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Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement

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A special issue of Materials (ISSN 1996-1944).

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 17207

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Special Issue Editor

Prof. Dr. Saverio Affatato

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Guest Editor

Laboratorio di Tecnologia Medica, IRCCS – Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy
Interests: biotribology; ceramic; metal; composite; biomaterials; hip; knee; simulator; in silico; prosthesis
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Special Issue Information

Dear Colleagues,

It is a great pleasure to announce this Special Issue, Metal and Ceramics composite Materials for Prosthetic Hip and Knee Joint Replacement.

Joint replacement surgery is a successful and consolidated branch of orthopaedics. It is a progressive achievement in alleviating pain and disability, helping patients to return to an active life. The research of new biomaterials plays an important role, and, as a consequence, in vitro tests for such materials are of great importance. Knowledge of the laboratory wear rate is an important aspect in the preclinical validation of prostheses. The research and development of wear-resistant materials continues to be a high priority, in order to evaluate the performance of the new materials intended to reduce wear it is essential to ascertaining their efficacy and to prevent the possibility of unexpected failure.

This international peer-reviewed open access journal is indexed by the Science Citation Index Expanded (Web of Science) ISSN: 1996-1944, Impact Factor: 2.972.

Among the biomaterials used in the orthopaedic field, ceramic and metal composites and alloys are currently investigated as valid solutions that aim to restore a patient’s mobility and alleviate pain, assuring a low wear rate and high biocompatibility.

I hope to receive many interesting contributions.

Best Regards,

Dr. Saverio Affatato
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Materials is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

hip prostheses
knee prostheses
orthopaedic
biomaterials
composites
alloys
wear
tribology
SEM analyses
micro-CT analyses
FEM
ceramic
metal
Raman spectroscopy
in silico simulation

Published Papers (5 papers)

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Research

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15 pages, 4090 KiB

Open AccessFeature PaperArticle

Burst Strength of BIOLOX^®delta Femoral Heads and Its Dependence on Low-Temperature Environmental Degradation

by Toshiyuki Tateiwa, Elia Marin, Alfredo Rondinella, Marco Ciniglio, Wenliang Zhu, Saverio Affatato, Giuseppe Pezzotti, Ryan M. Bock, Bryan J. McEntire, B. Sonny Bal and Kengo Yamamoto

Materials 2020, 13(2), 350; https://0-doi-org.brum.beds.ac.uk/10.3390/ma13020350 - 12 Jan 2020

Cited by 7 | Viewed by 2875

Abstract

Zirconia-toughened alumina (ZTA) currently represents the bioceramic gold standard for load-bearing components in artificial hip joints. ZTA is long known for its high flexural strength and fracture toughness, both properties arising from a microscopic crack-tip shielding mechanism due to the stress-induced tetragonal-to-monoclinic (t→m) polymorphic transformation of zirconia. However, there have been concerns over the years regarding the long-term structural performance of ZTA since the t→m transformation also spontaneously occurs at the material’s surface under low-temperature environmental conditions with a concomitant degradation of mechanical properties. Spontaneous surface degradation has been extensively studied in vitro, but predictive algorithms have underestimated the extent of in vivo degradation observed in retrievals. The present research focused on burst-strength assessments of Ø28 mm ZTA femoral before and after long-term in vitro hydrothermal ageing according to ISO 7206-10. An average burst strength of 52 kN was measured for pristine femoral heads. This value was ~36% lower than results obtained under the same standard conditions by other authors. A further loss of burst strength (~13% in ultimate load) was observed after hydrothermal ageing, with increased surface monoclinic content ranging from ~6% to >50%. Nevertheless, the repetitively stressed and hydrothermally treated ZTA heads exceeded the minimum burst strength stipulated by the US Food and Drug Administration (FDA) despite severe test conditions. Lastly, Raman spectroscopic assessments of phase transformation and residual stresses on the fracture surface of the femoral heads were used to clarify burst-strength fluctuations and the effect of hydrothermal ageing on the material’s overall strength degradation. Full article

(This article belongs to the Special Issue Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement)

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11 pages, 5469 KiB

Open AccessFeature PaperArticle

Comparison of Meshing Strategies in THR Finite Element Modelling

by Alessandro Ruggiero, Roberto D’Amato and Saverio Affatato

Materials 2019, 12(14), 2332; https://0-doi-org.brum.beds.ac.uk/10.3390/ma12142332 - 23 Jul 2019

Cited by 34 | Viewed by 4270

Abstract

In biomechanics and orthopedics, finite element modelling allows simulating complex problems, and in the last few years, it has been widely used in many applications, also in the field of biomechanics and biotribology. As is known, one crucial point of FEM (finite element model) is the discretization of the physical domain, and this procedure is called meshing. A well-designed mesh is necessary in order to achieve accurate results with an acceptable computational effort. The aim of this work is to test a finite element model to simulate the dry frictionless contact conditions of a hip joint prosthesis (a femoral head against an acetabular cup) in a soft bearing configuration by comparing the performances of 12 common meshing strategies. In the simulations, total deformation of the internal surface of the cup, contact pressure, and the equivalent von Mises stress are evaluated by using loads and kinematic conditions during a typical gait, obtained from a previous work using a musculoskeletal multibody model. Moreover, accounting for appropriate mesh quality metrics, the results are discussed, underlining the best choice we identified after the large amount of numerical simulations performed. Full article

(This article belongs to the Special Issue Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement)

