Artificial hip joints: The biomaterials challenge

Design, fabrication and clinical characterization of additively manufactured tantalum hip joint prosthesis

The joint prosthesis plays a vital role in the outcome of total hip arthroplasty. The key factors that determine the performance of joint prostheses are the materials used and the structural design of the prosthesis. This study aimed to fabricate a porous tantalum (Ta) hip prosthesis using selective laser melting (SLM) technology. The feasibility of SLM Ta use in hip prosthesis was verified by studying its chemical composition, metallographic structure and mechanical properties. In vitro experiments proved that SLM Ta exhibited better biological activities in promoting osteogenesis and inhibiting inflammation than SLM Ti6Al4V. Then, the topological optimization design of the femoral stem of the SLM Ta hip prosthesis was carried out by finite element simulation, and the fatigue performance of the optimized prosthesis was tested to verify the biomechanical safety of the prosthesis. A porous Ta acetabulum cup was also designed and fabricated using SLM. Its mechanical properties were then studied. Finally, clinical trials were conducted to verify the clinical efficacy of the SLM Ta hip prosthesis. The porous structure could reduce the weight of the prosthesis and stress shielding and avoid bone resorption around the prosthesis. In addition, anti-infection drugs can also be loaded into the pores for infection treatment. The acetabular cup can be custom-designed based on the severity of bone loss on the acetabular side, and the integrated acetabular cup can repair the acetabular bone defect while achieving the function of the acetabular cup.

Response of preosteoblasts on micromachined Ti-6Al-4V surface to microstructure dimension

The cell incubation depends on the cultured surface, but various machining methods produce different surface topographies, but it has not been clear how it is related to the topographic feature until now. Hence, the machined Ti-6Al-4V surface is characterized for preosteoblasts incubation via different mechanical fabrication. The relationship between surface topography created by various machining methods and cell incubation behaviour was explored. The objective is to control the surface preosteoblasts growth in machining of biological titanium alloy. According to the cell growth kinetic, the cell incubation behaviour was first proposed and modelled in relation to microstructural dimension and culture duration. Then, the topological cultured microstructure surface was fabricated via mechanical fabrication. Finally, the cell initial adhesion and incubation behaviour on microstructured surface was investigated. It is shown that the surface undulation on machined microstructure is conducive to controlling the direction and distribution of cell incubation from cell growth kinetic model. The cell culture can be controlled on the peak with a small undulation, while it is concentred on the sidewall with a high aspect ratio. Increasing the aspect ratio extends cell growth, while low aspect ratio promotes initial cell adhesion and growth rate. Within the optimal cultured duration, the microstructured surface is more favourable for cell survival, and the cell growth keep positive beyond critical aspect ratio. As a result, the cell adhesion ability is topologically controlled to 5.4 times higher and the growth rate can be improved by 101.7% on milled microgrooved surface. It may be applied to the rapid production of biomedical Ti-6Al-4V implant.

3D Printing of Bioinert Oxide Ceramics for Medical Applications

Three-dimensionally printed metals and polymers have been widely used and studied in medical applications, yet ceramics also require attention. Ceramics are versatile materials thanks to their excellent properties including high mechanical properties and hardness, good thermal and chemical behavior, and appropriate, electrical, and magnetic properties, as well as good biocompatibility. Manufacturing complex ceramic structures employing conventional methods, such as ceramic injection molding, die pressing or machining is extremely challenging. Thus, 3D printing breaks in as an appropriate solution for complex shapes. Amongst the different ceramics, bioinert ceramics appear to be promising because of their physical properties, which, for example, are similar to those of a replaced tissue, with minimal toxic response. In this way, this review focuses on the different medical applications that can be achieved by 3D printing of bioinert ceramics, as well as on the latest advances in the 3D printing of bioinert ceramics. Moreover, an in-depth comparison of the different AM technologies used in ceramics is presented to help choose the appropriate methods depending on the part geometry.

