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Hunger S, Rotsch C, Günther F, Drossel WG, Heyde CE. Influence of a Modified Procedure of Joining Ceramic Head and Adapter Sleeve on the Stem Taper in Revision: An Experimental Study. Bioengineering (Basel) 2024; 11:170. [PMID: 38391656 PMCID: PMC10886244 DOI: 10.3390/bioengineering11020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
In revision operations, ceramic heads of modular hip implants can be replaced. As the surface of the stem taper can be damaged, additional adapter sleeves are applied. The components are usually connected manually by the surgeon in a one-step procedure by hammer impacts. In this study, we investigated a two-step joining procedure with reproducible impaction force. First, the adapter sleeve and head were joined quasi-statically with a force of 2 kN using an assembly device. In the second step, these components were applied to the stem taper using a pulse-controlled instrument. For reference, the joints were assembled according to standard conditions using a tensile testing machine. An average pull-off force of 1309 ± 201 N was achieved for the components joined by the instrument, and the average measured values for the components joined by the testing machine were 1290 ± 140 N. All specimens achieved a force >350 N when released and therefore met the acceptance criterion defined for this study. This study showed that a modified procedure in two steps with a defined force has a positive effect on the reproducibility of the measured joining forces compared to previous studies.
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Affiliation(s)
- Sandra Hunger
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Christian Rotsch
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Florian Günther
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Welf-Guntram Drossel
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany
- Institute for Machine Tools and Production Processes, Faculty of Mechanical Engineering, Chemnitz University of Technology, 09111 Chemnitz, Germany
| | - Christoph-Eckhard Heyde
- Department of Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig Medical Center, 04103 Leipzig, Germany
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Rotsch C, Kemter-Esser K, Dohndorf J, Knothe M, Drossel WG, Heyde CE. Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups. Bioengineering (Basel) 2024; 11:75. [PMID: 38247952 PMCID: PMC10813518 DOI: 10.3390/bioengineering11010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which enables the loosening of ceramic inlays from acetabular hip cups without ceramic chipping or damaging the metal cup. This technical in vitro study exam-ines two principles of heating currents and hot water for thermal activation of the shape-memory-alloy-actuator to generate a force between the metal cup and the ceramic inlay. Mechanical tests concerning push-in and push-out forces, deformation of the acetabular cup according to international test standards, and force generated by the actuator were generated to prove the feasibility of this new approach to ceramic inlay revision. The required disassembly force for a modular acetabular device achieved an average value of 602 N after static and 713 N after cyclic loading. The actuator can provide a push-out force up to 1951 N. In addition, it is shown that the necessary modifications to the implant modules for the implementation of the shape-memory-actuator-system do not result in any change in the mechanical properties compared to conventional systems.
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Affiliation(s)
- Christian Rotsch
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany; (K.K.-E.); (J.D.); (W.-G.D.)
- University of Leipzig Medical Center, Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig, 04103 Leipzig, Germany;
| | - Karoline Kemter-Esser
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany; (K.K.-E.); (J.D.); (W.-G.D.)
| | - Johanna Dohndorf
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany; (K.K.-E.); (J.D.); (W.-G.D.)
- Institute of Biomedical Engineering, TUD Dresden University of Technology, 01307 Dresden, Germany
| | - Marcel Knothe
- IMA Materialforschung und Anwendungstechnik GmbH, 01099 Dresden, Germany;
| | - Welf-Guntram Drossel
- Fraunhofer Institute for Machine Tools and Forming Technology IWU, 01187 Dresden, Germany; (K.K.-E.); (J.D.); (W.-G.D.)
- Professorship Adaptronics and Lightweight Design in Production, Chemnitz University of Technology, 09107 Chemnitz, Germany
| | - Christoph-Eckhard Heyde
- University of Leipzig Medical Center, Orthopaedic, Trauma and Plastic Surgery Clinic, University of Leipzig, 04103 Leipzig, Germany;
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Morlock MM, Jäger M. [Endoprostheses in the elderly : Biomaterials, implant selection and fixation technique]. DER ORTHOPADE 2017; 46:4-17. [PMID: 27966180 DOI: 10.1007/s00132-016-3361-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The replacement of hip and knee joints is one of the greatest success stories in orthopedics. Due to continuous improvement of biomaterials and implant design, patient-associated problems are now mostly multifactorial and only rarely caused by the implant. Abrasion was significantly reduced by the introduction of highly cross-linked polyethylene (PE), antioxidant stabilized PE, new ceramics and the development of ceramic and protective surfaces. It is assumed that further reduction of frictional resistance will not lead to a significantly better clinical result: however, the problem of periprosthetic infections and implant-related incompatibility is still unsolved and remains challenging for biomaterial research. For the knee joint PE will be irreplaceable for joint articulation even in the future due to the contact situation. Mobile bearings and fixed bearings are two established successful philosophies, which have shown comparably good clinical results. For the hip joint, it is forecasted that ceramic-on-ceramic will be the system of the future if the correct positioning and mounting of the components can be solved so that the problems, such as development of noise and breakage can be reduced to a minimum. An in-depth understanding and detailed knowledge of the biomaterials by the surgeon can prevent implant-related problems. For elderly patients it is assumed that the economic burden on the public healthcare system will have the strongest impact on implant selection.
