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Series: ASM Handbook Archive
Volume: 11
Publisher: ASM International
Published: 01 January 2002
DOI: 10.31399/asm.hb.v11.a0001819
EISBN: 978-1-62708-180-1
.... Finally, the article discusses the fatigue properties of implant materials and the fractures of total hip joint prostheses. degradation fatigue properties fractures implant deficiencies internal fixation devices orthopedic implants prosthetic implants total hip joint prostheses...
Abstract
This article commences with a description of the prosthetic devices and implants used for internal fixation. It describes the complications related to implants and provides a list of major standards for orthopedic implant materials. The article illustrates the body environment and its interactions with implants. The considerations for designing internal fixation devices are also described. The article analyzes failed internal fixation devices by explaining the failures of implants and prosthetic devices due to implant deficiencies, mechanical or biomechanical conditions, and degradation. Finally, the article discusses the fatigue properties of implant materials and the fractures of total hip joint prostheses.
Series: ASM Handbook
Volume: 18
Publisher: ASM International
Published: 31 December 2017
DOI: 10.31399/asm.hb.v18.a0006404
EISBN: 978-1-62708-192-4
... of the typical standards used for testing wear behavior of tribological pairs in the human body are highlighted in the following sections. Hip-Wear Simulation Hip-wear simulation standards include ( Fig. 2 ): ISO 14242-1: “Implants for Surgery—Wear of Total Hip-Joint Prostheses—Part 1: Loading...
Abstract
The human internal environment plays a vital role in the friction and wear of implants and prosthetic devices. This article describes the tribological/wear behavior of implants. It discusses the classification of active tribological pairs, namely, amphiarthosis joints and diarthosis joints. The article details the classification of total knee replacement, depending on the type of mechanical stability, including nonconstrained knee replacement, semiconstrained knee replacement, and constrained knee replacement. It also discusses the classifications of passive tribological pairs, namely, total disc replacement in the spine, dental implants, and temporomandibular joint. It describes the various testing methods for characterizing the implant materials used in hip, knee, spine, and dental applications. The article also describes the typical standards used for testing wear behavior of tribological pairs, namely, hip-wear simulation standards, knee-wear simulation standards, and spinal disc-wear simulation standards.
Image
Published: 01 January 2002
Fig. 1 Typical examples for joint prostheses (schematic). (a) Classic Moore hip endoprosthesis. (b) Müller total hip prosthesis (metal against polyethylene acetabular cap). (c) Weber total hip prosthesis with movable head and metal, ceramic, and polyethylene components. (d) Müller total hip
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Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005678
EISBN: 978-1-62708-198-6
... prostheses in recent years, and it is therefore important to recognize the major contributions of McKee some 30 or 40 years ago. Fig. 2 McKee-Farrar total replacement hip joint incorporating lapped-in Vitallium femoral and acetabular cup components. Stud-shaped projections facilitate installation...
Abstract
Total joint replacement in orthopedic surgery can be achieved by excision, interposition, and replacement arthroplasty. This article details the most common materials used in total replacement synovial joints: metals, ceramics, and ultrahigh molecular weight polyethylene (UHMWPE). The principal physical properties and tribological characteristics of these materials are summarized. The article discusses pin-on-disk experiments and pin-on-plate experiments for determining friction and wear characteristics. It explains the use of various types of joint simulators, such as hip joint simulators and knee joint simulators, to evaluate the performance of engineering tribological components in machine simulators. The article concludes with a section on the in vivo assessment of total joint replacement performance.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005652
EISBN: 978-1-62708-198-6
... manufactured from commonly accepted alloys. The suitability of commonly accepted alloys primarily due to their corrosion resistance in the physiological environment. Recently, the resurgence in the use of metal-on-metal articulations in total hip prostheses has revived questions about the potential impact...
Abstract
This article discusses the mechanisms of metal and alloy biocompatibility. It provides information on early testing and experience with metals in medical device applications. The article describes the response of implant and particulate materials to severe corrosion. It provides a description of metal binding and its effects on metabolic processes. Hypersensitive responses to metal ions are also reviewed. The article concludes with a discussion on the possible cancer-causing effects of metallic biomaterials.
Series: ASM Handbook
Volume: 13C
Publisher: ASM International
Published: 01 January 2006
DOI: 10.31399/asm.hb.v13c.a0004205
EISBN: 978-1-62708-184-9
... accepted alloys. The suitability of commonly accepted alloys is primarily due to their corrosion resistance in the physiological environment. Recently, the resurgence in the use of metal-on-metal articulations in total hip prostheses has revived questions about the potential impact of metal ions...