Nanoparticle-Containing Hyaluronate Solution for Improved Lubrication of Orthopedic Ceramics

Premature failure caused by inadequate lubrication of an artificial joint is a major problem. Inspired by engine lubrication, in which various additives are used to enforce the oil lubricant, here, a bench test of a biomimetic lubricating fluid containing different substances was carried out. Bovine serum albumin (BSA), in the form of both molecules and nanoparticles, was used as a functional additive. Compared with BSA molecules, BSA nanoparticles dispersed in HA solution served as more effective additives in the biomimetic lubrication fluid to minimize the friction and wear of ceramic orthopedic materials made of zirconium dioxide (ZrO₂). Meanwhile, a tribo-acoustic study indicated that the “squeaking” problem associated with ZrO₂ could be suppressed by the biomimetic fluid. Together with a cytotoxicity assessment, the BSA nanoparticle-incorporated biomimetic fluid was confirmed as a potential reagent for use in the clinic to maintain an even longer service life of artificial joints.

Toward long-live ceramic on ceramic hip joints: In vitro investigation of squeaking of coated hip joint with layer-by-layer reinforced PVA coatings

This study attempts to find a promising solution for the squeaking of ceramic on ceramic (COC) bearing surfaces by introducing reinforced poly(vinylalcohol) (PVA) layer-by-layer coatings on the bearing surface of Stryker Trident femoral head. A customized hip simulator was established to provide a realistic simulation of the normal gait (flexion–extension) of the hip joint, and to examine squeaking for coated and uncoated femoral heads. Different characterization techniques were employed to study the coatings’ structure. The PVA macromolecules were successfully cross-linked via epichlorohydrin agent, and chemically bonded onto the surface, forming a superior reinforced PVA coating on the femoral head’s surface. These coatings play a dominant role in increasing the pre-squeaking age of the hip joint due to reduction in hard-on-hard contact and femoral head liner clearance with their good viscoelastic properties. Which cause, damping friction-induced vibrations. This improvement resembles novel-type, long-life, and stable hip joint biomaterials with distinguished and promising pre-squeaking age.

A Comparative Study of Hip Arthroplasty and Closed Reduction Proximal Femur Nail in the Treatment of Elderly Patients with Hip Fractures

Objective

To compare the clinical effect of hip arthroplasty and closed reduction intramedullary nailing of proximal femur in the treatment of elderly hip fracture patients.

Methods

There are 90 elderly hip fracture patients being recruited in the present study. Fifty patients in Group A received closed reduction intramedullary nailing of proximal femur, and 40 patients in Group B received hip arthroplasty. All patients were followed up for 12 months after surgery, clinical outcomes included surgical indicators, visual analog scale (VAS) score, Harris score, quality of life, mental status, and complications.

Results

The surgery time, bleeding volume, infusion volume of patients in Group A are all significantly lower than those in Group B (p < 0.05), while the weight-bearing activity time and first workout time of Group A are all significantly higher than those in Group B (p < 0.05). The VAS score in patients of Group A at 1 week postoperative is significantly lower than that in patients of Group B (p < 0.05). The Harris score in patients of Group A at 3, 6, and 12 months postoperative are all significantly higher than those in patients of Group B (p < 0.05), and the excellent and good rate of hip function recovery at 12 months postoperative in patient of Group A is significantly lower than that in patients of Group B (80% vs. 95%, p < 0.05). Furthermore, The score of SF-36 standardized physical component, SF-36 standardized mental component and Barthel in patients of Group A at 6 months postoperative are significantly lower than those in patients of Group B (p < 0.05), and the score of mini-mental state examination is significantly higher (p < 0.05), while there are not significantly different at 12 months postoperative (p > 0.05). The incidence of postoperative complications in Group A was significantly lower than that in Group B (10% vs. 27.5%, p < 0.05).

Conclusion

Elderly hip fracture patients treated with closed reduction intramedullary nailing of proximal femur has less surgical trauma and lower complication rates, but slower postoperative recovery compared with hip arthroplasty.

