The relationship between cement fatigue damage and implant surface finish in proximal femoral prostheses

The majority of cemented femoral hip replacements fail as a consequence of loosening. One design feature that may affect loosening rates is implant surface finish. To determine whether or not surface finish effects fatigue damage accumulation in a bone cement mantle, we developed an experimental model of the implanted proximal femur that allows visualisation of damage growth in the cement layer. Five matt surface and five polished surface stems were tested. Pre-load damage and damage after two million cycles was measured. Levels of pre-load (shrinkage) damage were the same for both matt and polished stems; furthermore damage for matt vs. polished stems was not significantly different after two million cycles. This was due to the large variability in damage accumulation rates. Finite element analysis showed that the stress is higher for the polished (assumed debonded) stem, and therefore we must conclude that either the magnitude of the stress increase is not enough to appreciably increase the damage accumulation rate or, alternatively, the polished stem does not debond immediately from the cement. Significantly (P = 0.05) more damage was initiated in the lateral cement compared to the medial cement for both kinds of surface finish. It was concluded that, despite the higher cement stresses with debonded stems, polished prostheses do not provoke the damage accumulation failure scenario. (C) 2003 IPEM. Published by Elsevier Ltd. All rights reserved.

Computer simulating a trial of a load-bearing implant: example of an intramedullary prosthesis

Computational modelling is becoming ever more important for obtaining regulatory approval for new medical devices. An accepted approach is to infer performance in a population from an analysis conducted for an idealised or ‘average’ patient; we present here a method for predicting the performance of an orthopaedic implant when released into a population—effectively simulating a clinical trial. Specifically we hypothesise that an analysis based on a method for predicting the performance in a population will lead to different conclusions than an analysis based on an idealised or ‘average’ patient. To test this hypothesis we use a finite element model of an intramedullary implant in a bone whose size and remodelling activity is different for each individual in the population. We compare the performance of a low Young’s modulus implant (View the MathML source) to one with a higher Young’s modulus (200 GPa). Cyclic loading is applied and failure is assumed when the migration of the implant relative to the bone exceeds a threshold magnitude. The analysis for an idealised of ‘average’ patient predicts that the lower modulus device survives longer whereas the analysis simulating a clinical trial predicts no statistically-significant tendency (p=0.77) for the low modulus device to perform better. It is concluded that population-based simulations of implant performance–simulating a clinical trial–present a very valuable opportunity for more realistic computational pre-clinical testing of medical devices.

Effects of sintering temperature on morphology and mechanical characteristics of 3D printed porous titanium used as dental implant

Porous titanium samples were manufactured using the 3D printing and sintering method in order to determine the effects of final sintering temperature on morphology and mechanical properties. Cylindrical samples were printed and split into groups according to a final sintering temperature (FST). Irregular geometry samples were also printed and split into groups according to their FST. The cylindrical samples were used to determine part shrinkage, in compressive tests to provide stress-strain data, in microCT scans to provide internal morphology data and for optical microscopy to determine surface morphology. All of the samples were used in microhardness testing to establish the hardness. Below 1100 C FST, shrinkage was in the region of 20% but increased to approximately 30% by a FST of 1300 C. Porosity varied from a maximum of approximately 65% at the surface to the region of 30% internally. Between 97 and 99% of the internal porosity is interconnected. Average pore size varied between 24 µm at the surface and 19 µm internally. Sample hardness increased to in excess of 300 HV0.05 with increasing FST while samples with an FST of below 1250 C produced an elastic-brittle stress/strain curve and samples above this displayed elastic-plastic behaviour. Yield strength increased significantly through the range of sintering temperatures while the Young's modulus remained fairly consistent. © 2013 Elsevier B.V.