Cobalt-based orthopaedic alloys: Relationship between forming route, microstructure and tribological performance

Wear Rate, Tribo-Corrosion, and Plastic Deformation Values of Co-Cr-Mo Alloy in Ringer Lactate Solution

This study investigates the tribocorrosion performance of a cast Co-Cr-Mo alloy prepared using casting and electromagnetic stirring (EMS) at specific frequencies. The tribocorrosion behaviour of the alloy was evaluated when exposed to Ringer's lactate solution to optimize the EMS parameters and improve its properties. The research focuses on biomedical implant applications and explores how EMS affects alloy wear and corrosion resistance. As did the friction coefficient and wear volume, the wear rate of samples produced with EMS frequencies of 75 Hz and 150 Hz decreased. These improvements are attributed to the ability of EMS to refine grain size and homogenize the microstructure, thereby increasing the resistance to tribocorrosion. Techniques such as scanning electron microscopy (SEM) and profilometry were used for surface and wear analysis, while mechanical properties were evaluated through instrumented indentation tests. The findings confirm that EMS improves the alloy's durability and tribocorrosion resistance, making it highly suitable for demanding biomedical applications such as joint replacements. This highlights the importance of advanced manufacturing techniques in optimizing biomedical alloys for simulated body conditions.

Spectroscopic imaging to assess biochemical alterations in liver carcinoma cells exposed to transition metals

Despite the invaluable role of transition metals in every living organism, it should be remembered that failure to maintain the proper balance and exceed the appropriate dose may have the opposite effect. In the era of such a popular and propagated need for supplementation in the media, one should bear in mind the harmful effects that may become the result of improper and excessive intake of transition metals. This article establishes the feasibility of Raman (RS) and Fourier-transform infrared (FT-IR) spectroscopic imaging at the single-cell level to investigate the cellular response to various transition metals. These two non-destructive and perfectly complementary methods allow for in-depth monitoring of changes taking place within the cell under the influence of the agent used. HepG2 liver carcinoma cells were exposed to chromium, iron, cobalt, molybdenum, and nickel at 1 and 2 mM concentrations. Spectroscopic results were further supported by biological evaluation of selected caspases concentration. The caspase- 3, 6, 8, 9, and 12 concentrations were determined with the use of the enzyme-linked immunosorbent assay (ELISA) method. This study shows the induction of apoptosis in the intrinsic pathway by all studied transition metals. Cellular metabolism alterations are induced by mitochondrial metabolism changes and endoplasmic reticulum (ER) metabolism variations. Moreover, nickel induces not only the intrinsic pathway of apoptosis but also the extrinsic pathway of this process.

Metal debris release is commonly seen from explanted total ankle replacements

This study aimed to characterise the damage mechanisms present on the metal components used in various contemporary total ankle replacements. Twenty-seven explanted total ankle replacements comprising 8 different designs (3 fixed bearing and 5 mobile bearing) were analysed using various explant analysis techniques. Pitting and scratching were the most commonly observed wear features. Microscopic analysis revealed metallic pitting on 52% of tibial components and 95% of talar components. Pitting was identified on more cobalt-chromium than titanium alloy tibial components (63% versus 0%). Non-contact profilometry confirmed the presence of pitting, with significant (p < 0.05) differences in the measured average surface roughness values of pitted and unpitted areas for tibial and talar components. There was macroscopically visible sliding plane scratching, indicating the presence of hard third body particles, on 78% of talar components. Changes to the non-articulating surfaces coatings in terms of coating loss and/or changes in reflectivity was identified visually on 80% of metal components. Scanning electron microscopy with energy dispersive X-ray spectroscopy identified metallic embedded debris in 19% of polyethylene inserts. This explant study demonstrates the release of metal debris from both the metallic tibial and talar component articulating surfaces and non-articulating surface coatings of various contemporary total ankle replacements. Metal particulate debris release from total ankle replacements may be more common than previously recognised. Metal debris should be considered in further study into the aetiology of failed total ankle arthroplasty.

