[PDF] The Bone Cement Interface In Total Hip Arthroplasty An In Vitro Study Of Bone Surface Preparation Fatigue And Interface Mechanics eBook
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Experimental results showed that the ultimate shear strength of the cement/bone interface increased with average surface roughness (Ra), Vi as well as surface profile slope (Delta q). The fatigue response of the cement/bone interface was also significantly influenced by the bone topography. The apparent fatigue strength of the cement/bone interfaces ranged from 0.8 to 4.35 MPa and the ratio of the apparent fatigue strength to ultimate shear strength was approximately 0.2. Regardless of the bone surface topography, the fatigue strength of the cement/bone interface can be estimated from the results of monotonic experiments.
Author : Ian D. Learmonth Publisher : Springer Science & Business Media Page : 42 pages File Size : 42,68 MB Release : 2012-12-06 Category : Medical ISBN : 1447104773
This book incorporates the experience of numerous experts who explore contemporary opinion of how best to rationalise and optimise the interfaces at total hip replacement to provide the most favourable and durable results. The survival of a total hip replacement depends principally on the enduring integrity of the fixation interfaces and of the articular interface. The design of the stem and the material properties of cement largely determine the state of the component-cement inter face, while the bone-cement interface is significantly influenced by both mechanical and biological factors. The surface finish and shape of cementless implants are designed to preserve the integrity of biological fixation (osseo-integration) at the bone-component interface. Once again, both mechanical and biological factors have to be considered, while bioactive coatings accelerate bone ongrowth. Metal-on-polyethylene is the most widely used articular interface. However, it has been suggested that wear of polyethylene is one of the major factors contributing to failure of total hip replacements. The increasing prevalence of total hip replacement in younger patients has stimulated the investigation of alternative, more durable couples -including ceramic-polyethylene, ceramic-ceramic and metal-on-metal. Modularity provides greater intra-operative flexibility, but each new modular interface introduces new mechanisms of failure. These need to be anticipated and appropriate measures taken to avoid them. Hopefully this book will provide a better understanding of the factors that contribute to stable interfaces and long-term survival of total hip arthroplasty.
The lasting integrity of the bond between bone cement and bone defines the long-term stability of cemented acetabular replacements. Although several studies have been carried out on bone-cement interface at continuum level, micromechanics of the interface has been studied only recently for tensile and shear loading cases. Furthermore, the mechanical and microstructural behaviour of this interface is complex due to the variation in morphology and properties that can arise from a range of factors. In this work in vitro studies of the bone- cement interfacial behaviour under selected loading conditions were carried out using a range of experimental techniques. Damage development in cemented acetabular reconstructs was studied under a combined physiological loading block representative of routine activities in a saline environment. A custom-made environmental chamber was developed to allow testing of acetabular reconstructs in a wet condition for the first time and damage was monitored and detected by scanning at selected loading intervals using micro-focus computed tomography (l1eT). Preliminary results showed that, as in dry cases, debonding at the bone-cement interface defined the failure of the cement fixation. However, the combination of mechanical loading and saline environment seems to affect the damage initiation site, drastically reducing the survival lives of the reconstructs. Interfacial behaviour of the bone-cement interface was studied under tensile, shear and mixed-mode loading conditions. Bone-cement coupons were first mechanically tested and then l1eT imaged. The influence of the loading angle, the extent of the cement penetration and the failure mechanisms with regard to the loading mode onthe interfacial behaviour 2 - • were examined. Both mechanical testing and post failure morphologies seem to suggest an effect of the loading angle on the failure mechanism of the interface. The micromechanical performance of bone-cement interface under compression was also examined. The samples were tested in step-wise compression using a custom-made micromechanical loading stage within the I1CT chamber, and the damage evolution with load was monitored. Results showed that load transfer in bone-cement interface occurred mainly in the bone-cement contact region, resulting in progressively developed deformation due to trabeculae bending and buckling. Compressive and fatigue behaviour of bovine cancellous bone and selected open-cell metallic foams were studied also, and their suitability as bone analogous materials for cemented biomechanical testing was investigated. Whilst the morphological parameters of the foams and the bone appear to be closer, the mechanical properties vary significantly between the foams and the bone. However, despite the apparent differences in their respective properties, the general deformation behaviour is similar across the bone and the foams. Multi-step fatigue tests were carried out to study the deformation behaviour under increasing compressive cyclic stresses. Optical and scanning electron microscopy (SEM) were used to characterise the microstructure of foams and bone prior to and post mechanical testing. The results showed that residual strain accumulation is the predominant driving force leading to failure of foams and bones. Although foams and bone fail by the same mechanism of cyclic creep, the deformation behaviour at the transient region of each step was different for both materials. Preliminary results of foam-cement interface performance under mixed-mode loading conditions are also presented.
