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Glowka K, Zubko M, Świec P, Prusik K, Szklarska M, Stróż D. Influence of Zirconium on the Microstructure, Selected Mechanical Properties, and Corrosion Resistance of Ti 20Ta 20Nb 20(HfMo) 20-xZr x High-Entropy Alloys. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2730. [PMID: 38893994 PMCID: PMC11173417 DOI: 10.3390/ma17112730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
The presented work considers the influence of the hafnium and molybdenum to zirconium ratio of Ti20Ta20Nb20(HfMo)20-xZrx (where x = 0, 5, 10, 15, 20 at.%) high-entropy alloys in an as-cast state for potential biomedical applications. The current research continues with our previous results of hafnium's and molybdenum's influence on a similar chemical composition. In the presented study, the microstructure, selected mechanical properties, and corrosion resistance were investigated. The phase formation thermodynamical calculations were also applied to predict solid solution formation after solidification. The calculations predicted the presence of multi-phase, body-centred cubic phases, confirmed using X-ray diffraction and scanning electron microscopy. The chemical composition analysis showed the segregation of alloying elements. Microhardness measurements revealed a decrease in microhardness with increased zirconium content in the studied alloys. The corrosion resistance was determined in Ringer's solution to be higher than that of commercially applied biomaterials. The comparison of the obtained results with previously reported data is also presented and discussed in the presented study.
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Affiliation(s)
- Karsten Glowka
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
| | - Maciej Zubko
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
- Faculty of Science, Department of Physics, University of Hradec Králové, Rokitanského 62, 500 03 Hradec Králové, Czech Republic
| | - Paweł Świec
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
| | - Krystian Prusik
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
| | - Magdalena Szklarska
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
| | - Danuta Stróż
- Institute of Materials Engineering, University of Silesia in Katowice, 75 Pułku Piechoty 1A St., 41-500 Chorzów, Poland; (K.G.); (P.Ś.); (K.P.); (M.S.); (D.S.)
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Spece H, Ouellette ES, Klein GR, Mont MA, Kurtz SM. Are Corrosion and Material Loss a Threat for Titanium-Titanium Tapers in Total Hip Arthroplasty Modular Acetabular Components? J Arthroplasty 2024; 39:1602-1608. [PMID: 38070717 DOI: 10.1016/j.arth.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/09/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Extensive research has reported on fretting corrosion and material loss for a variety of metal taper interfaces in orthopedic devices. For modular acetabular shell-liner constructs, the interfaces studied thus far have consisted of mixed-metal pairings, and the risk of fretting corrosion and material loss for the all-titanium (Ti) shell-liner taper junction in one ceramic-on-ceramic (COC) design remains poorly understood. We asked: do Ti shell-liner taper interfaces in COC total hip arthroplasty devices show in vivo evidence of (1) fretting and/or corrosion, and (2) quantifiable potential material loss? METHODS We examined 22 shell-liner pairs and 22 single liners from retrieved COC components. The taper interface surfaces were assessed for fretting corrosion using a semiquantitative scoring method and imaged with scanning electron microscopy. A subcohort of components was measured with a coordinate measuring machine, and volumetric material loss and maximum wear depth were calculated. RESULTS Fretting corrosion at the taper interfaces was minimal to mild for 95% of liners and 100% of shells. Imaging revealed fretting marks within a band of corrosion on some implants and evidence of corrosion not in the proximity of mechanical damage. Estimated material loss ranged from 0.2 to 1.3 mm3 for liners, and 0.5 to 1.1 mm3 for shells. Maximum wear depth for all components was 0.03 mm or less. CONCLUSIONS Our results indicate that, compared to other taper junctions in total joint arthroplasty, the risk of corrosion and material loss may be minimal for Ti shell-liner interfaces.
