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Heijnens LJ, Schotanus MG, Verburg AD, van Haaren EH. Disappointing long-term outcome of THA with carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) as acetabular insert liner: a prospective study with a mean follow-up of 14.3 years. Hip Int 2021; 31:735-742. [PMID: 32340489 DOI: 10.1177/1120700020918157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Insert liner wear of the acetabular component is one of the predictive values for survival of total hip arthroplasties (THAs). This prospective single-centre study was designed to evaluate the follow-up of carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) insert liner used as bearing in cementless THAs. METHODS 29 healthy patients with an indication for cementless THA were selected for a CFR-PEEK insert liner and followed over time. All patients received a cementless THA with a CFR-PEEK insert liner used as bearing. At different follow-up moments patients were routinely examined and were analysed using the Oxford Hip Score (OHS), the modified Merle d'Aubigne-Postel (MAP) score, and radiologically. At the follow up moments the plain radiographics where assessed for loosening, cyst formations and wear of the CFR-PEEK liners. RESULTS At a mean of 14.3 years follow-up 4 revisions of the acetabular component were performed, resulting in a survival rate of 86.5% (CI 95%, 72.4-96.6). A statistically significant difference in OHS and MAP scores between pre- and postoperative follow-up moments was observed. The acetabular components of the remaining patients showed no radiological abnormalities at 14.3 years follow-up. The overall CFR-PEEK wear was low, with a mean of 0.81 (0.2-1.4) mm wear at 14.3 years follow-up. CONCLUSIONS In this series we found an aseptic loosening with unclear reasons in 4 well-positioned acetabular components, hence we do not recommend routine use of CFR-PEEK insert liners as bearing in cementless THAs. All the remaining THAs and acetabular components were in situ without abnormalities at 14.3 years follow-up.
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Affiliation(s)
- Luc Jm Heijnens
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Martijn Gm Schotanus
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Aart D Verburg
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
| | - Emil H van Haaren
- Department of Orthopaedic Surgery, Zuyderland Medical Centre Sittard, The Netherlands
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Saracco M, Fulchignoni C, Velluto C, Rocchi L. SAFETY AND RELIABILITY OF CARBON-PEEK PLATE FOR THE TREATMENT OF DISTAL RADIUS FRACTURES: A REVIEW OF THE LITERATURE. Orthop Rev (Pavia) 2021; 13:28362. [PMID: 35478703 PMCID: PMC9037658 DOI: 10.52965/001c.28362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/17/2021] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Distal radius fractures are one of the most common injuries. Open reduction and internal fixation (ORIF) are the most diffused between surgical treatments. Carbon-fiber reinforced (CFR) polyetheretherketone (PEEK) plates have been proposed to prevent effects linked to stainless steel or titanium alloy traditional plates, such as radio-opacity, mismatch of bone-plate elasticity modulus, corrosion, limited fatigue life, osseointegration. OBJECTIVE This review aims to evaluate the actual safety and reliability of CFR- PEEK plates to treat distal radius fractures. METHODS Electronic databases PubMed, Google Scholars, and Cochrane Library were searched in December 2020. Eligible studies were published in peer-reviewed journals. Three authors independently selected relevant articles and discussed those. Searching identified 13 titles and abstracts, 11 manuscripts were considered eligible for the full-text analysis. Of these 11 papers, 7 studies were included in our review. RESULTS 215 patients were analyzed in this systematic review. The mean age of enrolled patients was 52,8 years. 34% were males and 66% were females. Fractures were classified according to AO/ASIF classification system. We reported 12 cases of complications specific to this device, such as intraoperative plate and screws rupture, erosive flexor tendons synovitis, and loosening. CONCLUSION CFR-PEEK distal radius plates are potentially an alternative to traditional ones. But we believe that the use of this device does not entail a significant advantage in the treatment of distal radius fractures, as safe and low-cost traditional devices are available. Further comparative studies are needed to demonstrate the superiority of carbon devices.