A tannic acid-reinforced PEEK-hydrogel composite material with good biotribological and self-healing properties for artificial joints

Polyetheretherketone (PEEK) is widely considered as a promising material for joint implants but it still has limitations involving high friction and wear. To mimic the cartilage-subchondral bone structure in natural joints, a polyvinyl alcohol (PVA) hydrogel layer was fabricated on the PEEK substrate to provide a lubrication mechanism. In addition, tannic acid was applied to form dynamic hydrogen bonds with PVA molecules, for the purpose of strengthening the hydrogel layer and endowing it with self-healing ability. Our experimental results demonstrated that the prepared PEEK-hydrogel composite exhibited good biotribological performance with a low average friction coefficient around 0.06 and little wear after the friction test. It also could repair the scratch made by a blade spontaneously at room temperature taking advantage of the reversibility of the hydrogen bonds. The influence of the properties of the PVA hydrogel and the concentration of tannic acid on the frictional and self-healing behavior of the composite structure was investigated and the internal mechanism was discussed. This work presents a facile method to fabricate a PEEK-hydrogel composite possessing outstanding tribological properties and self-healing capacity simultaneously, hopefully promoting its potential in producing artificial joints.

Tailor-made design, fabrication and validation of SrO doped nanostructured ZTA ceramic Femoral head - Acetabular socket liner assembly

An established commercial grade SrO doped ZTA composition has been considered to design, fabrication through uniaxial pressing followed by sintering and polishing, validation of dimension, 3D surface profile, 3D microstructure, and compressive load bearing capacity of femoral head - acetabular socket liner prototypes for the hip prosthesis. While design and dimensions are concerned, both the steel (HRC60) molds were designed and machined to achieve precious dimensions of femoral head (FH; OD - 30 ± 0.01 mm) and acetabular socket liner (ASL; ID - 30.15 ± 0.01 mm). A close variation in the range of ±0.01 mm was confirmed the precision geometry of polished FH and ASL with consideration of 22 points coordinate measuring method (CMM). 3D surface profile ensures the surface characteristics of R_a = 0.2 ± 0.01 μm and R_q = 0.5 ± 0.01 μm for outer surface of FH and an inner surface of ASL, respectively. Structure integrity and fabrication defects including cracks and pores free bulk structures were confirmed by Micro CT. The compressive load resistance known as burst strength for independent FH and FH-ASL assembly were measured 16.2 KN and 17.6 KN, respectively. The developed ceramic prototypes have an economic advantage and can be adopted as artificial hip prosthesis after extensive in-vitro and in-vivo analysis.

Effect of surface mechanical attrition treatment on the microstructure of cobalt-chromium-molybdenum biomedical alloy

This research work describes the impact of the surface mechanical attrition treatment (SMAT) on the microstructure of cobalt-chromium-molybdenum (CoCrMo), a biomedical alloy commonly used for orthopedic applications. This surface treatment induces crystalline phases transformations characterized by X-ray diffraction (XRD) and selected area electron diffraction (SAED). The corresponding structural changes are observed from cross-section images obtained by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results show that the SMAT process induces the martensitic transformation of the CoCrMo alloy (from γ-fcc phase to ε-hcp phase) related to an important grain refinement due to twinning and sliding.

A Mid- to Long-Term Follow-Up Experience with a Specific Metal-on-Metal Total Hip Arthroplasty Design

Purrpose  Metal-on-metal (MoM) total hip arthroplasty (THA) has been a subject of recent discussion and concern due to the early failures caused by local and systemic adverse reactions related to specific designs. The aim of this study is to analyze the outcomes and survival rates of a single brand of MoM implants implanted in a consecutive series of patients at a single institution.

Methods  Between 2007 and 2012, 116 (118 hips) patients were evaluated at a mean follow-up of 6.6 years after primary THA. The diagnosis leading to surgery was osteoarthritis (80 patients) and proximal femoral fracture (36 patients). A single design of THA was implanted. All patients were evaluated before surgery and postoperatively at 1, 3, 6, and 12 months by clinical scores and radiographic studies. The data analysis was made using Student's t -test.

Results  The minimum follow-up was of 4 years, with a mean follow-up of 6.6 years. Two aseptic loosenings of the acetabular component were recorded (one per group), which were not associated with local or systemic complications related to metal ion release. Both were revised by an isolated acetabular cup substitution with metal-on-polyethylene couplings. Nonprogressive radiolucency lines < 2 mm in zone 2 were observed in other six patients around the acetabular component without clinical manifestation (four in the arthritis group and two in the fracture group). Postoperative Harris Hip Score and SF-36 (36-Item Short Form Survey) score improved in both groups.

Conclusion  Despite several MoM implants showing early complications and failures, a specific MoM design may be associated with good clinical results at a mid- to long-term follow-up.

