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Bologna FA, Putame G, Audenino AL, Terzini M. Understanding the role of head size and neck length in micromotion generation at the taper junction in total hip arthroplasty. Sci Rep 2024; 14:6397. [PMID: 38493233 PMCID: PMC10944531 DOI: 10.1038/s41598-024-57017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Modular hip implants allow intra-operative adjustments for patient-specific customization and targeted replacement of damaged elements without full implant extraction. However, challenges arise from relative micromotions between components, potentially leading to implant failure due to cytotoxic metal debris. In this study magnitude and directions of micromotions at the taper junction were estimated, aiming to understand the effect of variations in head size and neck length. Starting from a reference configuration adhering to the 12/14 taper standard, six additional implant configurations were generated by varying the head size and/or neck length. A musculoskeletal multibody model of a prothesized lower limb was developed to estimate hip contact force and location during a normal walking task. Following the implant assembly, the multibody-derived loads were imposed as boundary conditions in a finite element analysis to compute the taper junction micromotions as the relative slip between the contacting surfaces. Results highlighted the L-size head as the most critical configuration, indicating a 2.81 μm relative slip at the mid-stance phase. The proposed approach enables the investigation of geometric variations in implants under accurate load conditions, providing valuable insights for designing less risky prostheses and informing clinical decision-making processes.
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Affiliation(s)
- Federico A Bologna
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy
| | - Giovanni Putame
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy
| | - Alberto L Audenino
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy
| | - Mara Terzini
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy.
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy.
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Soliman MM, Islam MT, Chowdhury MEH, Alqahtani A, Musharavati F, Alam T, Alshammari AS, Misran N, Soliman MS, Mahmud S, Khandakar A. Advancement in total hip implant: a comprehensive review of mechanics and performance parameters across diverse novelties. J Mater Chem B 2023; 11:10507-10537. [PMID: 37873807 DOI: 10.1039/d3tb01469j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
The UK's National Joint Registry (NJR) and the American Joint Replacement Registry (AJRR) of 2022 revealed that total hip replacement (THR) is the most common orthopaedic joint procedure. The NJR also noted that 10-20% of hip implants require revision within 1 to 10 years. Most of these revisions are a result of aseptic loosening, dislocation, implant wear, implant fracture, and joint incompatibility, which are all caused by implant geometry disparity. The primary purpose of this review article is to analyze and evaluate the mechanics and performance factors of advancement in hip implants with novel geometries. The existing hip implants can be categorized based on two parts: the hip stem and the joint of the implant. Insufficient stress distribution from implants to the femur can cause stress shielding, bone loss, excessive micromotion, and ultimately, implant aseptic loosening due to inflammation. Researchers are designing hip implants with a porous lattice and functionally graded material (FGM) stems, femur resurfacing, short-stem, and collared stems, all aimed at achieving uniform stress distribution and promoting adequate bone remodeling. Designing hip implants with a porous lattice FGM structure requires maintaining stiffness, strength, isotropy, and bone development potential. Mechanical stability is still an issue with hip implants, femur resurfacing, collared stems, and short stems. Hip implants are being developed with a variety of joint geometries to decrease wear, improve an angular range of motion, and strengthen mechanical stability at the joint interface. Dual mobility and reverse femoral head-liner hip implants reduce the hip joint's dislocation limits. In addition, researchers reveal that femoral headliner joints with unidirectional motion have a lower wear rate than traditional ball-and-socket joints. Based on research findings and gaps, a hypothesis is formulated by the authors proposing a hip implant with a collared stem and porous lattice FGM structure to address stress shielding and micromotion issues. A hypothesis is also formulated by the authors suggesting that the utilization of a spiral or gear-shaped thread with a matched contact point at the tapered joint of a hip implant could be a viable option for reducing wear and enhancing stability. The literature analysis underscores substantial research opportunities in developing a hip implant joint that addresses both dislocation and increased wear rates. Finally, this review explores potential solutions to existing obstacles in developing a better hip implant system.