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Affiliation(s)
- Michela Saracco
- Department of Orthopaedics - Hand Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore
| | - Camillo Fulchignoni
- Department of Orthopaedics - Hand Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore
| | - Calogero Velluto
- Department of Orthopaedics - Hand Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore
| | - Lorenzo Rocchi
- Department of Orthopaedics - Hand Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore
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Influence of the Acetabular Cup Material on the Shell Deformation and Strain Distribution in the Adjacent Bone-A Finite Element Analysis. MATERIALS 2020; 13:ma13061372. [PMID: 32197478 PMCID: PMC7142599 DOI: 10.3390/ma13061372] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 12/22/2022]
Abstract
In total hip arthroplasty, excessive acetabular cup deformations and altered strain distribution in the adjacent bone are potential risk factors for implant loosening. Materials with reduced stiffness might alter the strain distribution less, whereas shell and liner deformations might increase. The purpose of our current computational study was to evaluate whether carbon fiber-reinforced poly-ether-ether-ketones with a Young´s modulus of 15 GPa (CFR-PEEK-15) and 23 GPa (CFR-PEEK-23) might be an alternative shell material compared to titanium in terms of shell and liner deformation, as well as strain distribution in the adjacent bone. Using a finite element analysis, the press-fit implantation of modular acetabular cups with shells made of titanium, CFR-PEEK-15 and CFR-PEEK-23 in a human hemi-pelvis model was simulated. Liners made of ceramic and polyethylene were simulated. Radial shell and liner deformations as well as strain distributions were analyzed. The shells made of CFR-PEEK-15 were deformed most (266.7 µm), followed by CFR-PEEK-23 (136.5 µm) and titanium (54.0 µm). Subsequently, the ceramic liners were radially deformed by up to 4.4 µm and the polyethylene liners up to 184.7 µm. The shell materials slightly influenced the strain distribution in the adjacent bone with CFR-PEEK, resulting in less strain in critical regions (<400 µm/m or >3000 µm/m) and more strain in bone building or sustaining regions (400 to 3000 µm/m), while the liner material only had a minor impact. The superior biomechanical properties of the acetabular shells made of CFR-PEEK could not be determined in our present study.
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Wang JP, Guo D, Wang SH, Yang YQ, Li G. Structural stability of a polyetheretherketone femoral component-A 3D finite element simulation. Clin Biomech (Bristol, Avon) 2019; 70:153-157. [PMID: 31521918 DOI: 10.1016/j.clinbiomech.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/14/2019] [Accepted: 09/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Because its mechanical properties are similar to cortical bones of the knee, polyetheretherketone (PEEK) material has been used to make total knee arthroplasty (TKA) components. This study investigated the PEEK femoral component deformation of a TKA system and compared the data with that of a cobalt-chromium (CoCr) component. METHODS A 3D finite element knee model was constructed using CT images of a normal subject. A knee prosthesis was installed on the model to simulate a TKA knee. The material properties of the bone were assumed linear and transverse isotropic. The femoral component was modeled using a PEEK or CoCr material. A compressive load was applied to the knee at full extension. Tibiofemoral contact stresses and femoral component deformations were analyzed. FINDINGS Under a 3 kN load, the maximal Von-Mises stresses in the femoral component were 14.39 MPa and 30.05 MPa for the PEEK and CoCr components, respectively. At the tibial polyethylene surface, the CoCr femoral component caused higher contact stresses (>2.2%) than the PEEK component. The deformation of the PEEK component was over 3 times larger than that of the CoCr component (0.65 × 10-3 mm vs 0.2 × 10-3 mm). INTERPRETATION The PEEK femoral component could result in lower contact stresses, but larger deformations in the TKA knee compared to the CoCr component. An increased deformation of the PEEK component indicates a reduction in its structural strength. Future investigation should examine if the reduced structural strength will affect the in-vivo component-bone interface integration and affect the component fatigue life.
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Affiliation(s)
- Jian-Ping Wang
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital/Harvard Medical School, Boston, MA, United States of America; Henan Polytechnic University, Jiaozuo 454000, Henan Province, China
| | - Dong Guo
- Henan Polytechnic University, Jiaozuo 454000, Henan Province, China
| | - Shi-Hua Wang
- Henan Polytechnic University, Jiaozuo 454000, Henan Province, China
| | - Yong-Qiang Yang
- Henan Polytechnic University, Jiaozuo 454000, Henan Province, China
| | - Guoan Li
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital/Harvard Medical School, Boston, MA, United States of America.