Level of Evidence  This is a therapeutic case series, Level 4 study.

Path Planning for Laser Cladding Robot on Artificial Joint Surface Based on Topology Reconstruction

Artificial joint surface coating is a hot issue in the interdisciplinary fields of manufacturing, materials and biomedicine. Due to the complex surface characteristics of artificial joints, there are some problems with efficiency and precision in automatic cladding path planning for coating fabrication. In this study, a path planning method for a laser cladding robot for artificial joints surface was proposed. The key of this method was the topological reconstruction of the artificial joint surface. On the basis of the topological relation, a set of parallel planes were used to intersect the CAD model to generate a set of continuous, directed and equidistant surface transversals on the artificial joint surface. The arch height error method was used to extract robot interpolation points from surface transversal lines according to machining accuracy requirements. The coordinates and normal vectors of interpolation points were used to calculate the position and pose of the robot tool center point (TCP). To ensure that the laser beam was always perpendicular to the artificial joint surface, a novel laser cladding set-up with a robot was designed, of which the joint part clamped by a six-axis robot moved while the laser head was fixed on the workbench. The proposed methodology was validated with the planned path on the surface of an artificial acetabular cup using simulation and experimentation via an industrial NACHI robot. The results indicated that the path planning method based on topological reconstruction was feasible and more efficient than the traditional robot teaching method.

In Vitro Assessment of Bioactive Glass Coatings on Alumina/Zirconia Composite Implants for Potential Use in Prosthetic Applications

Achieving the stable osteointegration of prosthetic implants is one of the great challenges of modern orthopedic surgery. The fixation of ceramic acetabular cups of hip joint prostheses is usually achieved using a metal shell provided with screws or pegs that penetrate into the host pelvic bone. The deposition of bioactive coatings on the implant surface to be put in contact with bone could be a valuable strategy to promote a more "physiological" osteointegration. In this work, bioactive glass porous coatings were manufactured on the top of alumina/zirconia composite implants by two different methods, i.e., sponge replication and laser cladding. The coated samples underwent immersion studies in Kokubo's simulated body fluid (SBF) to assess in vitro bioactivity and were found to exhibit an excellent hydroxyapatite-forming ability, which is key to allow bonding to bone. Biological tests using mesenchymal stem and osteoblast-like cells revealed the good biocompatibility of both types of materials. Furthermore, a higher level of mineralization was induced by the sponge-replicated coatings at 10 days. Overall, these results are highly promising and encourage further research on these materials.

3D printed polyurethane prosthesis for partial tracheal reconstruction: a pilot animal study

A ready-made, acellular patch-type prosthesis is desirable in repairing partial tracheal defects in the clinical setting. However, many of these prostheses may not show proper biological integration and biomechanical function when they are transplanted. In this study, we developed a novel 3D printed polyurethane (PU) tracheal scaffold with micro-scale architecture to allow host tissue infiltration and adequate biomechanical properties to withstand physiological tracheal condition. A half-pipe shaped PU scaffold (1.8 cm of height, 0.18 cm thickness, and 2 cm of diameter) was fabricated by 3D printing of PU 200 μm PU beam. The 3D printed tracheal scaffolds consisted of a porous inner microstructure with 200 × 200 × 200 μm³ sized pores and a non-porous outer layer. The mechanical properties of the scaffolds were 3.21 ± 1.02 MPa of ultimate tensile strength, 2.81 ± 0.58 MPa of Young's modulus, and 725% ± 41% of elongation at break. To examine the function of the 3D printed tracheal scaffolds in vivo, the scaffolds were implanted into 1.0 × 0.7 cm² sized anterior tracheal defect of rabbits. After implantation, bronchoscopic examinations revealed that the implanted tracheal scaffolds were patent for a 16 week-period. Histologic findings showed that re-epithelialization after 4 weeks of implantation and ciliated respiratory epithelium with ciliary beating after 8 weeks of implantation were observed at the lumen of the implanted tracheal scaffolds. The ingrowth of the connective tissue into the scaffolds was observed at 4 weeks after implantation. The biomechanical properties of the implanted tracheal scaffolds were continually maintained for 16 week-period. The results demonstrated that 3D printed tracheal scaffold could provide an alternative solution as a therapeutic treatment for partial tracheal defects.