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Affiliation(s)
- Hannah Spece
- Implant Research Core, School of Biomedical Science, Engineering, and Health Systems, Drexel University, Philadelphia, Pennsylvania
| | | | - Gregg R Klein
- Department of Orthopaedic Surgery, Hackensack University Medical Center, Hackensack, New Jersey
| | - Michael A Mont
- Department of Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Steven M Kurtz
- Implant Research Core, School of Biomedical Science, Engineering, and Health Systems, Drexel University, Philadelphia, Pennsylvania
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Arioli M, Puiggalí J, Franco L. Nylons with Applications in Energy Generators, 3D Printing and Biomedicine. Molecules 2024; 29:2443. [PMID: 38893319 PMCID: PMC11173604 DOI: 10.3390/molecules29112443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Linear polyamides, known as nylons, are a class of synthetic polymers with a wide range of applications due to their outstanding properties, such as chemical and thermal resistance or mechanical strength. These polymers have been used in various fields: from common and domestic applications, such as socks and fishing nets, to industrial gears or water purification membranes. By their durability, flexibility and wear resistance, nylons are now being used in addictive manufacturing technology as a good material choice to produce sophisticated devices with precise and complex geometric shapes. Furthermore, the emergence of triboelectric nanogenerators and the development of biomaterials have highlighted the versatility and utility of these materials. Due to their ability to enhance triboelectric performance and the range of applications, nylons show a potential use as tribo-positive materials. Because of the easy control of their shape, they can be subsequently integrated into nanogenerators. The use of nylons has also extended into the field of biomaterials, where their biocompatibility, mechanical strength and versatility have paved the way for groundbreaking advances in medical devices as dental implants, catheters and non-absorbable surgical sutures. By means of 3D bioprinting, nylons have been used to develop scaffolds, joint implants and drug carriers with tailored properties for various biomedical applications. The present paper aims to collect evidence of these recently specific applications of nylons by reviewing the literature produced in recent decades, with a special focus on the newer technologies in the field of energy harvesting and biomedicine.
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Affiliation(s)
- Matteo Arioli
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
| | - Jordi Puiggalí
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
- Barcelona Research Center in Multiscale Science and Engineering, Universitat Politècnica de Catalunya, Campus Diagonal-Besòs, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain
| | - Lourdes Franco
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
- Barcelona Research Center in Multiscale Science and Engineering, Universitat Politècnica de Catalunya, Campus Diagonal-Besòs, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain
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Solou K, Panagopoulos A, Tatani I, Megas P. Fracture of femoral neck in modular total hip arthroplasty: a systematic review of the literature. Hip Int 2024; 34:409-420. [PMID: 37932248 DOI: 10.1177/11207000231211253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
BACKGROUND Modular femoral stems have the advantage of anatomic hip reconstruction by restoring the femoral offset thus minimising the bearing surface wear, implant loosening and dislocation. AIM This study aims to investigate the existing literature on modular neck fractures, to identify predisposing factors and guide the decision-making process in the management of these difficult cases. METHODS A systematic literature review was conducted until July 2022. PRISMA guidelines were followed, eligibility criteria were set, and methodology assessment of included studies was conducted based on MINORS criteria, size and primary outcome. Data were extracted and analysed thoroughly. RESULTS 5657 studies were initially screened; the full texts of 124 records were assessed and finally, 32 reports were included. There were 7 clinical studies and 25 case reports. A total of 4825 patients (5204 hips) with a mean age 62.38 years and a mean BMI 29.06 kg/m2 were analysed in the 7 clinical studies. The reported overall weighted revision rate was 0.86%, while the weighted mean modular neck fracture rate was 0.26%. The usual history was sudden experience of hip pain and instability. The average time interval to neck fracture was 4.57 (range 3-4.7) years and a long modular neck was identified in 91.17% of them. Data from case reports showed a mean age and average BMI of 55.85 and 31.63 kg/m2. 82.35% of the patients were male. Necks were fractured after an average time interval of 64.5 ± 8.8 months. CONCLUSIONS The incidence of modular neck fracture is significant. The profile of a male, obese patient with a long modular neck increased risk of neck fracture. Microstructural investigation of the retrieved implants demonstrated a higher incidence of fracture line in the base of the neck junction and at its anterolateral distal part. Surgeons should be aware of this complication while using or revising such protheses.
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Affiliation(s)
| | - Andreas Panagopoulos
- Faculty of Medicine, Patras University, Patra, Greece
- Orthopaedic Department, Patras General University Hospital, Patras, Greece
| | - Irini Tatani
- Faculty of Medicine, Patras University, Patra, Greece
- Orthopaedic Department, Patras General University Hospital, Patras, Greece
| | - Panagiotis Megas
- Faculty of Medicine, Patras University, Patra, Greece
- Orthopaedic Department, Patras General University Hospital, Patras, Greece
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Scott DF, Eppich K, Mehić E, Gray C, Smith CL, Johnston M. 15-year survivorship of a unique dual-modular femoral stem in primary hip arthroplasty. BMC Musculoskelet Disord 2024; 25:312. [PMID: 38649874 PMCID: PMC11036691 DOI: 10.1186/s12891-024-07422-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/06/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Hip offset, version, and length are interdependent femoral variables which determine stability and leg length. Balancing these competing variables remains a core challenge in hip arthroplasty. The potential benefits of modular femoral stems have been overshadowed by higher rates of failure. The objective of this study was to assess the survivorship of a unique dual-modular femoral stem at an average 15-year follow-up period. METHODS The records of all patients with osteoarthritis who underwent primary total hip arthroplasty with this device between 2004-2009 were reviewed. There were no exclusions for BMI or other factors. We examined the data with Kaplan-Meier survival analysis. The primary endpoint for survival was mechanical failure of the modular neck-body junction. RESULTS The survivorship of this device in 172 subjects was 100% with none experiencing mechanical failure of the modular junction at an average of 15 years. 60 patients died of causes unrelated to their THA and 9 patients were lost to follow-up. There were three early (≤ 12 months) dislocations (1.7%), and seven total dislocations (4.1%). 16 patients underwent reoperations during the follow-up period, none for any complication of the modular junction. Radiographic results showed well-fixed femoral stems in all cases. There were no leg length discrepancies of greater than 10 mm, and 85% were within 5 mm. CONCLUSION There were no mechanical failures of the modular junction in any of the subjects over the average 15-year period, demonstrating that this dual-modular design is not associated with increased failure rates. We achieved a 1.7% early dislocation rate and a 4.1% total dislocation rate without any clinically significant leg length discrepancies.
