However, a further tribology test is needed in an environment which replicates artificial joints to confirm the acceptability of these findings.
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Affiliation(s)
- Hee Ay Ching
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Dipankar Choudhury
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Faculty of Mechanical Engineering, Brno University of Technology, Technická 2896/2 616 69 Brno, Czech Republic
| | - Md Julker Nine
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Noor Azuan Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Reddy A, Caicedo MS, Samelko L, Jacobs JJ, Hallab NJ. Implant debris particle size affects serum protein adsorption which may contribute to particle size-based bioreactivity differences. J Long Term Eff Med Implants 2014; 24:77-88. [PMID: 24941408 PMCID: PMC4062925 DOI: 10.1615/jlongtermeffmedimplants.2014010118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Biologic reactivity to orthopedic implant debris mediates long-term clinical performance of total joint arthroplasty implants. However, the reasons that some facets of implant debris (e.g., particle size, shape, base material, etc.) are more pro-inflammatory remain controversial. This precludes accurate prediction and optimal design of modern total joint replacements. We hypothesized that debris particle size can influence adsorbed protein film composition and affect subsequent bioreactivity. We measured size-dependent proteinfilm adsorption, and adsorbed protein-film-dependent cytokine release using equal surface areas of different sized cobalt-chromium alloy (CoCr-alloy) particles and in vitro challenge of human macrophages (THP-1 and human primary). Smaller (5 μm diameter) versus larger (70 μm diameter) particles preferentially adsorbed more serum protein in general (p<0.03), where higher molecular weight serum proteins consistent with IgG were identified. Additionally, 5-μm CoCr-alloy particles pre-coated with different protein biofilms (IgG vs. albumin) resulted in a difference in cytokine expression in which albumin-coated particles induced more TNF-α release and IgG-coated particles induced more IL-1β release from human monocytes/macrophages. In these preliminary in vitro studies, we have demonstrated the capability of equal surface areas of different particle sizes to influence adsorbed protein composition and that adsorbed protein differences on identical particles can translate into complex differences in bioreactivity. Together, these findings suggest that adsorbed protein differences on different-sized particles of the same material may be a contributing mechanism by which certain particles induce different reactivities.
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Affiliation(s)
- Anand Reddy
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Marco S Caicedo
- Orthopedic Analysis, LLC, Chicago, IL 60612; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Lauryn Samelko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Joshua J Jacobs
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Nadim James Hallab
- Orthopedic Analysis, LLC, Department of Immunology, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
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Abstract
Total hip arthroplasty is an effective treatment option for advanced hip arthritis in elderly patients. Studies in young patients have traditionally shown less durable results. With current implants, surgical technique, and cementless fixation methods, the durability of total hip arthroplasty may now be related to the wear performance of the bearing surfaces. To improve implant longevity, there are several bearing surface choices currently available for this demanding group of patients. Alternatives must be evaluated in terms of the risks and benefits associated with each articulation, and all new technologies must be carefully monitored over the long term.
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Liu F, Williams S, Jin Z, Fisher J. Effect of head contact on the rim of the cup on the offset loading and torque in hip joint replacement. Proc Inst Mech Eng H 2013; 227:1147-54. [PMID: 23886972 DOI: 10.1177/0954411913496016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Head contact on the rim of the cup causes stress concentration and consequently increased wear. The head contact on the rim of the cup may in addition cause an offset load and torque on the cup. The head-rim contact resulting from microseparation or subluxation has been investigated. An analytical model has been developed to calculate the offset loading and resultant torque on the cup as a function of the translational displacement of the head under simplified loading condition of the hip joint at heel strike during a walking cycle. The magnitude of the torque on the cup was found to increase with the increasing translational displacement, larger diameter heads, eccentric cups, and the coefficient of friction of the contact. The effects of cup inclination, cup rim radius, and cup coverage angle on the magnitude of the torque were found to be relatively small with a maximum variation in the torque magnitude being lower than 20%. This study has shown an increased torque due to the head loading on the rim of the cup, and this may contribute to the incidence of cup loosening. Particularly, metal-on-metal hip joints with larger head diameters may produce the highest offset loading torque.