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Affiliation(s)
- M M Morlock
- Institut für Biomechanik, TUHH Hamburg University of Technology, Denickestr. 15, 21073, Hamburg, Deutschland.
| | - M Jäger
- Klinik für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Hufelandstr. 55, 45274, Essen, Deutschland
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Krenn S, Thomsen M, Usbeck S, Scheuber LF, Boettner F, Krukemeyer MG, Huber M, Kretzer JP, Gehrke T, Krenn V. Supramacroparticulate PE in 6 different joint endoprostheses localisations: An indicator for PE damage? Pathol Res Pract 2017; 213:987-996. [PMID: 28602486 DOI: 10.1016/j.prp.2017.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
In the histopathological particle algorithm polyethylene (PE) particles with maximum lengths of more than 100μm - called PE supramacroparticles - are identified exclusively for knee joint and hip prostheses. However, a definitive characterisation, detection in all joint localisations and a causal clarification of the pathogenesis are lacking. In this study a total of 175 SLIM (synovial-like interface membrane) cases with PE supramacroparticles of knee joint prostheses (n=89), hip joint prostheses (n=44), ankle joint prostheses (n=36) and prostheses in three localisations of the upper extremities (n=6) were systematically investigated. The arithmetic mean of the particle length varied greatly within the prosthesis types. This had a significant positive correlation with the prosthesis lifetime and negative correlation with the date of implantation. It can be concluded that both the lifetime and the time of implantation have an influence on the particle length. The prostheses with supramacroparticulate damage moreover showed a clearly reduced survival rate compared with other data published on the prosthesis lifetime. The material wear therefore could not be attributed solely to the usual fatigue factors. Since loosening of the prostheses, decentring of the PE components or damage to the PE inlay existed in all cases, mechanical dysloading seems to be the most probable cause of PE supramacroparticle genesis. Due to the striking length and for demarcation from PE macroparticles, the term supramacroparticulate PE is proposed for a length of more than 100μm. In the extended histopathological particle algorithm supramacroparticulate PE has been included in the macroparticles category and should be taken into account and interpreted causally in histopathological diagnostics of joint prosthesis failure.
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Affiliation(s)
- Simon Krenn
- MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Germany; Danube Private University, Krems-Stein, Austria.
| | | | | | | | | | | | - Monika Huber
- Pathologisch-bakteriologisches Institut, Otto Wagner Spital, Wien, Austria
| | - Jan Philippe Kretzer
- Labor für Biomechanik und Implantat-Forschung, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Germany
| | | | - Veit Krenn
- MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Germany
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Yousef AI, Akhtyamov IF. ARTHROPLASTY FEATURES IN OVERWEIGHT PATIENTS (REVIEW). TRAUMATOLOGY AND ORTHOPEDICS OF RUSSIA 2017. [DOI: 10.21823/2311-2905-2017-23-2-115-123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Supramakropartikuläres Polyethylen bei Entzündungen periprothetischer Membranen. DER ORTHOPADE 2016; 45:256-64. [DOI: 10.1007/s00132-015-3194-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hothan A, Morlock M, Hoenig E. The effect of body weight on the choice of material for the bearing couple in artificial hip joints. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.sart.2014.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Turger A, Köhler J, Denkena B, Correa TA, Becher C, Hurschler C. Manufacturing conditioned roughness and wear of biomedical oxide ceramics for all-ceramic knee implants. Biomed Eng Online 2013; 12:84. [PMID: 23988155 PMCID: PMC3766060 DOI: 10.1186/1475-925x-12-84] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/15/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ceramic materials are used in a growing proportion of hip joint prostheses due to their wear resistance and biocompatibility properties. However, ceramics have not been applied successfully in total knee joint endoprostheses to date. One reason for this is that with strict surface quality requirements, there are significant challenges with regard to machining. High-toughness bioceramics can only be machined by grinding and polishing processes. The aim of this study was to develop an automated process chain for the manufacturing of an all-ceramic knee implant. METHODS A five-axis machining process was developed for all-ceramic implant components. These components were used in an investigation of the influence of surface conformity on wear behavior under simplified knee joint motion. RESULTS The implant components showed considerably reduced wear compared to conventional material combinations. Contact area resulting from a variety of component surface shapes, with a variety of levels of surface conformity, greatly influenced wear rate. CONCLUSIONS It is possible to realize an all-ceramic knee endoprosthesis device, with a precise and affordable manufacturing process. The shape accuracy of the component surfaces, as specified by the design and achieved during the manufacturing process, has a substantial influence on the wear behavior of the prosthesis. This result, if corroborated by results with a greater sample size, is likely to influence the design parameters of such devices.
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Affiliation(s)
- Anke Turger
- Institute of Production Engineering and Machine Tools (IFW), Gottfried Wilhelm Leibniz Universität Hannover, An der Universität 2, 30823 Garbsen, Germany
| | - Jens Köhler
- Institute of Production Engineering and Machine Tools (IFW), Gottfried Wilhelm Leibniz Universität Hannover, An der Universität 2, 30823 Garbsen, Germany
| | - Berend Denkena
- Institute of Production Engineering and Machine Tools (IFW), Gottfried Wilhelm Leibniz Universität Hannover, An der Universität 2, 30823 Garbsen, Germany
| | - Tomas A Correa
- Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30628 Hannover, Germany
| | - Christoph Becher
- Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30628 Hannover, Germany
| | - Christof Hurschler
- Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30628 Hannover, Germany
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