Zirconia in biomedical applications

INTRODUCTION

The use of zirconia in medicine and dentistry has rapidly expanded over the past decade, driven by its advantageous physical, biological, esthetic, and corrosion properties. Zirconia orthopedic hip replacements have shown superior wear-resistance over other systems; however, risk of catastrophic fracture remains a concern. In dentistry, zirconia has been widely adopted for endosseous implants, implant abutments, and all-ceramic crowns. Because of an increasing demand for esthetically pleasing dental restorations, zirconia-based ceramic restorations have become one of the dominant restorative choices. Areas covered: This review provides an updated overview of the applications of zirconia in medicine and dentistry with a focus on dental applications. The MEDLINE electronic database (via PubMed) was searched, and relevant original and review articles from 2010 to 2016 were included. Expert commentary: Recent data suggest that zirconia performs favorably in both orthopedic and dental applications, but quality long-term clinical data remain scarce. Concerns about the effects of wear, crystalline degradation, crack propagation, and catastrophic fracture are still debated. The future of zirconia in biomedical applications will depend on the generation of these data to resolve concerns.

Bio-functionalization of biomedical metals

Bio-functionalization means to endow biomaterials with bio-functions so as to make the materials or devices more suitable for biomedical applications. Traditionally, because of the excellent mechanical properties, the biomedical metals have been widely used in clinic. However, the utilized functions are basically supporting or fixation especially for the implantable devices. Nowadays, some new functions, including bioactivity, anti-tumor, anti-microbial, and so on, are introduced to biomedical metals. To realize those bio-functions on the metallic biomedical materials, surface modification is the most commonly used method. Surface modification, including physical and chemical methods, is an effective way to alter the surface morphology and composition of biomaterials. It can endow the biomedical metals with new surface properties while still retain the good mechanical properties of the bulk material. Having analyzed the ways of realizing the bio-functionalization, this article briefly summarized the bio-functionalization concepts of six hot spots in this field. They are bioactivity, bony tissue inducing, anti-microbial, anti-tumor, anticoagulation, and drug loading functions.

May the surface roughness of the retrieved femoral head influence the wear behavior of the polyethylene liner?

This study was aimed at determining the surface degradation occurred on retrieved ceramic and metallic heads, as well as the influence of the head surface quality on the wear of the polyethylene counterface. To this purpose, 14 ceramic and 14 metallic femoral heads retrieved at revision surgery were examined. Scanning electron microscopic analysis provided visual evidence that some metallic heads presented crescent wear more often than the ceramic ones; the former showed a higher volumetric loss (as determined by Coordinate Measuring Machine) than the latter, but less negative Rsk values. This apparent lack of correlation between volumetric loss (i.e., wear factor) and roughness data may be explained by considering that they are two temporally variant parameters. No significant differences were observed between the Ra values of the two sets of femoral heads. The cups articulating against metal heads were characterized by higher mean wear volumes than those articulating against alumina although this difference was not statistically significant; metal heads displayed significantly higher mean wear volumes than alumina heads. The micro-Raman analysis of the cup articulated against the most worn alumina femoral head showed an orthorhombic into monoclinic phase transformation that was not observed in the cups coupled to metal heads. The obtained results showed that the surface finishing of the femoral head (in terms of Rsk values) determined the morphological changes experienced by the ultra-high-molecular-weight polyethylene crystalline phase at the molecular level. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1374-1385, 2016.

Finite element analysis of sliding distance and contact mechanics of hip implant under dynamic walking conditions

An explicit finite element method was developed to predict the dynamic behavior of the contact mechanics for a hip implant under normal walking conditions. Two key parameters of mesh sensitivity and time steps were examined to balance the accuracy and computational cost. Both the maximum contact pressure and accumulated sliding distance showed good agreement with those in the previous studies using the implicit finite element analysis and analytical methods. Therefore, the explicit finite element method could be used to predict the contact pressure and accumulated sliding distance for an artificial hip joint simultaneously in dynamic manner.