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Affiliation(s)
- Feng Liu
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
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Wang S, Zhang S, Zhao Y. A comparison of polyethylene wear between cobalt-chrome ball heads and alumina ball heads after total hip arthroplasty: a 10-year follow-up. J Orthop Surg Res 2013; 8:20. [PMID: 23835248 PMCID: PMC3720196 DOI: 10.1186/1749-799x-8-20] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 07/03/2013] [Indexed: 11/10/2022] Open
Abstract
Study design This is a retrospective study comparing polyethylene wear between ceramic ball heads and metal ball heads in total hip arthroplasty. Background The ceramic-on-polyethylene bearing option has been introduced as an alternative to metal-on-polyethylene to minimize polyethylene wear debris and reduce subsequent osteolysis and aseptic loosening. However, the reported data were debatable. We designed this retrospective study to compare polyethylene wear between alumina ceramic ball heads and cobalt-chrome ball heads. Methods Bilateral simultaneous primary total hip arthroplasty was performed in 22 patients between January 2002 and December 2002, with one side using metal-on-polyethylene bearing surface and the other side using alumina ceramic-on-polyethylene bearing surface. After 10 years of follow-up, the wear rate of polyethylene liner on both sides was measured using the Dorr method and compared. Results The annual wear rate of the polyethylene liner was 0.133 mm with a standard deviation of 0.045 in the metal-on-polyethylene group and 0.056 mm with a standard deviation of 0.032 in the ceramic-on-polyethylene group. The wear rate per year was significantly lower in the ceramic-on-polyethylene group (p < 0.001). Conclusions Although the implication is still controversial, our study showed that the use of ceramic head lowered the liner wear rate. Clinical relevance Ceramic is harder and more resistant to scratching than cobalt-chrome. By increasing polyethylene liner survivorship and decreasing potential osteolytic response and aseptic loosening, ceramic head is a better alternative than cobalt-chrome head.
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Affiliation(s)
- Shijun Wang
- Department of the Joint and Bone Surgery, Yantaishan Hospital, Yantai 264001, Shandong Province, China
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Hallab NJ, Jacobs JJ. Orthopedic Applications. Biomater Sci 2013. [DOI: 10.1016/b978-0-08-087780-8.00073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yang S, Dillon OW, Puleo DA, Jawahir IS. Effect of cryogenic burnishing on surface integrity modifications ofCo-Cr-Mobiomedical alloy. J Biomed Mater Res B Appl Biomater 2012; 101:139-52. [DOI: 10.1002/jbm.b.32827] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 07/31/2012] [Accepted: 08/20/2012] [Indexed: 12/28/2022]
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What's next? Alternative materials for articulation in total joint replacement. Acta Biomater 2012; 8:2434-41. [PMID: 22446959 DOI: 10.1016/j.actbio.2012.03.029] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/13/2012] [Accepted: 03/18/2012] [Indexed: 11/21/2022]
Abstract
The use of an artificial joint is always related to a certain amount of wear. Its biological effects, e.g., the osteolysis potential, are a function of the bulk material as well as its debris. Following comprehensive experiences with polyethylene (PE) wear, material science is tracking two ways to minimize the risk of a particle-induced aseptic implant loosening: (i) reduction of the PE debris by a low-wearing articulation partner; and (ii) replacement of the PE by other materials. Therefore, new ceramics (e.g., ZTA, Si(3)N(4)), as well as coatings (e.g., TiN, "diamond-like" carbon) and modifications of a bulk metal (e.g., oxidizes zirconium) or cushion bearings (polyurethane, hydrogels), are currently available for total joint replacements or have been used for pre-clinical testing. This review gives a brief overview and evaluates the potential of those that have recently been published in literature.
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Pospischill M, Knahr K. Strategies for head and inlay exchange in revision hip arthroplasty. INTERNATIONAL ORTHOPAEDICS 2010; 35:261-5. [PMID: 21088833 DOI: 10.1007/s00264-010-1164-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 11/02/2010] [Accepted: 11/02/2010] [Indexed: 10/18/2022]
Abstract
Due to the increasing number of total hip arthroplasties performed during the last three decades and the limited long-term survival, mainly because of wear, the number of revisions has increased during the last two years. If the implant itself is still considered to be stable, only head and inlay exchange is necessary. This requires comprehensive knowledge of the characteristics of the articulating materials by the surgeon as the wrong choice of wear couple can lead to early failure for a second time. The aim of this paper is to present considerations and strategies for head and inlay exchange in case of failure, either due to wear of the articulation material or of other indications for revision hip arthroplasty.