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Affiliation(s)
- Md Mohiuddin Soliman
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Malaysia.
| | - Mohammad Tariqul Islam
- Centre for Advanced Electronic and Communication Engineering, Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Malaysia.
| | - Muhammad E H Chowdhury
- Department of Electrical Engineering, College of Engineering, Qatar University, Doha 2713, Qatar.
| | - Abdulrahman Alqahtani
- Department of Medical Equipment Technology, College of Applied, Medical Science, Majmaah University, Majmaah City 11952, Saudi Arabia
- Department of Biomedical Technology, College of Applied Medical Sciences in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
| | - Farayi Musharavati
- Department of Mechanical & Industrial Engineering, Qatar University, Doha 2713, Qatar.
| | - Touhidul Alam
- Pusat Sains Ankasa (ANGKASA), Institut Perubahan Iklim, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Selangor, Malaysia.
| | - Ahmed S Alshammari
- Department of Electrical Engineering, College of Engineering, University Hail, Hail 81481, Saudi Arabia.
- Department of Electrical Engineering, College of Engineering, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
| | - Norbahiah Misran
- Centre for Advanced Electronic and Communication Engineering, Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Malaysia.
| | - Mohamed S Soliman
- Department of Electrical Engineering, College of Engineering, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
- Department of Electrical Engineering, Faculty of Energy Engineering, Aswan University, Aswan, 81528, Egypt
| | - Sakib Mahmud
- Department of Electrical Engineering, College of Engineering, Qatar University, Doha 2713, Qatar.
| | - Amith Khandakar
- Department of Electrical Engineering, College of Engineering, Qatar University, Doha 2713, Qatar.
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Zhang G, Yang S, Cui W, Huang Z, Zhang X, Zhang Y, Li J, Jin Z. Decomposition of micromotion at the head-neck interface in total hip arthroplasty during walking. Comput Methods Biomech Biomed Engin 2023; 26:548-558. [PMID: 35549565 DOI: 10.1080/10255842.2022.2073788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Fretting corrosion as one of the leading causes for failure of modular hip prostheses has been associated with micromotion at head-neck taper junction. Decomposition of micromotion is helpful to promote the development of more realistic experiments investigating failure mechanisms of the head-neck junction in total hip arthroplasty. The aim of this study was to decompose the complex three-dimensional micromotion at the head-neck junction into multiple fundamental modes, including three translational and three rotational components. A three-dimensional finite element model composed of head-neck junction, liner and acetabular cup with a typical 12/14 taper size, as well as the taper mismatch of -4', was developed during walking. The analysis was divided into three procedures: a) the assembly simulation of the head and neck during surgery, b) verification with a simplified axisymmetric model, and c) three-dimensional modelling under normal walking. This study revealed that the main forms of micromotion contained circumferential, longitudinal micromotion and longitudinal rolling toggling, and were closely related to the state of motion. The maximum translational micromotion was predicted to be 10.9 μm during the walking gait, with the predominant modes of the circumferential translation of 9.6 μm, the longitudinal translation of 5.5 μm and the longitudinal rotation of 0.29° along the taper junction. These findings may provide design considerations for further experimental testing about fretting and facilitate the understanding of the fretting mechanisms in hip prostheses.
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Affiliation(s)
- Guoxian Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Shu Yang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Wen Cui
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Zhi Huang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Xiaogang Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Yali Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Junyan Li
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
| | - Zhongmin Jin
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
- School of Mechanical Engineering, University of Leeds, Leeds, UK
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Soliman MM, Chowdhury MEH, Islam MT, Musharavati F, Mahmud S, Hafizh M, Ayari MA, Khandakar A, Alam MK, Nezhad EZ. Design and Performance Evaluation of a Novel Spiral Head-Stem Trunnion for Hip Implants Using Finite Element Analysis. Materials (Basel) 2023; 16:ma16041466. [PMID: 36837096 PMCID: PMC9962303 DOI: 10.3390/ma16041466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 05/27/2023]
Abstract
With an expectation of an increased number of revision surgeries and patients receiving orthopedic implants in the coming years, the focus of joint replacement research needs to be on improving the mechanical properties of implants. Head-stem trunnion fixation provides superior load support and implant stability. Fretting wear is formed at the trunnion because of the dynamic load activities of patients, and this eventually causes the total hip implant system to fail. To optimize the design, multiple experiments with various trunnion geometries have been performed by researchers to examine the wear rate and associated mechanical performance characteristics of the existing head-stem trunnion. The objective of this work is to quantify and evaluate the performance parameters of smooth and novel spiral head-stem trunnion types under dynamic loading situations. This study proposes a finite element method for estimating head-stem trunnion performance characteristics, namely contact pressure and sliding distance, for both trunnion types under walking and jogging dynamic loading conditions. The wear rate for both trunnion types was computed using the Archard wear model for a standard number of gait cycles. The experimental results indicated that the spiral trunnion with a uniform contact pressure distribution achieved more fixation than the smooth trunnion. However, the average contact pressure distribution was nearly the same for both trunnion types. The maximum and average sliding distances were both shorter for the spiral trunnion; hence, the summed sliding distance was approximately 10% shorter for spiral trunnions than that of the smooth trunnion over a complete gait cycle. Owing to a lower sliding ability, hip implants with spiral trunnions achieved more stability than those with smooth trunnions. The anticipated wear rate for spiral trunnions was 0.039 mm3, which was approximately 10% lower than the smooth trunnion wear rate of 0.048 mm3 per million loading cycles. The spiral trunnion achieved superior fixation stability with a shorter sliding distance and a lower wear rate than the smooth trunnion; therefore, the spiral trunnion can be recommended for future hip implant systems.