Abstract
In the field of medical device development and testing, the corrosion of metallic parts can lead to significant adverse effects on the biocompatibility of the device. This article describes the mechanisms of metal and alloy biocompatibility. It reviews the response of implant metals and particulate materials to corrosion. The effect of metal ions from an implanted device on the human body is also discussed. The article concludes with information on the possible cancer-causing effects of metallic biomaterials.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005656
EISBN: 978-1-62708-198-6
... Abstract Porous coatings are used in the field of joint replacement, particularly in cementless total hip/knee arthroplasty. This article reviews the offerings and biomaterial properties in orthopedic surgery for the contemporary class of highly porous metals. It describes the traditional...
Abstract
Porous coatings are used in the field of joint replacement, particularly in cementless total hip/knee arthroplasty. This article reviews the offerings and biomaterial properties in orthopedic surgery for the contemporary class of highly porous metals. It describes the traditional porous metals/coatings having an open-cell structure, high porosity, and a microstructure resembling that of the cancellous bone. The traditional porous metal/coating includes fiber-metal mesh, cobalt-chromium (CoCr) beads, cancellous-structured titanium, and plasma spray. The article discusses other porous metals/coatings that have been developed due to the limitations of traditional porous metals for numerous open-cell-structured metals, such as titanium-base foams and trabecular metals.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005682
EISBN: 978-1-62708-198-6
... ( Ref 2 ). Currently, one of the main achievements in the field of arthroplasty is total joint replacement (TJR), where the entire load-bearing joint (mainly in the knee, hip, or shoulder) is replaced surgically by ceramic, metal, or polymeric artificial materials. As stated earlier, the problem...
Abstract
This article outlines the selection criteria for choosing an implant material for biomedical devices in orthopedic, dental, soft-tissue, and cardiovascular applications. It details the development of various implants, such as metallic, ceramic, and polymeric implants. The article discusses specific problems associated with implant manufacturing processes and the consequent compromises in the properties of functionally graded implants. It describes the manufacturing of the functionally-graded hip implant by using the LENS process. The article reviews four different types of tissue responses to the biomaterial. It discusses the testing methods of implant failure, such as in vitro and in vivo assessment of tissue compatibility.
Series: ASM Desk Editions
Publisher: ASM International
Published: 01 December 1998
DOI: 10.31399/asm.hb.mhde2.a0003168
EISBN: 978-1-62708-199-3
... for fracture fixation. There are numerous other structural metallic implants. Fig. 1 Diagram of total hip and knee replacements showing component shape and location of implantation Fig. 2 Investment cast titanium alloy knee and hip implant prostheses Fig. 3 Total hip replacement...
Abstract
Biomaterials are the man-made metallic, ceramic, and polymeric materials used for intracorporeal applications in the human body. This article primarily focuses on metallic materials. It provides information on basic metallurgy, biocompatibility, chemistry, and the orthopedic and dental applications of metallic biomaterials. A table compares the mechanical properties of some common implant materials with those of bone. The article also provides information on coatings, ceramics, polymers, composites, cements, and adhesives, especially where they interact with metallic materials.
Series: ASM Handbook
Volume: 13C
Publisher: ASM International
Published: 01 January 2006
DOI: 10.31399/asm.hb.v13c.a0004206
EISBN: 978-1-62708-184-9
... tapers from a variety of prostheses showing evidence of corrosion. (a) Cross section of a retrieved modular femoral component for a total hip replacement. The head comprises Co-Cr-Mo alloy and the stem is a Ti-6Al-4V alloy. The taper interface is revealed by sectioning. (b) Retrieved Co-Cr-Mo modular...
Abstract
This article reviews the understanding of corrosion interactions between alloys in complex geometries and in applications where there are significant cyclic stresses and potential for wear and fretting motion. These alloys include iron-base, titanium-base, and cobalt-base alloys. The article discusses the surface characteristics and electrochemical behavior of metallic biomaterials. It summaries the clinical context for mechanically assisted corrosion and describes mechanically assisted crevice corrosion. There have been several tests developed to investigate aspects of mechanically assisted corrosion. The article also explains the scratch test and the in vitro fretting corrosion test.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005653
EISBN: 978-1-62708-198-6
... of modular tapers from a variety of prostheses showing evidence of corrosion. (a) Cross section of a retrieved modular femoral component for a total hip replacement. The head comprises Co-Cr-Mo alloy and the stem is a Ti-6Al-4V alloy. The taper interface is revealed by sectioning. (b) Retrieved Co-Cr-Mo...