Scratch and Wear Behaviour of Co-Cr-Mo Alloy in Ringer's Lactate Solution

Cobalt-chromium-molybdenum (Co-Cr-Mo) alloy is a material recommended for biomedical implants; however, to be suitable for this application, it should have good tribological properties, which are related to grain size. This paper investigates the tribological behaviour of a Co-Cr-Mo alloy produced using investment casting, together with electromagnetic stirring, to reduce its grain size. The samples were subjected to wear and scratch tests in simulated body fluid (Ringer's lactate solution). Since a reduction in grain size can influence the behaviour of the material, in terms of resistance and tribological response, four samples with different grain sizes were produced for use in our investigation of the behaviour of the alloy, in which we considered the friction coefficient, wear, and scratch resistance. The experiments were performed using a tribometer, with mean values for the friction coefficient, normal load, and tangential force acquired and recorded by the software. Spheres of Ti-6Al-4V and 316L steel were used as counterface materials. In addition, to elucidate the influence of grain size on the mechanical properties of the alloy, observations were conducted via scanning electron microscopy (SEM) with electron backscatter diffraction (EBSD). The results showed changes in the structure, with a reduction in grain size from 5.51 to 0.79 mm. Using both spheres, the best results for the friction coefficient and wear volume corresponded to the sample with the smallest grain size of 0.79 mm. The friction coefficients obtained were 0.37 and 0.45, using the Ti-6Al-4V and 316L spheres, respectively. These results confirm that the best surface finish for Co-Cr-Mo alloy used as a biomedical implant is one with a smaller grain size, since this results in a lower friction coefficient and low wear.

Surface integrity modification of CoCrMo alloy by deep rolling in combination with sub-zero cooling as potential implant application

Alloys made of CoCrMo are well established as implants materials since decades in orthopedic surgery. The good mechanical properties, biocompatibility and especially the corrosion resistance are important rationales for the use of these alloys. Nevertheless, retrieved implants from revision surgery showed the occurrence of abrasion and corrosion. The wear mechanisms and the occurring corrosion processes might be reduced with a functionalization of the surface. The hexagonal phase of the cobalt chromium matrix plays an important role in the surface functionalization. It can be specifically transformed and set during the manufacturing process. One possibility for the induction of the transformation is the use of a deep rolling process in combination with a novel "sub-zero" cooling strategy during machining. The influence of force and temperature during the deep rolling process on the formation of the hexagonal Co-phase is examined in this study. The results from the targeted setting of the hexagonal Co-phase in the subsurface are shown. For this purpose, EBSD studies have been carried out to detect and quantify the proportion of Co-hex phase in the subsurface of the modified alloys. To analyze the mechanical properties, we measured the residual stress and hardness in the near surface layer under conditions close to the application. Furthermore, we performed biological tests to show a potential influence of the modification on the biocompatibility when using the sub-zero cooling approach. We observed no negative effect on the osteoblastic cell line which attached similarly to all tested surfaces. The investigations provide first insights into the potential use of "sub-zero" cooling in modifying orthopedic implant materials, but also the respective limits with regard to the surface functionalization. Deep rolling in combination with an innovative cooling strategy has a great potential to improve the mechanical properties of CoCr28Mo6 wrought alloy, by subsurface hardening and phase transformation.

The effect of metal rate on the gamma shielding parameters of hydroxyapatite at medical treatment energies

The hydroxyapatite (HAp) is a kind of biomaterial which is used for bone treatment applications. We have scrutinized the gamma attenuation parameters such as such as the effective atomic number (Zeff), electron density (Nel), mass attenuation coefficient (MAC), linear attenuation coefficient (LAC), half value layer (HVL), tenth value layer (TVL) and mean free path (MFP) for only single liquid gamma source and a narrow beam geometry for the energy (medical treatment energy) ranging from 778 keV to 1408 keV (Eu-152) for the animal bone, iron, cobalt, copper, and zinc decorated Nano hydroxyapatite (nFeHAp, nCoHAp, nCuHAp, and nZnHAp) artificial bone powders. The gamma-rays were counted with using Ultra Low Energy Germanium detection system with a resolution 150 eV at 5,95 keV and a high purity germanium detector with a resolution of 1.85 keV at 1.33 MeV experimentally. The gamma ray attenuation parameters are calculated for the metal doped hydroxyapatite and compare with the animal bone. The results were compared with the output XCOM NIST data. While the mass absorption coefficient values for animal bone range from 0.08 to 0.05 at current energy levels, the values for metal-added artificial bone powders range from 0.07 to 0.05. While the linear absorption coefficient values for existing energy values for animal bone range from 0.04 to 0.02, they range from 0.03 to 0.02 for metal-added artificial bone powders. Mean free path values for real bone range from 24 to 36 at current energies, while half value layer values range from 16 to 25 and tenth value layer values range from 56 to 83. For metal-doped artificial bone powders, these parameters range from 26 to 35, 18 to 24, and 61 to 80, respectively. The results points that, the data of the gamma ray attenuation parameters are very close to the value of the animal bone due to the removal of calcium atoms from the structure when metal is added.