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Chatterjee S, Kobylinski S, Basu B. Finite Element Analysis to Probe the Influence of Acetabular Shell Design, Liner Material, and Subject Parameters on Biomechanical Response in Periprosthetic Bone. J Biomech Eng 2019; 140:2681672. [PMID: 30029239 DOI: 10.1115/1.4040249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Indexed: 11/08/2022]
Abstract
The implant stability and biomechanical response of periprosthetic bone in acetabulum around total hip joint replacement (THR) devices depend on a host of parameters, including design of articulating materials, gait cycle and subject parameters. In this study, the impact of shell design (conventional, finned, spiked, and combined design) and liner material on the biomechanical response of periprosthetic bone has been analyzed using finite element (FE) method. Two different liner materials: high density polyethylene-20% hydroxyapatite-20% alumina (HDPE-20%HA-20%Al2O3) and highly cross-linked ultrahigh molecular weight polyethylene (HC-UHMWPE) were used. The subject parameters included bone condition and bodyweight. Physiologically relevant load cases of a gait cycle were considered. The deviation of mechanical condition of the periprosthetic bone due to implantation was least for the finned shell design. No significant deviation was observed at the bone region adjacent to the spikes and the fins. This study recommends the use of the finned design, particularly for weaker bone conditions. For stronger bones, the combined design may also be recommended for higher stability. The use of HC-UHMWPE liner was found to be better for convensional shell design. However, similar biomechanical response was captured in our FE analysis for both the liner materials in case of other shell designs. Overall, the study establishes the biomechanical response of periprosthetic bone in the acetabular with preclinically tested liner materials together with new shell design for different subject conditions.
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Affiliation(s)
- Subhomoy Chatterjee
- Materials Research Centre, Indian Institute of Science, Bengaluru 560012, Karnataka, India; Translational Center on Biomaterials for Orthopaedic and Dental Applications, Indian Institute of Science, Bengaluru 560012, Karnataka, India
| | - Sabine Kobylinski
- Materials Research Centre, Indian Institute of Science, Bengaluru 560012, Karnataka, India; Centre for BioSystems and Engineering, Indian Institute of Science, Bengaluru 560012, Karnataka, India; Technical University of Applied Sciences Regensburg (OTH Regensburg), Regensburg 93047, Germany
| | - Bikramjit Basu
- Materials Research Centre, Indian Institute of Science, Bengaluru 560012, Karnataka, India; Translational Center on Biomaterials for Orthopaedic and Dental Applications, Indian Institute of Science, Bengaluru 560012, Karnataka, India; Centre for BioSystems and Engineering, Indian Institute of Science, Bengaluru 560012, Karnataka, India e-mails:
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Wear behaviour of CFR PEEK articulated against CoCr under varying contact stresses: Low wear of CFR PEEK negated by wear of the CoCr counterface. J Mech Behav Biomed Mater 2019; 97:117-125. [PMID: 31108368 DOI: 10.1016/j.jmbbm.2019.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 01/29/2023]
Abstract
Total hip replacement with metal-on-polymer hip prostheses is the most common treatment for late-stage osteoarthritis. However, the wear debris generated from the polymer acetabular liner remains a problem. Alternative materials with claimed superior wear properties have been proposed to overcome this problem. In this study, the wear behaviour of carbon fibre reinforced polyether ether ketone (CFR PEEK) was investigated under different contact stresses that are observed in the natural hip joint. A 50-station pin-on-disc machine (SuperCTPOD) was used to investigate the wear behaviour of 50 CFR PEEK pins articulated against cobalt chromium (CoCr) discs under five different contact stresses, namely 1.11, 1.38, 1.61, 2.00 and 5.30 MPa. The results showed that the wear rates of the pins did not differ significantly between groups under different contact stresses. In addition, CFR PEEK produced lower wear rates than ultrahigh molecular weight polyethylene and cross-linked polyethylene. However, the weight of the CoCr discs was found to decrease significantly at the end of the wear test, which was indicative of metallic wear. The findings of this study indicated that, despite having relatively low wear rates, CFR PEEK is not a good alternative to be utilised against orthopaedic metals.