Abstract
This article reviews the corrosion interactions between biomedical alloys, in particular iron-base, titanium-base, and cobalt-base alloys, in complex geometries and in applications where there are significant cyclic stresses and potential for wear and fretting motion. It discusses the nature of these metal surfaces and their propensity for corrosion reactions when combined with similar or different alloys in complex restrictive environments within the human body and under loading conditions. The article describes the factors that influence mechanically assisted crevice corrosion. It reviews the tests developed to investigate the aspects of mechanically assisted corrosion of metallic biomaterials: the scratch test and the in vitro fretting corrosion test.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005666
EISBN: 978-1-62708-198-6
... proinflammatory response particulate debris soluble debris stainless steel titanium alloys NEARLY HALF TO A THIRD of elderly people in the United States will eventually require a total joint replacement of one type or another (hip, knee, shoulder, disc, etc.) to maintain mobility and a high quality...
Abstract
Implant debris is known to cause local inflammation, local osteolysis, and, in some cases, local and systemic hypersensitivity. The debris can be stainless steel, cobalt alloy, and titanium alloy, and soluble debris obtained due to wear from all orthopedic implants. This article addresses the biologic aspects of implant debris, both locally and systemically. It describes debris-induced local effects, particle-induced proinflammatory responses, and debris-induced systemic effects. The article concludes with a discussion on the four systemic effects of implant debris, namely, neuropathic effects, hypersensitivity effects, carcinogenicity, and general toxicity.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005660
EISBN: 978-1-62708-198-6
.... These range from simple wires and screws to fracture fixation plates and total joint prostheses (artificial joints) for hips, knees, shoulders, ankles, and so on. In addition to orthopaedics, metallic implants are used in maxillofacial surgery, cardiovascular surgery, and as dental materials. Although many...
Abstract
The biocompatibility of a material relates to its immunological response, toxicity profile, and ability to integrate with surrounding tissue without undesirable local or systemic effects on a patient. This article underscores the transformation of the medical device design ecosystem engaged as an integral part of the device ecosystem. It discusses the applications of biomaterials, including orthopedic, cardiovascular, ophthalmic, and dental applications. The article describes four major categories of biomaterials such as metals, polymers, glass and ceramics, and composites. A discussion on natural materials, nanomaterials, and stem cells is also provided. The article concludes with examples of biomaterials applications, such as endovascular devices, knee implants, and neurostimulation.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005674
EISBN: 978-1-62708-198-6
... Abstract Titanium and its alloys have been used extensively in a wide variety of implant applications, such as artificial heart pumps, pacemaker cases, heart valve parts, and load-bearing bone or hip joint replacements or bone splints. This article discusses the properties of titanium and its...
Abstract
Titanium and its alloys have been used extensively in a wide variety of implant applications, such as artificial heart pumps, pacemaker cases, heart valve parts, and load-bearing bone or hip joint replacements or bone splints. This article discusses the properties of titanium and its alloys and presents a list of titanium-base biomaterials. Titanium components are produced in wrought, cast, and powder metallurgy (PM) form. The article describes forging, casting, and heat treating of titanium alloys for producing titanium components. Typical mechanical properties of titanium biomedical implant alloys are listed in a tabular form. The article presents an overview of the surface-modification methods for titanium and its alloys implants. It concludes with a section on biocompatibility and in vivo corrosion of titanium alloys.
Series: ASM Handbook
Volume: 11A
Publisher: ASM International
Published: 30 August 2021
DOI: 10.31399/asm.hb.v11A.a0006811
EISBN: 978-1-62708-329-4
... a joint or bone or provide support for a damaged bone. Note that this section focuses on devices intended to be permanent or semipermanent. The most common type of such orthopedic devices is the artificial hip, implanted during a total hip arthroplasty procedure. Second to these procedures by frequency...
Abstract
Bearing in mind the three-legged stool approach of device design/manufacturing, patient factors, and surgical technique, this article aims to inform the failure analyst of the metallurgical and materials engineering aspects of a medical device failure investigation. It focuses on the device "failures" that include fracture, wear, and corrosion. The article first discusses failure modes of long-term orthopedic and cardiovascular implants. The article then focuses on short-term implants, typically bone screws and plates. Lastly, failure modes of surgical tools are discussed. The conclusion of this article presents several case studies illustrating the various failure modes discussed throughout.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005665
EISBN: 978-1-62708-198-6
... in Patients Who Have Had a Primary Total Hip Arthroplasty, A Prospective, Controlled, Longitudinal Study , J. Bone Joint. Surg. Am. , Vol 80 ( No. 10 ), Oct 1 , 1998 , p 1447 – 1458 10.2106/00004623-199810000-00006 10. Geis-Gerstorfer J. , Gopel W. , and Weber H. , Scanning...