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Affiliation(s)
- Md Mohiuddin Soliman
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | | | - Mohammad Tariqul Islam
- Centre for Advanced Electronic and Communication Engineering, Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Selangor, Malaysia
| | - Farayi Musharavati
- Department of Mechanical & Industrial Engineering, Qatar University, Doha 2713, Qatar
| | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
| | - Muhammad Hafizh
- Department of Mechanical & Industrial Engineering, Qatar University, Doha 2713, Qatar
| | | | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
| | | | - Erfan Zal Nezhad
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX 78249, USA
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Fallahnezhad K, Feyzi M, Hashemi R, Taylor M. The Role of the Assembly Force in the Tribocorrosion Behaviour of Hip Implant Head-Neck Junctions: An Adaptive Finite Element Approach. Bioengineering (Basel) 2022; 9:629. [PMID: 36354540 PMCID: PMC9687484 DOI: 10.3390/bioengineering9110629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/20/2022] [Accepted: 10/23/2022] [Indexed: 09/13/2023] Open
Abstract
The cyclic loading, in the corrosive medium of the human body, results in tribocorrosion at the interface of the head-neck taper junction of hip implants. The resulting metal ions and wear debris adversely affect the local tissues. The force applied by surgeons to assemble the junction has proven to play a major role in the mechanics of the taper junction which, in turn, can influence the tribocorrosion damage. Recently, finite element method has been used to predict the material loss at the head-neck interface. However, in most finite element studies, the contribution of electrochemical corrosion has been ignored. Therefore, a detailed study to investigate the influence of the assembly force on the tribocorrosive behaviour of the head-neck junction, which considers both the mechanical and chemical material removal, is of paramount interest. In this study, a finite-element-based algorithm was used to investigate the effect of assembly force on the tribocorrosion damage at the junction interface, for over four million cycles of simulated level gait. The patterns of the material removal in the modelling results were compared with the damage patterns observed in a group of retrieved modular hip implants. The results of this study showed that for different cases, chemical wear was in the range of 25-50% of the total material loss, after four million cycles. A minimum assembly force (4 kN for the studied cases) was needed to maintain the interlock in the junction. The computational model was able to predict the damage pattern at the retrieved head-neck interface.
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Affiliation(s)
- Khosro Fallahnezhad
- Medical Device Research Institute, College of Science and Engineering, Flinders University, 1284 South Road, Clovelly Park, SA 5042, Australia
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Mech DJ, Chakraborty A, Chowdhury AR, Datta P. Finite element approach to design of modular hip implants minimizing fretting wear. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Feyzi M, Fallahnezhad K, Taylor M, Hashemi R. The mechanics of head-neck taper junctions: What do we know from finite element analysis? J Mech Behav Biomed Mater 2021; 116:104338. [PMID: 33524892 DOI: 10.1016/j.jmbbm.2021.104338] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/16/2020] [Accepted: 01/15/2021] [Indexed: 12/18/2022]
Abstract
Modular hip implants are widely used in hip arthroplasty because of the advantages they can offer such as flexibility in material combinations and geometrical adjustments. The mechanical environment of the modular junction in the body is quite challenging due to the complex and varying off-axial mechanical loads of physical activities applied to a tapered interface of two contacting materials (head and neck) assembled by an impact force intraoperatively. Experimental analogies to the in-vivo condition of the taper junction are complex, expensive and time-consuming to implement; hence, computational simulations have been a preferred approach taken by researchers for studying the mechanics of these modular junctions that can help us understand their failure mechanisms and improve their design and longevity after implantation. This paper provides a clearer insight into the mechanics of the head-neck taper junction through a careful review on the finite element studies of the junction and their findings. The effects of various factors on the mechanical outputs namely: stresses, micromotions, and contact situations are reviewed and discussed. Also, the simulation methodology of the studies in the literature is compared. Research opportunities for future are scrutinised through tabulating data and information that have been carefully retrieved form the reported findings.