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Affiliation(s)
- Martin Pospischill
- Orthopedic Hospital Vienna-Speising, Speisingerstr. 109, 1130, Vienna, Austria.
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14
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A Morlet wavelet signal analysis with a Daubechies filter for the wear assessment of hip prostheses coated with diamond-like carbon by triboadhesion. J Appl Biomech 2010; 26:273-80. [PMID: 20841618 DOI: 10.1123/jab.26.3.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the present work, based on high frequency wavelet analysis of dynamic signals of mechanical systems, a multiple-resolution wavelet analysis is carried out, to the signal obtained from an accelerometer mounted on the structure of a hip prosthesis wearing test device. The prostheses employed had a femoral head made of aluminum oxide and the acetabular cup of ultra-high-molecular-weight polyethylene. The first two aluminum oxide femoral heads were coated with diamond-like carbon and a third one was tested without coating and used as a reference. The coating was carried out by triboadhesion. Tests results showed that maximum vibration amplitude reached after 32 hr for the coated prostheses was 0.2 g. The noncoated prosthesis amplitude presented was 0.75 g in the same time interval. These values were attributed to wear damage on the surface of the prostheses, indicating that thin film DLC coating caused an increase of stiffness on the surface and therefore an increase in wear resistance approximately of 314%.
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Paleochorlidis IS, Badras LS, Skretas EF, Georgaklis VA, Karachalios TS, Malizos KN. Clinical outcome study and radiological findings of Zweymuller metal on metal total hip arthroplasty. a follow-up of 6 to 15 years. Hip Int 2010; 19:301-8. [PMID: 20041375 DOI: 10.1177/112070000901900402] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis.
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Abstract
BACKGROUND Biologic-reactivity to implant-debris is the primary determinant of long-term clinical performance. The following reviews: 1) the physical aspects of spinal-implant debris and 2) the local and systemic biologic responses to implant debris. METHODS Methods included are: 1) gravimetric wear analysis; 2) SEM and LALLS; 3) metal-ion analysis; 4) ELISA, toxicity testing, patch testing; and 5) metal-lymphocyte transformation testing (metal-LTT). RESULTS Wear and corrosion of spine-implants produce particles and ions. Particles (0.01-1000 μm) are generally submicron ( <1 µm). Wear rates of metal-on-polymer and metal-on-metal disc arthroplasties are approximately 2-20 and 1 mm(3)/yr, respectively. Metal-on-metal total disc replacement components have significant increases in circulating metal (less than 10-fold that of controls at 4 ppb-Co and 3 ppb-Cr or ng/mL). Debris reactivity is local and systemic. Local inflammation is caused primarily by ingestion of debris by local macrophages, which produce pro-inflammatory cytokines TNFα, IL-1β, IL-6, and PGE2. Systemic responses associated with implant-debris have been limited to hypersensitivity reactions. Elevated amounts of in the liver, spleen, etc of patients with failed TJA have not been associated with remote toxicological or carcinogenic pathology to date. Implant debris are differentially bioreactive. Greater numbers are pro-inflammatory; the smaller-sized debris are more bioreactive by virtue of their greater numbers (dose) for a given amount of implant mass loss (one 100-μm-diameter particle is equivalent in mass to 1 million 1-μm-diameter particles). Elongated particles are pro-inflammatory (ie, aspect ratio of greater than 3). Metal particles are more proinflammatory than polymers, ceteris paribus. CONCLUSION Spinal arthroplasty designs have been in use for more than 20 years internationally; therefore, concerns about neuropathology, toxicity, and carcinogenicity are mitigated. Debris-induced inflammation still depends on the individual and the type of debris. The consequence of debris-induced inflammation is continued; vigilance by physicians is recommended monitoring of spinal implants using physical exams and testing of metal content and bioreactivity, as is planning for the likelihood of revision in younger individuals.