Amorphous Carbon Coatings for Total Knee Replacements-Part I: Deposition, Cytocompatibility, Chemical and Mechanical Properties

Diamond-like carbon (DLC) coatings have the potential to reduce implant wear and thus to contribute to avoiding premature failure and increase service life of total knee replacements (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While a detailed characterization of the tribological behavior is the subject of part II, part I focusses on the deposition of pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coatings (a-C:H:W) and the detailed characterization of their chemical, cytological, mechanical and adhesion behavior. The coatings are fabricated by physical vapor deposition (PVD) and display typical DLC morphology and composition, as verified by focused ion beam scanning electron microscopy and Raman spectroscopy. Their roughness is higher than that of the plain substrates. Initial screening with contact angle and surface tension as well as in vitro testing by indirect and direct application indicate favorable cytocompatibility. The DLC coatings feature excellent mechanical properties with a substantial enhancement of indentation hardness and elastic modulus ratios. The adhesion of the coatings as determined in modified scratch tests can be considered as sufficient for the use in TKAs.

Comparison of microstructures and mechanical properties of 3 cobalt-chromium alloys fabricated with soft metal milling technology

STATEMENT OF PROBLEM

Although several manufacturers market soft metal milling blanks and systems, comprehensive comparative studies of differences in properties across commercially available soft metal milling alloys are lacking.

PURPOSE

The purpose of this in vitro study was to compare the microstructures and mechanical properties of 3 soft metal milling cobalt-chromium (Co-Cr) alloys (Ceramill Sintron, Soft Metal, and Sintermetall).

MATERIAL AND METHODS

Disk-shaped specimens (for surface characterization and hardness test) and dumbbell-shaped specimens (for tensile test as per International Organization for Standardization (ISO) 22674) were prepared by following each soft metal milling manufacturer's instructions. The crystal structures and microstructures of the 3 alloys were evaluated with optical microscopy, X-ray diffractometry (XRD), and scanning electron microscopy with electron backscattered diffraction (EBSD). The mechanical properties were investigated with a tensile test and Vickers hardness test (n=6). The results of the mechanical (tensile and hardness) tests were analyzed with 1-way ANOVA and the post hoc Tukey multiple comparison test (α=.05).

RESULTS

The Sintermetall specimen showed a finer microstructure and more porosity than the other 2 alloys. The XRD and EBSD analyses showed that the γ (face-centered cubic, fcc) matrix phase was predominant in the Ceramill Sintron alloy and the ε (hexagonal close-packed, hcp) matrix phase was predominant in the Soft Metal alloy. The Sintermetall alloy showed a slightly higher amount of ε phase than γ phase, with more chromium carbide formation than the other 2 alloys. The Ceramill Sintron alloy showed a significantly higher tensile strength than the other 2 alloys (P<.05), but a significantly lower 2% offset yield strength than the other 2 alloys (P<.05). The highest elongation was found in the Ceramill Sintron alloy, followed by the Sintermetall and Soft Metal alloys. The elastic modulus was the highest in the Sintermetall alloy, followed by the Soft Metal and Ceramill Sintron alloys. No significant differences in Vickers hardness values were detected among the 3 alloys (P=.263).

CONCLUSIONS

The different commercially available soft metal milling blanks and systems produced dissimilar alloys in terms of crystal structures and microstructures and, as a result, different mechanical properties.

Are precontoured cobalt-chromium spinal rods mechanically superior to manually contoured rods?

STUDY DESIGN

Laboratory based study.

OBJECTIVE

To compare reduction force and plastic deformation of cobalt-chromium (Co-Cr) spinal rods using a rigid, thoracolumbar spinal deformity model. Pre-contoured spinal rods are growing in their utilization for spinal deformity. Although there are theoretical advantages to pre-contouring rods, no previous studies have compared pre-contoured and manually contoured rods for their ability to maintain sagittal contour and resist mechanical load.