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12 pages, 8684 KiB

Open AccessArticle

In Silico Optimization of Femoral Fixator Position and Configuration by Parametric CAD Model

by Nikola Korunovic, Dragan Marinkovic, Miroslav Trajanovic, Manfred Zehn, Milorad Mitkovic and Saverio Affatato

Materials 2019, 12(14), 2326; https://0-doi-org.brum.beds.ac.uk/10.3390/ma12142326 - 22 Jul 2019

Cited by 4 | Viewed by 3088

Abstract

Structural analysis, based on the finite element method, and structural optimization, can help surgery planning or decrease the probability of fixator failure during bone healing. Structural optimization implies the creation of many finite element model instances, usually built using a computer-aided design (CAD) model of the bone-fixator assembly. The three most important features of such CAD models are: parameterization, robustness and bidirectional associativity with finite elements (FE) models. Their significance increases with the increase in the complexity of the modeled fixator. The aim of this study was to define an automated procedure for the configuration and placement of fixators used in the treatment of long bone fractures. Automated and robust positioning of the selfdynamisable internal fixator on the femur was achieved and sensitivity analysis of fixator stress on the change of major design parameters was performed. The application of the proposed methodology is considered to be beneficial in the preparation of CAD models for automated structural optimization procedures used in long bone fixation. Full article

(This article belongs to the Special Issue Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement)

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13 pages, 2927 KiB

Open AccessArticle

A Critical Analysis of TKR In Vitro Wear Tests Considering Predicted Knee Joint Loads

by Saverio Affatato and Alessandro Ruggiero

Materials 2019, 12(10), 1597; https://0-doi-org.brum.beds.ac.uk/10.3390/ma12101597 - 15 May 2019

Cited by 9 | Viewed by 2832

Abstract

Detailed knowledge about loading of the knee joint is essential for preclinical testing of total knee replacement. Direct measurement of joint reaction forces is generally not feasible in a clinical setting; non-invasive methods based on musculoskeletal modelling should therefore be considered as a valid alternative to the standards guidelines. The aim of this paper is to investigate the possibility of using knee joint forces calculated through musculoskeletal modelling software for developing an in vitro wear assessment protocol by using a knee wear simulator. In particular, in this work we preliminarily show a comparison of the predicted knee joint forces (in silico) during the gait with those obtained from the ISO 14243-1/3 and with those measured in vivo by other authors. Subsequently, we compare the wear results obtained from a knee wear joint simulator loaded by calculated forces in correspondence to the “normal gait” kinematics with those obtained in correspondence to the loads imposed by the ISO. The obtained results show that even if the predicted load profiles are not totally in good agreement with the loads deriving from ISO standards and from in vivo measurements, they can be useful for in vitro wear tests, since the results obtained from the simulator in terms of wear are in agreement with the literature data. Full article

(This article belongs to the Special Issue Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement)

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Review

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14 pages, 2519 KiB

Open AccessReview

Revision of a Monoblock Metal-on-Metal Cup Using a Dual Mobility Component: Is It a Reasonable Option?

by Saverio Affatato, Emanuela Castiello, Luca Amendola, Saverio Comitini, Jean Louis Prudhon and Domenico Tigani

Materials 2020, 13(9), 2040; https://0-doi-org.brum.beds.ac.uk/10.3390/ma13092040 - 27 Apr 2020

Cited by 6 | Viewed by 3319

Abstract

Revision of large-diameter, monoblock acetabular components for both hip resurfacing arthroplasty and metal-on-metal (MoM) total hip arthroplasty (THA) is correlated to a high amount of complications. For this reason, performing a limited revision by conversion to a dual mobility (DM) without acetabular component exchange has been proposed in order to limit these complications. Although DM bearing offers an easy solution avoiding the intraoperative and time-associated complications, concern about polyethylene wear and stability remains due to the difference regarding the design, the coverage angle and the clearance of the two implants. In order to evaluate the performance of this new solution with the new material to prevent the possibility of failure it is essential to conduct a review of the literature A qualitative systematic review of the literature has been conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, EMBASE, Google Scholar, and Scopus for English and French articles between January 2000 and October 2019 was performed, with the primary objective of finding articles about dual mobility bearing coupling with large metal-on-metal cup in the case of hip revision procedure. Various combinations of the key words were used in the search strategy. Thirteen articles with DM bearing mated with MoM cup were analyzed. Of the 130 hip revisions selected, with a follow-up from 6 to 53 months, there were a total of 14 with complications (10.77%): four true dislocations (3.08%); six intra-prosthetic dislocations (IPD, 4.6%), two of which presented plastic deformation and polyethylene wear; four other complications (3.08%), included a cup osteolysis, a clicking noise, a superficial infection and a periprosthetic fracture. All the mentioned true dislocations occurred during the first month while IPDs appeared during the first two years from the index revision. In conclusion, according to the literature analyzed, we can stress that the concerns and doubts about mating a DM bearing with large MoM cup cannot be dissolved. It has been pointed out that a DM bearing is not designed for a MoM cup; it is not mechanically tested on MoM cups, which presents different clearance and coverage angles. Predictable complications may occur, such as IPD, polyethylene wear and true dislocation. These complications have been reported at an even higher rate than they were in the eighties, when the first generation of DM implants were of a lower quality of polyethylene and the characteristic of the design was less optimal than modern ones. Full article

(This article belongs to the Special Issue Metal and Ceramics Composite Materials for Prosthetic Hip and Knee Joint Replacement)

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