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Affiliation(s)
- David F Scott
- Elson S. Floyd College of Medicine at Washington State University, 412 E Spokane Falls, Blvd, Spokane, WA, 99202, USA
- Spokane Joint Replacement Center, Inc., Spokane, WA, USA
| | - Kade Eppich
- Elson S. Floyd College of Medicine at Washington State University, 412 E Spokane Falls, Blvd, Spokane, WA, 99202, USA
| | - Edin Mehić
- University of Washington, School of Medicine, Seattle, WA, USA
| | - Celeste Gray
- Spokane Joint Replacement Center, Inc., Spokane, WA, USA
| | - Crystal Lederhos Smith
- Elson S. Floyd College of Medicine at Washington State University, 412 E Spokane Falls, Blvd, Spokane, WA, 99202, USA
| | - Michael Johnston
- Elson S. Floyd College of Medicine at Washington State University, 412 E Spokane Falls, Blvd, Spokane, WA, 99202, USA.
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López RE, Pelayo de Tomás JM, Morales Suárez Varela M, Rodrigo Pérez JL. Comparison of chromium and cobalt serum levels between a modular neck stem and its monoblock counterpart in primary total hip arthroplasty. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:3403-3409. [PMID: 37140672 DOI: 10.1007/s00590-023-03567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/27/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND The addition of junctions in modular stems implies a greater susceptibility to corrosion. PURPOSE The aim of this study is to compare serum chromium and cobalt levels after using a bimodular stem and its monoblock counterpart in primary total hip arthroplasty. Postoperative clinical scores were also compared. PATIENTS AND METHODS A prospective cohort study between 2012 and 2015 was designed. One arm of the cohort included patients with the cementless modular neck stem H-Max M® and the other with the cementless monoblock stem counterpart H-Max S®. RESULTS No statistically significant difference was found in chromium value between groups (p = 0.621) at two years postoperative. Cobalt value was higher in the modular group (p = < 0.001). No statistically significant difference was found in clinical postoperative scores except for the Harris Hip Score, with better results at six months in modular group (p = 0.007). CONCLUSIONS Higher serum cobalt level in the modular group has limited the use of modular stems in our daily practice. Advantages of modular stem were not found. LEVEL OF EVIDENCE II.
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Affiliation(s)
- R E López
- Doctor Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain.
| | - J M Pelayo de Tomás
- Doctor Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain
- School of Medicine, Valencia University, Av. Blasco Ibañez, 15, 46010, Valencia, Spain
| | - M Morales Suárez Varela
- Unit of Public Health, Hygiene and Enviromental Health, Departament of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, Av. Vicente Andrés Estellés, Burjassot, Valencia, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte De Lemos 3-5, Pavillon 11, Floor 0, 28029, Madrid, Spain
| | - J L Rodrigo Pérez
- Doctor Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain
- School of Medicine, Valencia University, Av. Blasco Ibañez, 15, 46010, Valencia, Spain
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Trunnions and Modularity in Total Hip Arthroplasty: A Historical Review With Current Clinical Implications. J Am Acad Orthop Surg 2023; 31:189-197. [PMID: 36728328 DOI: 10.5435/jaaos-d-22-00498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/27/2022] [Indexed: 02/03/2023] Open
Abstract
Trunnion in total hip arthroplasty refers to the interface between the neck of a femoral stem and the femoral head. Clinical complications arising from damage to this junction, whether it be due to mechanical wear, corrosion, or a combination, are referred to as mechanically assisted crevice corrosion (MACC), also commonly known as trunnionosis. With the use of modular hip prostheses, which help customize offset and leg length to an individual patient's anatomy, the incidence of MACC and revision due to MACC has increased in recent years. Although the cause of MACC is multifactorial, with patient factors and technique factors contributing to this condition, taper design and geometry, metallurgical properties of implants, and size mismatch of the bearing couple are some of the implant factors that have also been implicated in this clinical phenomenon. Understanding the history of taper design and geometry, the track record of older implants, and the rationale behind the development of current prostheses can help surgeons choose the right implants for their patients and accurately assess the pros and cons of new implants being introduced to the market each year.