Abstract
This article describes the corrosion resistance and ion release from main transition metallic bearings used as medical devices. It discusses the main issues associated with the in vivo presence of ions and their biocompatibility during the exposure of patients to different aspects of ion toxicity. These include ion concentration and accumulation in organisms, reactive oxygen species and oxidative stress, and carcinogenicity stimulated by the corrosion process and toxic ions release.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005659
EISBN: 978-1-62708-198-6
... to migrate into the blood stream, a characteristic of the symptoms of patients with metal-on-metal joints. The particle will also increase its reactivity with tissue rather than the reverse. Fixation of the femoral stem and acetabulum is a serious problem for the total hip and also for the femoral...
Abstract
This article provides a summary of the biocompatibility or biological response of metals, ceramics, and polymers used in medical implants, along with their clinical issues. The polymers include ultrahigh-molecular-weight polyethylene, nonresorbable polymer, and resorbable polymers.
Series: ASM Handbook
Volume: 23
Publisher: ASM International
Published: 01 June 2012
DOI: 10.31399/asm.hb.v23.a0005657
EISBN: 978-1-62708-198-6
... devices. Permanent prostheses include joint replacement devices such as hips, knees, elbows, ankles, and jaws. These devices typically include several components to allow articulation and may use dissimilar materials. Permanent prostheses are anchored using bone cement or rely on osseointegration...
Abstract
This article focuses on the analysis of materials and mechanical- (or biomechanical-) based medical device failures. It reviews the failure analysis practices, including evidence receipt, cleaning, nondestructive examination, destructive examination, exemplars analysis, and device redesign. The article examines the common failure modes, such as overload, fatigue, corrosion, hydrogen embrittlement, and fretting, of medical devices. The failure analysis of orthopedic implants, such as permanent prostheses and internal fixation devices, is described. The article reviews the failure mechanisms in some of the more common medical device materials, namely, stainless steels, titanium alloys, cobalt-base alloys, and nitinol. It presents case histories with examples for failure analysis.
Series: ASM Handbook
Volume: 23A
Publisher: ASM International
Published: 12 September 2022
DOI: 10.31399/asm.hb.v23A.a0006889
EISBN: 978-1-62708-392-8
... the yield strength and tensile strength as cast F75 alloy. A complete list of the alloys, compositional makeup, and intended/standardized applications is displayed in Tables 1 and 2 for biomedical-grade materials. The applications vary from total joint replacement to simple fixation devices and have...
Abstract
This article discusses some of the additive manufacturing (AM) based fabrication of alloys and their respective mechanical, electrochemical, and in vivo performance. Firstly, it briefly discusses the three AM techniques that are most commonly used in the fabrication of metallic biomedical-based devices: binder jetting, powder-bed fusion, and directed-energy deposition. The article then characterizes the electrochemical properties of additive-manufactured/processed cobalt-chromium alloys. This is followed by sections providing an evaluation of the biological response to CoCr alloys in terms of the material and 3D printing fabrication. Discussion on the biological response as a function of direct cellular activity on the surface of CoCr alloys in static conditions (in vitro), in dynamic physiological conditions (in vivo), and in computer-simulated conditions (in silico) are further discussed in detail. Finally, the article provides information on the qualification and certification of AM-processed medical devices.
Series: ASM Handbook
Volume: 24A
Publisher: ASM International
Published: 30 June 2023
DOI: 10.31399/asm.hb.v24A.a0006966
EISBN: 978-1-62708-439-0
... more details about the unique designs of AM devices on an joint-by-joint basis. Total Hip Arthroplasty Total hip arthroplasty (THA) is a common orthopedic surgery that replaces arthritic portions of the femur and acetabulum with metal components coupled with an ultra-high-molecular-weight...
Abstract
This article provides an overview of currently available metal AM processes for the medical industry; outlines a step-by-step review of the typical workflow for design, manufacturing, evaluation, and implantation of patient-specific AM devices; and examines the existing research trends in medical applications of AM with specific focus on metallic biomedical implants. Finally, challenges and opportunities for future developments in AM pertaining to the medical field are also explored.
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