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Grieco PW, Pascal S, Newman JM, Shah NV, Stroud SG, Sheth NP, Maheshwari AV. New alternate bearing surfaces in total hip arthroplasty: A review of the current literature. J Clin Orthop Trauma 2018; 9:7-16. [PMID: 29628677 PMCID: PMC5884051 DOI: 10.1016/j.jcot.2017.10.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/26/2017] [Indexed: 01/01/2023] Open
Abstract
As indications for total hip arthroplasty (THA) have expanded, the incidence of THA has increased among younger patients, who live longer and tend to place more strain on implants via higher activity levels. This demographical shift accentuates the importance of advancing innovation to ensure implant longevity for younger and more active patients. Future innovation, as it pertains to THA components, is likely to focus on modifying implant designs and tribology in conjunction with identification and application of newer biomaterials. By reviewing the literature for development status of various materials and novel design advancements in THA component outside of the standard highly cross-linked polyethylene, this investigation provided an update on the current and future status of design initiatives as they pertain to THA. Though the highlighted alternative bearing surfaces have shown promising in vitro and limited, yet encouraging clinical data, they lack larger and longer-term clinical trial results. Further research and innovation is warranted to identify the optimal bearing surface to most effectively accommodate for the trend of younger and more active patients undergoing THA. Implant longevity is crucial if the clinical success of THA is to be maintained.
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Affiliation(s)
- Preston W. Grieco
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Scott Pascal
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Jared M. Newman
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Neil V. Shah
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Sarah G. Stroud
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Neil P. Sheth
- Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 1 Cathcart 800 Spruce Street, Philadelphia, PA 19107, USA
| | - Aditya V. Maheshwari
- Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA,Corresponding author at: Adult Reconstruction and Musculoskeletal Oncology Divisions SUNY Downstate Medical Center 450 Clarkson Ave., Box 3 Box 3 Box 30 Brooklyn, NY 11203, USA.
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8
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Morlock MM, Jäger M. [Endoprostheses in the elderly : Biomaterials, implant selection and fixation technique]. DER ORTHOPADE 2017; 46:4-17. [PMID: 27966180 DOI: 10.1007/s00132-016-3361-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The replacement of hip and knee joints is one of the greatest success stories in orthopedics. Due to continuous improvement of biomaterials and implant design, patient-associated problems are now mostly multifactorial and only rarely caused by the implant. Abrasion was significantly reduced by the introduction of highly cross-linked polyethylene (PE), antioxidant stabilized PE, new ceramics and the development of ceramic and protective surfaces. It is assumed that further reduction of frictional resistance will not lead to a significantly better clinical result: however, the problem of periprosthetic infections and implant-related incompatibility is still unsolved and remains challenging for biomaterial research. For the knee joint PE will be irreplaceable for joint articulation even in the future due to the contact situation. Mobile bearings and fixed bearings are two established successful philosophies, which have shown comparably good clinical results. For the hip joint, it is forecasted that ceramic-on-ceramic will be the system of the future if the correct positioning and mounting of the components can be solved so that the problems, such as development of noise and breakage can be reduced to a minimum. An in-depth understanding and detailed knowledge of the biomaterials by the surgeon can prevent implant-related problems. For elderly patients it is assumed that the economic burden on the public healthcare system will have the strongest impact on implant selection.
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Affiliation(s)
- M M Morlock
- Institut für Biomechanik, TUHH Hamburg University of Technology, Denickestr. 15, 21073, Hamburg, Deutschland.