METHODS

A spinal deformity model was utilized, simulating a rigid, thoracolumbar spinal deformity fixated with pedicle screws. Roll-formed pre-contoured and manually contoured 5.5 mm and 6.0 mm Co-Cr rods were reduced to the model with a load cell attached to the apical screw to measure corrective force. Rods remained reduced in the model for 20 min and change in contour was assessed to characterize plastic deformation.

RESULTS

Twenty-four rods were tested with six rods per group (Table 1). The load to reduction was significantly lower in the 5.5 mm rods compared to the 6.0 mm rods (95% CI -254.0 to -61.42; p = 0.008). Although there was no difference in the corrective forces for manual and pre-contoured 5.5 mm rods (p = 0.722), the 6.0 mm rod produced significantly less corrective force compared to the manually contoured 6.0 mm rods (95% CI -134.42 to -5.317; p = 0.039). Additionally, rod contour for the manual group showed significantly less plastic deformation than the pre-contoured group in both 5.5 mm and 6.0 mm rods (5.5 mm: 57.1% vs. 61.6%, p = 0.006; 6.0 mm: 54.3% vs. 62.28%, p = 0.003).

CONCLUSIONS

Roll formed, pre-contoured Co-Cr rods demonstrated significantly greater plastic deformation when compared with manually contoured rods of the same diameter. Furthermore, 6.0 mm pre-contoured rods required significantly lower load for rod reduction, the equivalent of 15 lb-force. Post-manufacturing, roll-formed pre-contouring of larger diameter Co-Cr may impair the rods mechanical properties.

Plasma-immersion ion implantation surface oxidation on a cobalt-chromium alloy for biomedical applications

Co-Cr alloys such as L605 are widely applied for the manufacture of medical devices, including tiny cardiovascular stents. The presence of potentially toxic and allergenic release of Ni, Co, and Cr ions from these devices remains an unsolved concern. Surface modification by oxygen plasma immersion implantation (PIII) could be an excellent technique to create a dense and thin passive oxide layer on a relatively complex shape of a tiny device, such as a stent, thus reducing the potential release of metallic ions. The effect of oxygen PIII was investigated on L605 alloy specimens, from 5 to 50 mTorr gas pressures, and under pulsed bias voltages from -0.1 to -10 kV. The surface chemistry was investigated by x-ray photoelectron spectroscopy, while its morphology and surface energy were evaluated, respectively, by atomic force microscopy and scanning electron microscopy and by a sessile drop static contact angle. Electrochemical characterization was performed by potentiodynamic tests in the saline solution. Mechanical properties of the modified surface layer, specifically film adhesion and hardness (H), were assessed by scratch and nanoindentation tests. Results shown that the oxidized layers were composed of a mixture of Co and Cr oxides and hydroxides and were rich in Co. The corrosion rate was considerably reduced after O PIII, even for treatments using low bias voltage (-0.1 kV) and with consequent low oxygen implantation depth. Moreover, O PIII also improved surface hardness. The oxidized layers were found to have good adhesion and to be scratch resistant.

Spark Plasma Sintering of Cobalt Powders in Conjunction with High Energy Mechanical Treatment and Nanomodification

Spark plasma sintering (SPS) investigations were carried out on three sets of Co specimens: untreated, high energy mechanically (HEMT) pre-treated, and nanomodified powders. The microstructure, density, and mechanical properties of sintered pellets were investigated as a function of various pre-treatments and sintering temperatures (700–1000 °C). Fine-grained sinters were obtained for pre-treated Co powders; nano-additives tended to inhibit grain growth by reinforcing particles at grain boundaries and limiting grain-boundary movement. High degree of compaction was also achieved with relative densities of sintered Co pellets ranging between 95.2% and 99.6%. A direct co-relation was observed between the mechanical properties and densities of sintered Co pellets. For a comparable sinter quality, sintering temperatures for pre-treated powders were lower by 100 °C as compared to untreated powders. Highest values of bending strength (1997 MPa), microhardness (305 MPa), and relative density (99.6%) were observed for nanomodified HEMT and SPS processed Co pellets, sintered at 700 °C.