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Drobniewski M, Synder M, Synder MA, Krasińska M, Olewnik L, Borowski A. Future of total hip arthroplasty with the Metha short stem in modern surgeries. Sci Rep 2021; 11:21763. [PMID: 34741121 PMCID: PMC8571394 DOI: 10.1038/s41598-021-01367-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 10/25/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of the study was to analyse the results of uncemented total hip replacement, using the Metha (metaphyseal) stem. A total of 158 patients (70 females and 88 males) were qualified to the study and submitted to total hip arthroplasty (183 procedures altogether), using the Metha stem. The mean age of the patients on the day of surgery was 51.7 years (the range from 17 to 69 years). The mean follow up period was 9.2 years (the range from 5 to 13.5 years). Preoperative assessments gave poor scores, according to the Merle d’Aubigne and Postel classification, modified by Charnley. The average improvement after surgery, according to the used scale, was 6.9 points. A very good outcome was recorded in 154 cases (84.2%), a good outcome was achieved in 20 cases (10.9%) and a poor outcome was confirmed in 9 cases, while no satisfactory case was observed. Poor outcomes were associated with implant loosening. Extraskeletal ossification was noted in 10 cases (5.5%). According to the Kaplan–Meier estimator, the 10-year survival was 93.2% and 97.3% for the whole implant and the stem alone, respectively. 1. Our follow-up period of more than 9 years on the average, indicates that Metha stems produce excellent clinical and functional results in operated young patients with advanced degenerative changes of the hip joint. 2. Assuming a proper qualification for the procedure, the absence of complications and a correct surgical technique, which is slightly more difficult, when compared to standard stem implantation, the risk of aseptic loosening is fairly negligible.
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Affiliation(s)
- Marek Drobniewski
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Marek Synder
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Marek Aleksander Synder
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Magdalena Krasińska
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Lukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Andrzej Borowski
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland.
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Updates in biomaterials of bearing surfaces in total hip arthroplasty. ARTHROPLASTY 2021; 3:32. [PMID: 35236490 PMCID: PMC8796426 DOI: 10.1186/s42836-021-00092-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022] Open
Abstract
Total hip arthroplasty (THA) is one of the most successful surgical procedures. It entails replacement of the damaged or diseased joint surface with artificial materials. Various materials had been developed and used to achieve optimal outcomes, including longer survivorship and minimal complications. The primary materials used in the manufacture of THA implants are polymers, metal alloys, and ceramics. The failures of THA mainly result from aseptic loosening due to the production of wear particles and the development of periprosthetic joint injection. A lot of advancement and introduction of new biomaterials in THA implants’ armamentarium are designed to avoid the common failure mechanisms and improve the longevity of the implants. In this review, we discussed various aspects of commonly used biomaterials in THA implants, to provide some updated information.
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Shan J, Wang S, Xu H, Zhan H, Geng Z, Liang H, Dai M. Incorporation of cerium oxide into zirconia toughened alumina ceramic promotes osteogenic differentiation and osseointegration. J Biomater Appl 2021; 36:976-984. [PMID: 34496655 DOI: 10.1177/08853282211036535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Due to its high wear resistance and good biocompatibility, zirconia toughened alumina (ZTA) is an ideal material used as load-bearing implant. However, ZTA needs to be modified to overcome its bio-inert and thus improve osseointegration. Cerium oxide, which has been proved to be a bone-friendly ceramic, might be a desired material to enhance the bioactivity of ZTA. In this study, ZTA and cerium oxide doped ZTA (ZTAC) were prepared via sintering method. The in vitro study showed that the addition of cerium oxide promoted MC3T3-E1 cell adhesion and spreading through upregulating ITG α5 and ITG β1. In addition, the incorporation of cerium oxide enhanced cell proliferation, ALP activity, and ECM mineralization capacity. Moreover, the incorporation of cerium oxide promoted the expressions of osteogenesis related genes, such as ALP, Col-I, and OCN. The in vivo implantation test via a SD rat model showed that the incorporation of cerium oxide promoted new bone formation and bone-implant integration. In summary, this study provided a new strategy to fabricate bioactive ZTA implant for potential application in orthopedics field.
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Affiliation(s)
- Jing Shan
- Department of Orthopedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
| | - Song Wang
- Department of Orthopedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
| | - Huaen Xu
- Department of Orthopedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
| | - Haibo Zhan
- Department of Orthopedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
| | - Zhen Geng
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Hanqin Liang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China
| | - Min Dai
- Department of Orthopedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
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