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Affiliation(s)
- Nadim James Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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Kretzer JP, Kleinhans JA, Jakubowitz E, Thomsen M, Heisel C. A meta-analysis of design- and manufacturing-related parameters influencing the wear behavior of metal-on-metal hip joint replacements. J Orthop Res 2009; 27:1473-80. [PMID: 19472378 DOI: 10.1002/jor.20921] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This article aims to clarify the influence of design- and manufacturing-related parameters on wear of metal-on-metal (MoM) joint bearings. A database search for publications on wear simulator studies of MoM bearings was performed. The results of published studies were normalized; groups with individual parameters were defined and analyzed statistically. Fifty-six investigations studying a total of 200 implants were included in the analysis. Clearance, head size, carbon content, and manufacturing method were analyzed as parameters influencing MoM wear. This meta-analysis revealed a strong influence of clearance on running-in wear for implants of 36-mm diameter and an increase in steady-state wear of heat treated components.
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Affiliation(s)
- Jan Philippe Kretzer
- Laboratory of Biomechanics, Department of Orthopaedics, University of Heidelberg, Heidelberg, Germany
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18
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Lee R, Essner A, Wang A. Tribological considerations in primary and revision metal-on-metal arthroplasty. J Bone Joint Surg Am 2008; 90 Suppl 3:118-24. [PMID: 18676946 DOI: 10.2106/jbjs.h.00531] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Metal-on-metal hip bearings undergo biphasic wear, starting with a short period of high wear (bedding-in) and followed by low steady-state wear. Bedding-in is the process by which the cup wears locally to conform to the geometry of the head. This process reduces the maximum contact stress and allows for appropriate lubrication. A critical area of conformance and wear is required for the bearing to reach a low steady-wear state. Cups were analyzed in this study after primary and revision wear scenarios to determine this critical area for this specific bearing. METHODS Forty and 56-mm cobalt-chromium resurfacing bearings with 150 and 400-microm clearances were wear tested in a hip simulator for 5 million cycles. The cups underwent an additional 5 million cycles of testing against new heads, simulating a revision scenario. The revision heads were manufactured to cause the highest mismatch with the pre-worn cups, resulting in polar or local annular contact. Cup wear area was determined from weight-loss measurements after each phase of testing. RESULTS All bearings experienced a biphasic wear performance with a short period of high wear followed by low steady-state wear. A consistent critical area of conformance was reached by all bearings after primary and revision testing conditions, regardless of bearing size, bearing clearance, or contact mode. CONCLUSIONS An area of conformity (wear) reduces contact pressures, is beneficial for lubrication, and is critical to reach a low steady-state wear rate. This study shows that this critical area is consistent regardless of bearing size, clearance, or contact mode. Bearing designs that allow the proper formation of this conformance area should bed-in and reach a low steady-state wear rate.
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Affiliation(s)
- Reginald Lee
- Stryker Orthopaedics, 325 Corporate Drive, Mahwah, NJ 07430, USA.
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19
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Stuart Kerrigan C, McKenna SJ, Ricketts IW, Wigderowitz C. Automated assessment of polyethylene wear in cemented acetabular components using anteroposterior radiographs of total hip replacements. Comput Med Imaging Graph 2008; 32:221-38. [PMID: 18242954 DOI: 10.1016/j.compmedimag.2007.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/30/2007] [Accepted: 12/11/2007] [Indexed: 11/18/2022]
Abstract
Polyethylene wear in the acetabular components of hip prostheses is implicated in loosening and failure. Radiographic measurement of wear is used to identify patients at risk and to assess prosthesis designs. This paper focuses on analysis of prostheses with cemented acetabular cups from anteroposterior (AP) radiographs. The articular surface of the femoral head and the acetabular rim marker are modelled as spherical and circular respectively, resulting in elliptical image projections. Methods for automatically localising these structures in radiographs are presented using robust ellipse fitting and various error functions. Special attention is paid to the acetabular marker since this often projects as a highly eccentric ellipse. Robust fitting enables successful localisation in the presence of clutter without the need for user interaction. Finally, the use of these ellipses as reference structures for wear estimation is investigated and the effect of eccentricity errors is highlighted.