Effect of Different Post-Sintering Temperatures on the Microstructures and Mechanical Properties of a Pre-Sintered Co–Cr Alloy

Although a cobalt–chromium (Co–Cr) blank in a pre-sintered state has been developed, there are few data on the optimal temperature for the alloy in terms of the desired mechanical properties. A metal block (Soft Metal, LHK, Chilgok, Korea) was milled to produce either disc-shaped or dumbbell-shaped specimens. All the milled specimens were post-sintered in a furnace at 1250, 1350 or 1450 °C. The microstructures, shrinkage and density of the three different alloys were investigated using the disc-shaped specimens. The mechanical properties were investigated with a tensile test according to ISO 22674 (n = 6). The number and size of the pores in the alloys decreased with increased temperature. The shrinkage and density of the alloys increased with temperature. In the 1250 °C alloy, the formation of the ε (hexagonal close-packed) phase was more predominant than that of the γ (face-centered cubic) phase. The 1350 °C and 1450 °C alloys showed γ phase formation more predominantly. Carbide formation was increased along with temperature. The 1450 °C group showed the largest grain size among the three groups. In general, the 1350 °C group exhibited mechanical properties superior to the 1250 °C and 1450 °C groups. These findings suggest that 1350 °C was the most optimal post-sintering temperature for the pre-sintered blank.

Biocompatibility evaluation and corrosion resistance of tungsten added Co-30Cr-4Mo-1Ni alloy

Biomaterials are continuously being developed to overcome the drawbacks of existing materials and provide improved function in artificial organs. Currently Co-Cr based alloys are used in many medical applications such as hip and knee implants which still require modification to better perform. In this article, therefore, the influence of tungsten allying element on electrochemical corrosion resistance and biocompatibility behaviour of a recently developed Co-30Cr-4Mo-1Ni alloy composition were investigated. The tungsten modified alloys were prepared by using a high temperature vertical vacuum casting technique at five different weight percentages (0-4wt.% tungsten). The electrochemical corrosion behaviour of all the samples under NaCl solution was studied by using potentiodynamic scan method. The corrosion characteristics were investigated in terms of corrosion potential (Ecorr) and corrosion current density (Icorr). From the results of the analysis, it was observed that out of all samples, an alloy with 2wt.% of tungsten in composition (i.e. Co-30Cr-4Mo-1Ni-2W) exhibited better corrosion resistance. Furthermore, histopathological evaluations in subcutaneous tissue were performed in rats according to the standard ISO 10993 to examine the biocompatibility of the prepared samples. The results showed no evidence of inflammatory cell migration, no epidermal necrosis, no vacuolar degeneration of basal cell, no adnexal atrophy and vesicle formation of any samples. The obtained findings indicate that Co-30Cr-4Mo-1Ni-2W can be used in biomedical applications including femoral component of hip and knee implants.

Biological Impact of Silicon Nitride for Orthopaedic Applications: Role of Particle Size, Surface Composition and Donor Variation

The adverse biological impact of orthopaedic wear debris currently limits the long-term safety of human joint replacement devices. We investigated the role of particle size, surface composition and donor variation in influencing the biological impact of silicon nitride as a bioceramic for orthopaedic applications. Silicon nitride particles were compared to the other commonly used orthopaedic biomaterials (e.g. cobalt-chromium and Ti-6Al-4V alloys). A novel biological evaluation platform was developed to simultaneously evaluate cytotoxicity, inflammatory cytokine release, oxidative stress, and genotoxicity potential of particles using peripheral blood mononuclear cells (PBMNCs) from individual human donors. Irrespective of the particle size, silicon nitride did not cause any adverse responses whereas cobalt-chromium wear particles caused donor-dependent cytotoxicity, TNF-α cytokine release, oxidative stress, and DNA damage in PBMNCs after 24 h. Despite being similar in size and morphology, silicon dioxide nanoparticles caused the release of significantly higher levels of TNF-α compared to silicon nitride nanoparticles, suggesting that surface composition influences the inflammatory response in PBMNCs. Ti-6Al-4V wear particles also released significantly elevated levels of TNF-α cytokine in one of the donors. This study demonstrated that silicon nitride is an attractive orthopaedic biomaterial due to its minimal biological impact on human PBMNCs.

Microstructure and Surface Damage in Retrieved Metal-on-Metal Hip Arthroplasties

BACKGROUND

Besides promising results of metal-on-metal (MOM) hip arthroplasty (HA), frequent failures have been reported even in the short term. Many host, surgical, design, metallurgical, and processing factors have been evoked in the base of these events. We have tried to characterize and to evaluate metallurgical and processing features present in this type of implants.

METHODS

The acetabular and femoral components of 20 MOM HAs collected from a multicenter retrieval program were examined. All the specimens were inspected with naked eye, with confocal microscopy and vertical scanning interferometry, scanning electron microscopy, back-scattered electron imaging, and energy-dispersive X-ray spectroscopy, in 25 zones of each articular component.