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Affiliation(s)
- Mohsen Feyzi
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Khosro Fallahnezhad
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Mark Taylor
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Reza Hashemi
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia.
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Feyzi M, Fallahnezhad K, Taylor M, Hashemi R. A review on the finite element simulation of fretting wear and corrosion in the taper junction of hip replacement implants. Comput Biol Med 2020; 130:104196. [PMID: 33516962 DOI: 10.1016/j.compbiomed.2020.104196] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 12/13/2022]
Abstract
Taperosis/trunnionosis is a scientific term for describing tribocorrosion (fretting corrosion) at the head-neck taper junction of hip implants where two contacting surfaces are undergone oscillatory micromotions while being exposed to the body fluid. Detached ions and emitted debris, as a result of taperosis, migrate to the surrounding tissues and can cause inflammation, infection, and aseptic loosening with an ultimate possibility of implant failure. Improving the tribocorrosion performance of the head-neck junction in the light of minimising the surface damage and debris requires a better understanding of taperosis. Given its complexity associated with both the mechanical and electrochemical aspects, computational methods such as the finite element method have been recently employed for analysing fretting wear and corrosion in the taper junction. To date, there have been more efforts on the fretting wear simulation when compared with corrosion. This is because of the mechanical nature of fretting wear which is probably more straightforward for modelling. However, as a recent research advancement, corrosion has been a focus to be implemented in the finite element modelling of taper junctions. This paper aims to review finite element studies related to taperosis in the head-neck junction to provide a detailed understanding of the design parameters and their role in this failure mechanism. It also reviews and discusses the methodologies developed for simulating this complex process in the taper junction along with the simplifications, assumptions and findings reported in these studies. The current needs and future research opportunities and directions in this field are then identified and presented.
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Affiliation(s)
- Mohsen Feyzi
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Khosro Fallahnezhad
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Mark Taylor
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia
| | - Reza Hashemi
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Tonsley, SA, 5042, Australia.
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K N C, Ogulcan G, Bhat N S, Zuber M, Shenoy B S. Wear estimation of trapezoidal and circular shaped hip implants along with varying taper trunnion radiuses using finite element method. Comput Methods Programs Biomed 2020; 196:105597. [PMID: 32574903 DOI: 10.1016/j.cmpb.2020.105597] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE The hip joint is the vital joint that is responsible for the bodyweight transfer from the upper body to the lower body. Due to age these joints are worn out and need to be replaced by artificial hip implants. Wear is the predominant factor that is responsible for the loosening of hip implants. The wear occurs between the joints due to various reasons. The wear estimation at the design stage gives a clear idea about the life of the implants and also minor changes in the design may also significantly increase the life expectancy of the implant which can further reduce the rate of revision surgery. The linear wear rate is estimated in the taper trunnion surface. METHODS In this study, the circular and trapezoidal-shaped stem implant is designed, and wear studies are performed at the trunnion junction. The femoral head of size 28 mm, acetabular cup thickness of 4 mm, and a backing cup of thickness 2 mm are considered for the study. The neck taper radiuses at the top surface are altered. Ansys is used to perform the simulations. RESULTS At the time of assembly of the femoral head into the stem, the stresses were found to be increasing with an increase in the top surface radius of the neck taper junctions. However, when the walking conditions are considered for wear estimation of implants the circular implants with the 12/14 mm taper exhibited the lesser linear wear rate of 0.003 mm/year. The trapezoidal implants with the 10/14 mm taper exhibited a lesser linear wear rate of 0.032 mm/year. CONCLUSIONS Wear is an important parameter that leads to the revision of implants due to loosening. It is found that with the decrease in the taper radius at the top surface against the standard 12/14 mm taper there is no significant decrease in the wear rate at the taper junction. Overall the circular implants exhibited less wear rate results over the trapezoidal-shaped stem implants. Due to the less linear wear rate, the circular implant has a higher life over the trapezoidal-shaped implant. Further, these implants can be manufactured to test using a hip simulator with the same conditions to validate the obtained results.