| | - M Jäger
- Klinik für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Hufelandstr. 55, 45274, Essen, Deutschland
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Yamane S, Kyomoto M, Moro T, Hashimoto M, Takatori Y, Tanaka S, Ishihara K. Wear resistance of poly(2‐methacryloyloxyethyl phosphorylcholine)‐grafted carbon fiber reinforced poly(ether ether ketone) liners against metal and ceramic femoral heads. J Biomed Mater Res B Appl Biomater 2017; 106:1028-1037. [DOI: 10.1002/jbm.b.33918] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 03/21/2017] [Accepted: 04/22/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Shihori Yamane
- Department of Materials EngineeringSchool of Engineering, The University of TokyoBunkyo‐ku Tokyo113‐8656 Japan
- Division of Science for Joint ReconstructionGraduate School of Medicine, The University of TokyoBunkyo‐ku Tokyo113‐8655 Japan
- Medical R&D CenterCorporate R&D Group, KYOCERA CorporationYodogawa‐ku Osaka532‐0003 Japan
| | - Masayuki Kyomoto
- Department of Materials EngineeringSchool of Engineering, The University of TokyoBunkyo‐ku Tokyo113‐8656 Japan
- Division of Science for Joint ReconstructionGraduate School of Medicine, The University of TokyoBunkyo‐ku Tokyo113‐8655 Japan
- Medical R&D CenterCorporate R&D Group, KYOCERA CorporationYodogawa‐ku Osaka532‐0003 Japan
| | - Toru Moro
- Division of Science for Joint ReconstructionGraduate School of Medicine, The University of TokyoBunkyo‐ku Tokyo113‐8655 Japan
| | - Masami Hashimoto
- Materials Research and Development LaboratoryJapan Fine Ceramics CenterAtsuta‐ku Nagoya456‐8587 Japan
| | - Yoshio Takatori
- Division of Science for Joint ReconstructionGraduate School of Medicine, The University of TokyoBunkyo‐ku Tokyo113‐8655 Japan
| | - Sakae Tanaka
- Department of Orthopaedic SurgeryFaculty of Medicine, The University of TokyoBunkyo‐ku Tokyo113‐8655 Japan
| | - Kazuhiko Ishihara
- Department of Materials EngineeringSchool of Engineering, The University of TokyoBunkyo‐ku Tokyo113‐8656 Japan
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Merolli A, Rocchi L, De Spirito M, Federico F, Morini A, Mingarelli L, Fanfani F. Debris of carbon-fibers originated from a CFRP (pEEK) wrist-plate triggered a destruent synovitis in human. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:50. [PMID: 26758897 DOI: 10.1007/s10856-015-5664-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 12/29/2015] [Indexed: 06/05/2023]
Abstract
Application of carbon-fiber-reinforced-polymer (CFRP) artifacts in humans has been promoted in Orthopedic and Trauma Surgery. Literature documents the biocompatibility of materials used, namely carbon fibers (CF) and poly-ether thermoplastics, like poly-ether-ether-ketone (PEEK). A properly designed and accurately implanted composite artifact should not expose its fibers during or after surgery: however this may happen. A white Caucasian woman came to our attention 11 months after surgery for a wrist fracture. She had a severe impairment, being unable to flex the thumb; index finger and distal phalanx of third finger. We retrieved a correctly positioned plate and documented an aggressive erosive flexor tendons synovitis with eroded stumps of flexor tendons. The plate and soft tissues were analyzed by Visible Light and Scanning Electron Microscopy. Histopathology showed granulomatous fibrogenic process with CF engulfed inside multinucleated giant cells. Fibers were unmasked and disrupted inside the holes where screws were tightened and corrugation of the polymer coating led to further unmasking. The mechanism of foreign-body reaction to CF has not been studied in depth yet, particularly at the ultrastructural level and in Humans. This case documents a damage occurred in a clinical application and which was theoretically possible. Our opinion is that a proper way to promote the use of CRFP in the Clinic in the short term is to direct Research towards finding a better way to prevent CF debris to be exposed and released. In the longer term, the biological response to CF deserves a deeper understanding.