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20
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Schultze C, Klüss D, Martin H, Hingst V, Mittelmeier W, Schmitz KP, Bader R. [Finite element analysis of a cemented ceramic femoral component for the assembly situation in total knee arthroplasty]. BIOMED ENG-BIOMED TE 2007; 52:301-7. [PMID: 17691864 DOI: 10.1515/bmt.2007.051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The femoral components of the total knee replacements are generally made of metal. In contrast, ceramic femoral components promise improved tribological and allergological properties. However, ceramic components present a risk of failure as a result of stress peaks. Stress peaks can be minimised through adequate implant design, proper material composition and optimum force transmission between bone and implant. Thus, the quality of the implant fixation is a crucial factor. The objective of the present study was to analyse the influence of the cement layer thickness on stress states in the ceramic femoral component and in the femur. Two- and three- dimensional finite element analyses of an artificial knee joint with cement layers of different thickness and with an unbalanced cement layer thickness between the ceramic femoral component and the femur were performed. Higher stress regions occurred in the area of force transmission and in the median plane. The maximum calculated stresses were below the accepted tensile strength. Stresses were found to be lower for cement layer thickness of <2.0 mm.
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Bal BS, Kazmier P, Burd T, Aleto T. Anterior trochanteric slide osteotomy for primary total hip arthroplasty. Review of nonunion and complications. J Arthroplasty 2006; 21:59-63. [PMID: 16446186 DOI: 10.1016/j.arth.2005.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Indexed: 02/01/2023] Open
Abstract
The radiographic results of 73 anterior trochanteric slide osteotomies were retrospectively reviewed at an average of 36 months after primary hip arthroplasty to determine the incidence of nonunion of the trochanter and complications related to trochanteric hardware. In each case, the trochanter was retracted anteriorly, with the gluteus medius and vastus lateralis muscle insertions left intact. Reattachment was performed with 2 monofilament wires or cables passed through the lesser trochanter in each case. Ninety-two percent of the trochanters healed; nonunion was associated with anterior displacement of the trochanteric fragment with external rotation of the femur. The incidence of repeat surgery for hardware-related problems was 28%. Although the slide osteotomy prevented proximal migration of the trochanteric fragment, the incidence of hardware complications was too high to justify the routine use of this approach in primary hip arthroplasty.
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Affiliation(s)
- B Sonny Bal
- University of Missouri-Columbia, Columbia, Missouri, USA
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Savarino L, Granchi D, Ciapetti G, Cenni E, Greco M, Rotini R, Veronesi CA, Baldini N, Giunti A. Ion release in stable hip arthroplasties using metal-on-metal articulating surfaces: a comparison between short- and medium-term results. J Biomed Mater Res A 2003; 66:450-6. [PMID: 12918026 DOI: 10.1002/jbm.a.10595] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The use of metallic heads articulating with metallic cups could solve the problem of polyethylene (PE) wear in total hip replacement (THR) with metal-on-PE bearings. A conspicuous release of metal ions from new models of metal-on-metal bearings has been found in the short-term, but it is yet unclear whether the medium-term corrosion rate is high or, on the contrary, it becomes negligible, because of the continuous surface finishing. Our purpose was to compare the serum ion values (nanograms per milliliter) in 15 patients with metal-on-metal stable prosthesis (Group A), in the short-term (subgroup A(1); mean follow-up: 24 mo) and medium-term (subgroup A(2); mean follow-up: 52 mo), in order to determine whether the ion release decreased with time of implant. Chromium (Cr), cobalt (Co), molybdenum (Mo) and aluminum (Al) were analyzed. Twenty-two presurgical patients were used for comparison (Group B). The reference range was obtained from a population of 27 healthy subjects (Group C). Co and Cr levels in the medium-term (subgroup A(2)) were not decreased in comparison with the short-term values (subgroup A(1)) and were significantly higher (p < 0.001) than presurgical and reference values. Otherwise, Mo and Al concentrations were not significantly increased in comparison with reference values. In conclusion, despite the apparent advantage of metal-on-metal coupling, especially in younger patient populations, there is a major concern about the extent and duration of the relevant "internal" exposure to Cr and Co ions. This exposure should be carefully monitored, in order to clarify the biologic effects of ion dissemination and, consequently, to identify risks concerning long-term toxicity of metals.
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Affiliation(s)
- L Savarino
- Laboratorio di Fisiopatologia degli Impianti Ortopedici, Istituti Ortopedici Rizzoli, Bologna, Italy.
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