RESULTS

Gas pores, shrinkage voids and holes of detached carbides, carbides on surface, embedded particles, scratches and marks of wear, surface discoloration, surface deposits, and tribochemical reaction layers were widely dispersed through a substantial percentage of the total bearing surface in all the implanted components. Surface cup and head voids, and cup scratches showed significant correlation with the clearance of pair. A higher surface damage of the cup and head was observed mainly in the low clearance prostheses. There was no other significant correlation or difference in the incidence and importance of any of these defects between resurfacing hip arthroplasties and total hip arthroplasties, or according to the pair diameter.

CONCLUSION

Some metallurgical features and surface damage were significantly present in the retrieved implants of MoM HAs. It would be desirable to improve the structure and metallurgical characteristics of these implants to avoid those effects and optimize their performance.

Corrosion and surface modification on biocompatible metals: A review

Corrosion prevention in biomaterials has become crucial particularly to overcome inflammation and allergic reactions caused by the biomaterials' implants towards the human body. When these metal implants contacted with fluidic environments such as bloodstream and tissue of the body, most of them became mutually highly antagonistic and subsequently promotes corrosion. Biocompatible implants are typically made up of metallic, ceramic, composite and polymers. The present paper specifically focuses on biocompatible metals which favorably used as implants such as 316L stainless steel, cobalt-chromium-molybdenum, pure titanium and titanium-based alloys. This article also takes a close look at the effect of corrosion towards the implant and human body and the mechanism to improve it. Due to this corrosion delinquent, several surface modification techniques have been used to improve the corrosion behavior of biocompatible metals such as deposition of the coating, development of passivation oxide layer and ion beam surface modification. Apart from that, surface texturing methods such as plasma spraying, chemical etching, blasting, electropolishing, and laser treatment which used to improve corrosion behavior are also discussed in detail. Introduction of surface modifications to biocompatible metals is considered as a "best solution" so far to enhanced corrosion resistance performance; besides achieving superior biocompatibility and promoting osseointegration of biocompatible metals and alloys.

Microstructure, mechanical property and metal release of As-SLM CoCrW alloy under different solution treatment conditions

In the study, the microstructure, mechanical property and metal release behavior of selective laser melted CoCrW alloys under different solution treatment conditions were systemically investigated to assess their potential use in orthopedic implants. The effects of the solution treatment on the microstructure, mechanical properties and metal release were systematically studied by OM, SEM, XRD, tensile test, and ICP-AES, respectively. The XRD indicated that during the solution treatment the alloy underwent the transformation of γ-fcc to ε-hcp phase; the ε-hcp phase nearly dominated in the alloy when treated at 1200°C following the water quenching; the results from OM, SEM showed that the microstructural change was occurred under different solution treatments; solution at 1150°C with furnace cooling contributed to the formation of larger precipitates at the grain boundary regions, while the size and number of the precipitates was decreased as heated above 1100°C with the water quenching; moreover, the diamond-like structure was invisible at higher solution temperature over 1150°C following water quenching; compared with the furnace cooling, the alloy quenched by water showed excellent mechanical properties and low amount of metal release; as the alloy heated at 1200°C, the mechanical properties of the alloy reached their optimum combination at UTS=1113.6MPa, 0.2%YS=639.5MPa, and E%=20.1%, whilst showed the lower total quantity of metal release. It is suggested that a proper solution treatment is an efficient strategy for improving the mechanical properties and corrosion resistance of As-SLM CoCrW alloy that show acceptable tensile ductility.

In vitro wear testing of a contemporary design of reverse shoulder prosthesis

Reverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion-extension and abduction-adduction axes and up to 90° in the internal-external rotation axis. Dynamic loading of up to 1500 N can be provided. The simulator is computer controlled so that the motions and loading associated with particular activities of daily living can be applied. A 4.5 million cycle wear test of commercially available reverse shoulder prostheses was undertaken using a 'mug to mouth' activity of daily living. Gravimetric analysis was used to characterise wear. After 4.5 million cycles of 'mug to mouth', the average wear rate of the test components was 14.3mm(3)/million cycles. Polyethylene test components showed a reduction in roughness and the median wear particle diameter was 167 nm. A three axis shoulder simulator has been designed and used to successfully test multiple samples of a commercially available reverse shoulder prosthesis.

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.