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Affiliation(s)
- Chethan K N
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Guldeniz Ogulcan
- Department of Mechanical Engineering, Faculty of Engineering, Yeditepe University, Atasehir, Istanbul, Turkey
| | - Shyamasunder Bhat N
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Mohammad Zuber
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Satish Shenoy B
- Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Messellek AC, Ould Ouali M, Amrouche A. Adaptive finite element simulation of fretting wear and fatigue in a taper junction of modular hip prosthesis. J Mech Behav Biomed Mater 2020; 111:103993. [DOI: 10.1016/j.jmbbm.2020.103993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 01/20/2023]
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van Doesburg PG, van Langelaan EJ, Apachitei I, Bénard MR, Verdegaal SHM. Femoral prosthesis neck fracture following total hip arthroplasty - a systematic review. Arthroplasty 2020; 2:28. [PMID: 35236443 PMCID: PMC8796592 DOI: 10.1186/s42836-020-00047-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Head-neck modularity was introduced into total hip arthroplasty to provide more intraoperative surgical options. However, modularity led to new problems, such as trunnionosis and fractures of the femoral prosthesis neck. The purpose of this study was to identify risk factors for hip neck fractures and to provide recommendations to prevent damage and fractures of the neck. METHODS A systematic review of the literature was performed according to the PRISMA guidelines. RESULTS Thirty-three case studies were included. Methodologically, most included studies were of moderate or good quality. The 80 neck fractures included in the review took place, on average, 7 years after stem placement. Male gender, high body weight, obesity, previous revision surgery, mixing components from different manufacturers, use of long skirted heads, cobalt-chromium (large size) heads were identified as potential risk factors. CONCLUSION Hip neck fractures occur on average 7 years after stem placement. The etiology of hip neck fractures is multifactorial. This review revealed several preventable implant- and surgeon-related risk factors.
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Affiliation(s)
- P G van Doesburg
- Department of Orthopaedic Surgery, Alrijne Hospital Leiderdorp, Simon Smitweg 1, 2353GA, Leiderdorp, The Netherlands.
| | - E J van Langelaan
- Biomechanical Engineering Department Biomaterials & Tissue Biomechanics Section, Delft University of Technology, Delft, The Netherlands
| | - I Apachitei
- Biomechanical Engineering Department Biomaterials & Tissue Biomechanics Section, Delft University of Technology, Delft, The Netherlands
| | - M R Bénard
- Department of Orthopaedic Surgery, Alrijne Hospital Leiderdorp, Simon Smitweg 1, 2353GA, Leiderdorp, The Netherlands
| | - S H M Verdegaal
- Department of Orthopaedic Surgery, Alrijne Hospital Leiderdorp, Simon Smitweg 1, 2353GA, Leiderdorp, The Netherlands
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Haschke H, Falkenberg A, Morlock MM, Huber G. Do SiNx coatings bear the potential to reduce the risk of micromotion in modular taper junctions? Proc Inst Mech Eng H 2020; 234:897-908. [PMID: 32507037 DOI: 10.1177/0954411920930616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fretting corrosion is one contributor to the clinical failure of modular joint arthroplasty. It is initiated by micromotion in metal junctions exposed to fluids. Omitting metal-on-metal contacts could help to reduce the corrosion risk. The coating of one metal taper partner with a ceramic-based silicon nitride (SiNx) coating might provide this separation. The aim of the study was to identify whether a SiNx coating of the male taper component influences the micromotion within a taper junction. Hip prosthesis heads made of CoCr29Mo6 (Aesculap) and Ti6Al4V (Peter Brehm) were assembled (2000 N) to SiNx-coated and uncoated stem tapers made of Ti6Al4V and CoCr29Mo6 (2×2×2 combinations, each n = 4). Consecutive sinusoidal loading representing three daily activities was applied. Contactless relative motion in six degrees of freedom was measured using six eddy-current sensors. Micromotion in the junction was determined by compensating for the elastic deformation derived from additional monoblock measurements. After pull-off, the taper surfaces were microscopically inspected. Micromotion magnitude reached up to 8.4 ± 0.8 µm during loading that represented stumbling. Ti6Al4V stems showed significantly higher micromotion than those made of CoCr29Mo6, while taper coating had no influence. Statistical differences in pull-off forces were found for none of the taper junctions. Microscopy revealed CoCr29Mo6 abrasion from the head taper surface if combined with coated stem tapers. Higher micromotion of Ti6Al4V tapers was probably caused by the lower Young's modulus. Even in the contact areas, the coating was not damaged during loading. The mechanics of coated tapers was similar to uncoated prostheses. Thus, the separation of the two metal surfaces with the objective to reduce in vivo corrosion appears to be achievable if the coating is able to withstand in vivo conditions. However, the hard ceramic-based stem coating lead to undesirable debris from the CoCr29Mo6 heads during loading.