Cemented Total Hip Arthroplasty (THA) remains one of the most successful procedures in Orthopaedic surgery. It has become very clear that it is the surgical expertise, in particular the quality of the cementing technique, which will affect long-term outcome and success. It is the intention of this book to provide an up-to-date comprehensive assessment of the entire field of cemented THA. Special emphasis has been given to practice-relevant aspects: well-illustrated and detailed operative steps as a practical guideline, a basic science chapter and long-term outcome data are provided. Minimally invasive surgery, modern perioperative management and patient fast tracking are covered. A number of highly respected experts have contributed to this in-depth compilation of the "state of the art" in 2005. This book is written and intended for both, trainees and established arthroplasty surgeons who are dedicated to perform a well-cemented THA.
G. H. I. M. WALENKAMP, D. W. MURRAY Since the first use of bone cement, there has been much discussion about this important tool in arthroplasty. Many authors consider the cemented prosthesis as the gold standard when evaluating the outcome of primary prostheses. In a large number of total hip arthroplasties, as registered in the Scandi navian Hip Registers, important differences in revision risks have been docu mented between hospitals. These differences are partly due to the use of di verse cement techniques. In the analysis of data, the influence of these tech niques, as well as the different cement types, is clear. A recent disaster with a newly developed cement also illustrated that the quality of the cement must be assured, and that the introduction of a new material must be carefully prepared and followed-up. The new Palamed cement has been developed by the makers of the well known Palacos and Refobacin Palacos, which appeared to be the best ce ments in the Swedish register. An improvement was noted in slightly better handling characteristics, but the end product is the same as Palacos. As men tioned, this cement will be carefully followed-up in the near future. However, its introduction is a good reason to gather the expertise of some of the lead ing figures in the field in this book. II History of Bone Cements CHAPTER 2. 1 Industrial Development of Bone Cement Twenty-Five Years of Experience w. EGE, K. D.
Total joint arthroplasty is an effective surgical procedure for end-stage osteoarthritis of major joints with satisfactory long term clinical outcome. A large and growing number of arthroplasties are performed annually worldwide and a great number of orthopaedic surgeons are practicing arthroplasty surgery as their main surgical activity. The biological behavior of the bone-implant interface is crucial for the long term survival of the artificial joint. All factors which have a positive or negative effect on the interface are of great interest for those practicing arthroplasty surgery. Basic scientists and the industry are continuously searching for new implant fixation mechanisms and improved materials. There is an accumulation of a great amount of basic science data (both biological, material and mechanical) related to the incorporation or loosening of the bone-implant interface. However, basic science data does not always translate to satisfactory clinical application, and orthopaedic practitioners often wonder which piece of information is clinically useful. A further problem is that basic scientists often speak their own scientific language and may not fully appreciate common clinical practice needs. In this textbook the biological and mechanical mechanisms of implant incorporation and loosening will be presented. All new data concerning materials and methods for incorporation enhancement will be critically analyzed. Data useful for clinical application will be stressed. Orthopaedic Surgeons will find information which will improve their clinical practice and basic scientists will be helped to understand and appreciate clinical needs.
An update on current knowledge is given for surgeons and researchers involved in implant surgery and the development of implant arthroplasty. The contributions come from a distinguished international faculty of orthopaedic surgeons, biologists and engineers. They examine the junctional tissues between an implant and the bone in joint replacement surgery. The factors that influence junctional tissues and so affect the life-span of the implant are thoroughly discussed. These include: detailed data on the microscopy of the junctional tissues, the mechanical properties of cement, and the architecture of bone and implant design. The discussions following each contribution give meaningful insight into background information and the controversial aspects of surgical implants.
This book presents analyses of the most commonly reported failure modes of hip stems: loosening and thigh pain; both are attributed to the relative motion and instability at the bone-implant interface due to failure to achieve sufficient primary fixation. The book investigates various factors that could affect primary stability and therefore the long-term outcome of hip arthroplasty. The results complement experimental work carried out in this area as in-vitro experiments have several limitations that could be addressed through computer simulations.
This handbook describes several current trends in the development of bioceramics and biocomposites for clinical use in the repair, remodelling, and regeneration of bone tissue. Comprehensive coverage of these materials allows fundamental aspects of the science and engineering to be seen in close relation to the clinical performance of dental and orthopaedic implants. Bioceramics and biocomposites appear to be the most dynamic area of materials development for both tissue engineering and implantable medical devices. Almost all medical specialties will continue to benefit from these developments, but especially dentistry and orthopaedics. In this Handbook, leading researchers describe the use of bionanomaterials to create new functionalities when interfaced with biological molecules or structures. Also described are technologies for bioceramics and biocomposites processing in order to fabricate medical devices for clinical use. Another important section of the book is dedicated to tissue regeneration with development of new matrices. A targeted or personalized treatment device reduces drug consumption and treatment expenses, resulting in benefits to the patient and cost reductions for public health systems. This authoritative reference on the state-of-the-art in the development and use of bioceramics and biocomposites can also serve as the basis of instructional course lectures for audiences ranging from advanced undergraduate students to post-graduates in materials science and engineering and biomedical engineering.