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Affiliation(s)
- Antonio Merolli
- Orthopedic and Trauma Surgery, Policlinico Gemelli, Clinica Ortopedica, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy.
| | - Lorenzo Rocchi
- Orthopedic and Hand Surgery, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Marco De Spirito
- Central Laboratory for Microscopy, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Federico
- Service for Histopathology, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Morini
- Orthopedic and Hand Surgery, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Mingarelli
- Orthopedic and Hand Surgery, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- Orthopedic and Hand Surgery, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
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Abdullah MR, Goharian A, Abdul Kadir MR, Wahit MU. Biomechanical and bioactivity concepts of polyetheretherketone composites for use in orthopedic implants-a review. J Biomed Mater Res A 2015; 103:3689-702. [DOI: 10.1002/jbm.a.35480] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/22/2015] [Accepted: 04/06/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Mohamed Ruslan Abdullah
- Centre for Composites; Department of Applied Mechanics and Design; Universiti Teknologi Malaysia (UTM); 81310 Skudai, Johor Malaysia
| | - Amirhossein Goharian
- Medical Devices & Technology Group; Faculty of Biosciences & Medical Engineering, Universiti Teknologi Malaysia (UTM); 81310 Skudai, Johor Malaysia
- R&D Department; Leonix Sdn. Bhd.; Penang 11960 Malaysia
| | - Mohammed Rafiq Abdul Kadir
- Medical Devices & Technology Group; Faculty of Biosciences & Medical Engineering, Universiti Teknologi Malaysia (UTM); 81310 Skudai, Johor Malaysia
| | - Mat Uzir Wahit
- Center for Composites, Institute of Vehicle System and Engineering (IVeSE), Universiti Teknologi Malaysia (UTM); 81310 Skudai, Johor Malaysia
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Abstract
We reviewed the literature on the currently available choices of bearing surface in total hip replacement (THR). We present a detailed description of the properties of articulating surfaces review the understanding of the advantages and disadvantages of existing bearing couples. Recent technological developments in the field of polyethylene and ceramics have altered the risk of fracture and the rate of wear, although the use of metal-on-metal bearings has largely fallen out of favour, owing to concerns about reactions to metal debris. As expected, all bearing surface combinations have advantages and disadvantages. A patient-based approach is recommended, balancing the risks of different options against an individual’s functional demands. Cite this article: Bone Joint J 2014;96-B:147–56.
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Affiliation(s)
- A. Rajpura
- Wrightington Hospital, The Centre
for Hip Surgery, Appley Bridge, Wigan
WN6 9EP, UK
| | - D. Kendoff
- Helios ENDO Klinik, Holstenstr. 2, 22767
Hamburg, Germany
| | - T. N. Board
- Wrightington Hospital, The Centre
for Hip Surgery, Appley Bridge, Wigan
WN6 9EP, UK
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13
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Gillard FC, Dickinson AS, Schneider U, Taylor AC, Browne M. Multi-pelvis characterisation of articular cartilage geometry. Proc Inst Mech Eng H 2013; 227:1255-64. [DOI: 10.1177/0954411913500265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The shape of the acetabular cartilage follows the contact stress distribution across the joint. Accurate characterisation of this geometry may be useful for the development of acetabular cup devices that are more biomechanically compliant. In this study, the geometry of the acetabular cartilage was characterised by taking plaster moulds of the acetabulum from 24 dry bone human pelvises and digitising the mould shapes using a three-dimensional laser scanner. The articular bone surface geometry was analysed, and the shape of the acetabulum was approximated by fitting a best-fit sphere. To test the hypothesis that the acetabulum is non-spherical, a best-fit ellipsoid was also fitted to the geometry. In each case, points around the acetabular notch edge that disclosed the articular surface geometry were identified, and vectors were drawn between these and the best-fit sphere or ellipsoid centre. The significantly larger z radii (into the pole) of the ellipsoids indicated that the acetabulum was non-spherical and could imply that the kinematics of the hip joint is more complex than purely rotational motion, and the traditional ball-and-socket replacement may need to be updated to reflect this motion. The acetabular notch edges were observed to be curved, with males exhibiting deeper, wider and shorter notches than females, although the difference was not statistically significant (mean: p = 0.30) and supports the use of non-gender-specific models in anatomical studies.
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Affiliation(s)
- Faye C Gillard
- Bioengineering Science Research Group, University of Southampton, Southampton, UK
| | | | - Urs Schneider
- Department of Biomechatronic Systems, Fraunhofer Institute for Manufacturing Engineering and Automation IPA, Stuttgart, Germany
| | | | - Martin Browne
- Bioengineering Science Research Group, University of Southampton, Southampton, UK
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