Novel artificial hip joint: A layer of alumina on Ti-6Al-4V alloy formed by micro-arc oxidation

In many hip replacement surgeries, monolithic alumina is used as a femoral head due to its high wear resistance. However, it is liable to fracture under load bearing operations in artificial joints. We propose a promising way to overcome this limitation by forming a dense alumina layer onto a relatively tough substrate such as Ti-6Al-4V alloy to obtain high wear resistance on a material that can sustain relatively high toughness. For this purpose, Al metal powders were deposited onto Ti-6Al-4V alloy by cold spraying in N2 atmosphere. Interfacial adhesion between Al and the Ti alloy was improved by the formation of a reaction layer of Al3Ti between them by heating at 640 °C for 1h in air. Subsequently, micro-arc oxidation treatment was performed to oxidize Al. The oxidized layer was composed of an outer porous layer of γ-alumina and inner-most dense layer of α-alumina. The α-alumina layer was almost fully densified and exhibited high Vickers hardness almost equal to that of alumina ceramics used as the femoral head. Thus, the newly developed dense alumina/Ti alloy can be potentially used to produce the reliable bearing surfaces of artificial hip joint.

A novel tribological study on DLC-coated micro-dimpled orthopedics implant interface

This study investigates a tribological performance of diamond like carbon (DLC) coated micro dimpled prosthesis heads against ceramic cups in a novel pendulum hip joint simulator. The simulator enables determining friction coefficient and viscous effects of a concave shaped specimen interface (conformal contact). Two types of DLC such as hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) and one set of micro dimple (diameter of 300µm, depth of 70µm, and pitch of 900µm) were fabricated on metallic prosthesis heads. The experiment results reveal a significant friction coefficient reduction to the 'dimpled a-C:H/ceramic' prosthesis compared to a 'Metal (CoCr)/ceramic' prosthesis because of their improved material and surface properties and viscous effect. The post-experiment surface analysis displays that the dimpled a-C:H yielded a minor change in the surface roughness, and generated a larger sizes of wear debris (40-200nm sized, equivalent diameter), a size which could be certainly stored in the dimple, thus likely to reducing their possible third body abrasive wear rate. Thus, dimpled a:C-H can be used as a 'metal on ceramic hip joint interface', whereas the simulator can be utilized as an advanced bio-tribometer.

Articulating Biomaterials

This chapter examines the importance of surface characteristics such as microstructure, composition, crystallographic texture, and surface free energy in achieving desired biocompatibility and tribological properties thereby improving in vivo life of artificial articulating implants. Current implants often fail prematurely due to inadequate mechanical, tribological, biocompatibility, and osseointegration properties, apart from issues related to design and surgical procedures. For long-term in vivo stability, artificial implants intended for articulating joint replacement must exhibit long-term stable articulation surface without stimulating undesirable in vivo effects. Since the implant's surface plays a vital and decisive role in their response to biological environment, and vice versa, surface modification of implants assumes a significant importance. Therefore, overview on important surface modification techniques, their capabilities, properties of modified surfaces/implants are presented in the chapter. The clinical performance of surface modified implants and new surfaces for potential next-generation articulating implant applications are discussed at the end.

Novel Bone-Like Porous Glass Coatings on Al2O3 Prosthetic Substrates

Over the last two decades, the philosophy behind an optimal fixation of orthopaedic implants progressively evolved towards “bone-conservative” solutions and, accordingly, the researchers’ attention moved from simple mechanical fixation of the prosthesis to host bone by using screws or acrylic cement to new strategies based on a physico-chemical bond (surface modification) in order to minimize bone resection/loss and maximize tissue-implant integration. This research work explores the feasibility of a novel bioceramic single-piece acetabular cup for hip joint prosthesis that can be anchored to the patient’s pelvic bone by means of a bone-like trabecular coating (scaffold) able to promote implant osteointegration.