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Affiliation(s)
- Henning Haschke
- Institute of Biomechanics, Hamburg University of Technology (TUHH), Hamburg, Germany
| | - Adrian Falkenberg
- Institute of Biomechanics, Hamburg University of Technology (TUHH), Hamburg, Germany
| | - Michael M Morlock
- Institute of Biomechanics, Hamburg University of Technology (TUHH), Hamburg, Germany
| | - Gerd Huber
- Institute of Biomechanics, Hamburg University of Technology (TUHH), Hamburg, Germany
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Bechstedt M, Gustafson JA, Mell SP, Gührs J, Morlock MM, Levine BR, Lundberg HJ. Contact conditions for total hip head-neck modular taper junctions with microgrooved stem tapers. J Biomech 2020; 103:109689. [PMID: 32139099 DOI: 10.1016/j.jbiomech.2020.109689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
Abstract
Implant failure due to fretting-corrosion of head-neck modular junctions is a rising problem in total hip arthroplasty. Fretting-corrosion initiates when micromotion leads to metal release; however, factors leading to micromotion, such as microgrooves on the stem taper, are not fully understood. The purpose of this study is to describe a finite element analysis technique to determine head-neck contact mechanics and investigate the effect of stem taper microgroove height during head-neck assembly. Two-dimensional axisymmetric finite element models were created. Models were created for a ceramic femoral head and a CoCrMo femoral head against Ti6Al4V stem tapers and compared to available data from prior experiments. Stem taper microgroove height was investigated with a generic 12/14 model. Head-neck assembly was performed to four maximum loads (500 N, 2000 N, 4000 N, 8000 N). For the stem taper coupled with the ceramic head, the number of microgrooves in contact and plastically deformed differed by 2.5 microgrooves (4%) and 6.5 microgrooves (11%), respectively, between the finite element models and experiment. For the stem taper coupled with the CoCrMo head, all microgrooves were in contact after all assembly loads in the finite element model due to an almost identical conical angle between the taper surfaces. In the experiments, all grooves were only in contact for the 8000 N assembly load. Contact area, plastic (permanent) deformation, and contact pressure increased with increasing assembly loads and deeper microgrooves. The described modeling technique can be used to investigate the relationship between implant design factors, allowing for optimal microgroove design within material couples.
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Affiliation(s)
- Maren Bechstedt
- Institute of Biomechanics, TUHH Hamburg University of Technology, 21073 Hamburg, Germany
| | - Jonathan A Gustafson
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St Suite 201, Chicago, IL 60612, United States
| | - Steven P Mell
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St Suite 201, Chicago, IL 60612, United States
| | - Julian Gührs
- Institute of Biomechanics, TUHH Hamburg University of Technology, 21073 Hamburg, Germany
| | - Michael M Morlock
- Institute of Biomechanics, TUHH Hamburg University of Technology, 21073 Hamburg, Germany
| | - Brett R Levine
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St Suite 201, Chicago, IL 60612, United States
| | - Hannah J Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St Suite 201, Chicago, IL 60612, United States.
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Fallahnezhad K, Oskouei RH, Badnava H, Taylor M. The Influence of Assembly Force on the Material Loss at the Metallic Head-Neck Junction of Hip Implants Subjected to Cyclic Fretting Wear. Metals 2019; 9:422. [DOI: 10.3390/met9040422] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The impaction force required to assemble the head and stem components of hip implants is proven to play a major role in the mechanics of the taper junction. However, it is not clear if the assembly force could have an effect on fretting wear, which normally occurs at the junction. In this study, an adaptive finite element model was developed for a CoCr/CoCr head-neck junction with an angular mismatch of 0.01° in order to simulate the fretting wear process and predict the material loss under various assembly forces and over a high number of gait cycles. The junction was assembled with 2, 3, 4, and 5 kN and then subjected to 1,025,000 cycles of normal walking gait loading. The findings showed that material removal due to fretting wear increased when raising the assembly force. High assembly forces induced greater contact pressures over larger contact regions at the interface, which, in turn, resulted in more material loss and wear damage to the surface when compared to lower assembly forces. Although a high assembly force (greater than 4 kN) can further improve the initial strength and stability of the taper junction, it appears that it also increases the degree of fretting wear. Further studies are needed to investigate the assembly force in the other taper designs, angular mismatches, and material combinations.
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