Oxygen hole states in zirconia lattices: quantitative aspects of their cathodoluminescence emission

Systematic assessments of cathodoluminescence (CL) spectroscopy, Raman spectroscopy (RS), and X-ray diffraction (XRD) are presented for pure zirconia and for a series of Y-doped zirconia powders (henceforth, simply referred to as undoped ZrO2 and YSZ powders, respectively) synthesized according to a coprecipitation method of Zr and Y chlorides. Emphasis is placed here on spectral emissions related to oxygen-vacancy sites (i.e., oxygen hole states) equally detected from undoped and Y-doped ZrO2 samples, either as intrinsic defects or, extrinsically induced, by means of cathodoluminescence. Most counterintuitively, the undoped ZrO2 sample (i.e., the one with presumably the lowest amount of oxygen vacancies) experienced the strongest CL emission. A progressive "quenching" effect on CL emission with increasing the fraction of Y(3+) dopant could also be observed because the intrinsic vacancies present in the undoped lattice are the most efficient since they can trap two electrons to gain electrical neutrality. However, as soon as Y(3+) ions are introduced in the system, those intrinsic vacancies migrate to Y-sites in next-nearest-neighbor locations, namely in a less efficient lattice location. This phenomenon is tentatively referred to as "delocalization" of vacancy sites. Moreover, the fact that Y-doped zirconia series presents quite similar CL spectra compared to the undoped zirconia could be an evidence that the radiative centers of undoped and Y-doped ZrO2 are basically the same. A fitting procedure has been made aiming to give a rational description of the variation of the spectra morphology, and a parameter able to describe the monoclinic to tetragonal phase transformation has been found. This parameter and the overall set of CL data enabled us to quantitatively assess polymorphic phase fractions by CL spectroscopy in the scanning electron microscope.

Bioceramics for Hip Joints: The Physical Chemistry Viewpoint

Which intrinsic biomaterial parameter governs and, if quantitatively monitored, could reveal to us the actual lifetime potential of advanced hip joint bearing materials? An answer to this crucial question is searched for in this paper, which identifies ceramic bearings as the most innovative biomaterials in hip arthroplasty. It is shown that, if in vivo exposures comparable to human lifetimes are actually searched for, then fundamental issues should lie in the physical chemistry aspects of biomaterial surfaces. Besides searching for improvements in the phenomenological response of biomaterials to engineering protocols, hip joint components should also be designed to satisfy precise stability requirements in the stoichiometric behavior of their surfaces when exposed to extreme chemical and micromechanical conditions. New spectroscopic protocols have enabled us to visualize surface stoichiometry at the molecular scale, which is shown to be the key for assessing bioceramics with elongated lifetimes with respect to the primitive alumina biomaterials used in the past.

Benefit of a Surface Nanocrystallization Treatment on Co28Cr6Mo Abrasive Wear Properties

In this work, the use of a nanocrystallization surface treatment is considered on a cobalt based alloy. Since the Co28Cr6Mo is widely used as an articular bearing surface for artificial joints like hip and knee prostheses, the improvement of its tribological properties is a matter of concern to extend the lifespan of implants. By means of SMA (Surface Mechanical Attrition) treatment, a nanostructured layer is formed at the surface of a CoCrMo alloy establishing an optimized hardness gradient down to a depth of a few hundred of microns. Different treatment times (5, 15 and 25 minutes) are assessed comparatively and several surface polishing methods are studied: with clothes, brushes and a liquid filled with abrasive particles. The influence of processing parameters is discussed regarding hardness and topography. Moreover, the impact of surface modification is examined in terms of wear strengthening through scratch testing. The use of increasing loads mode gives some evidence of the benefit of SMAT. A significant decrease of penetration depth is noticed, from 30% to 60% on average. A straight correlation is also noticed depending on the surface finish method. This study illustrates both the ability of micro scratch testing to assess comparatively treated surface layer and to highlight the benefit of SMAT for wear strengthening in an abrasive wear mode.

Long-term hip simulator testing of the artificial hip joint bearing surface grafted with biocompatible phospholipid polymer

To prevent periprosthetic osteolysis and subsequent aseptic loosening of artificial hip joints, we recently developed a novel acetabular highly cross-linked polyethylene (CLPE) liner with graft polymerization of 2-methacryloyloxyethyl phosphorylcholine (MPC) on its surface. We investigated the wear resistance of the poly(MPC) (PMPC)-grafted CLPE liner during 20 million cycles in a hip joint simulator. We extended the simulator test of one liner to 70 million cycles to investigate the long-term durability of the grafting. Gravimetric, surface, and wear particle analyses revealed that PMPC grafting onto the CLPE liner surface markedly decreased the production of wear particles and showed that the effect of PMPC grafting was maintained through 70 million cycles. We believe that PMPC grafting can significantly improve the wear resistance of artificial hip joints.