The effect of coating characteristics on implant-bone interface mechanics.

Successful osseointegration of press-fit implants depends on the initial stability, often measured by the micromotions between the implant and bone. A good primary stability can be achieved by optimizing the compressive and frictional forces acting at the bone-implant interface. The frictional properties of the implant-bone interface, which depend on the roughness and porosity of the implant surface coating, can affect the primary stability. Several reversible (elastic) and non-reversible (permanent) deformation processes take place during frictional loading of the implant-bone interface. In case of a rough coating, the asperities of the implant surface are compressed into the bone leading to mechanical interlocking. To optimize fixation of orthopaedic implants it is crucial to understand these complex interactions between coating and bone. The objective of the current study was to gain more insight into the reversible and non-reversible processes acting at the implant-bone interface. Tribological experiments were performed with two types of porous coatings against human cadaveric bone. The results indicated that the coefficient of friction depended on the coating roughness (0.86, 0.95, and 0.45 for an Ra roughness of 41.2, 53.0, and a polished surface, respectively). Larger elastic and permanent displacements were found for the rougher coating, resulting in a lower interface stiffness. The experiments furthermore revealed that relative displacements of up to 35 µm can occur without sliding at the interface. These findings have implications for micromotion thresholds that currently are assumed for osseointegration, and suggest that bone ingrowth actually occurs in the absence of relative sliding at the implant-bone interface.

Analysis of contact pressure in a 3D model of dual-mobility hip joint prosthesis under a gait cycle.

Hip joint prostheses are used to replace hip joint function in the human body. The latest dual-mobility hip joint prosthesis has an additional component of an outer liner that acts as a cover for the liner component. Research on the contact pressure generated on the latest model of a dual-mobility hip joint prosthesis under a gait cycle has never been done before. The model is made of ultrahigh molecular weight polyethylene (UHMWPE) on the inner liner and 316L stainless steel (SS 316L) on the outer liner and acetabular cup. Simulation modeling using the finite element method is considered static loading with an implicit solver for studying the geometric parameter design of dual-mobility hip joint prostheses. In this study, simulation modeling was carried out by applying varying inclination angles of 30°, 40°, 45°, 50°, 60°, and 70° to the acetabular cup component. Three-dimensional loads were placed on femoral head reference points with variations of femoral head diameter used at 22 mm, 28 mm, and 32 mm. The results in the inner surface of the inner liner, the outer surface of the outer liner, and the inner surface of the acetabular cup showed that the variations in inclination angle do not have a major effect on the maximum contact pressure value on the liner component, where the acetabular cup with an inclination angle of 45° can reduce contact pressure more than the other studied inclination angle variations. In addition, it was found that the 22 mm diameter of the femoral head increases the contact pressure. The use of a larger diameter femoral head with an acetabular cup configuration at a 45° inclination can minimize the risk of implant failure due to wear.

Adopted walking condition for computational simulation approach on bearing of hip joint prosthesis: review over the past 30 years.

Bearing on artificial hip joint experiences friction, wear, and surface damage that impact on overall performance and leading to failure at a particular time due to continuous contact that endangers the user. Assessing bearing hip joint using clinical study, experimental testing, and mathematical formula approach is challenging because there are some obstacles from each approach. Computational simulation is an effective alternative approach that is affordable, relatively fast, and more accessible than other approaches in examining various complex conditions requiring extensive resources and several different parameters. In particular, different gait cycles affect the sliding distance and distribution of gait loading acting on the joints. Appropriate selection and addition of gait cycles in computation modelling are crucial for accurate and reliable prediction and analysis of bearing performance such as wear a failure of implants. However, a wide spread of gait cycles and loading data are being considered and studied by researchers as reported in literature. The current article describes a comprehensive literature review adopted walking condition that has been carried out to study bearing using computational simulation approach over the past 30 years. Many knowledge gaps related to adoption procedures, simplification, and future research have been identified to obtain bearing analysis results with more realistic computational simulation approach according to physiological human hip joints.

Computational Contact Pressure Prediction of CoCrMo, SS 316L and Ti6Al4V Femoral Head against UHMWPE Acetabular Cup under Gait Cycle.

Due to various concerns about the use of metal-on-metal that is detrimental to users, the use of metal as acetabular cup material was later changed to ultra high molecular weight polyethylene (UHMWPE). However, the wear on UHMWPE releases polyethylene wear particles, which can trigger a negative body response and contribute to osteolysis. For reducing the wear of polyethylene, one of the efforts is to investigate the selection of metal materials. Cobalt chromium molybdenum (CoCrMo), stainless steel 316L (SS 316L), and titanium alloy (Ti6Al4V) are the frequently employed materials. The computational evaluation of contact pressure was carried out using a two-dimensional axisymmetric model for UHMWPE acetabular cup paired with metal femoral head under gait cycle in this study. The results show Ti6Al4V-on-UHMWPE is able to reduce cumulative contact pressure compared to SS 316L-on-UHMWPE and CoCrMo-on-UHMWPE. Compared to Ti6Al4V-on-UHMWPE at peak loading, the difference in cumulative contact pressure to respective maximum contact pressure is 9.740% for SS 316L-on-UHMWPE and 11.038% for CoCrMo-on-UHMWPE.

Predicting friction at the bone - Implant interface in cementless total knee arthroplasty.

Cementless total knee arthroplasty (TKA) components have rough and porous surface coatings which can enhance bone ingrowth and stability at the bone-implant. To achieve primary stability in the postoperative period where no apposition is formed, the resistance against motions between bone and implant is optimized by increasing the friction at the interface. This is necessary, as excessive relative motions can inhibit bone ingrowth, which might result in loosening and pain. In this research, it was found that the friction can be predicted by measuring the surface morphology of rough implants, and calculating the corresponding perpendicular and lateral contact area parameters. The ratio between these areas, is used to predict the resulting coefficient of friction (COF). This is validated experimentally, by analysing the tribological behaviour of 2 porous and rough titanium coatings against human cadaveric knee bones using reciprocal friction tests with varying normal loads. The results for 2 different coatings showed similar findings for the predicted COF (0.75 and 0.88) versus the calculated values based on the measurement (0.82 and 0.86) proving the feasibility of the approach.

Tresca Stress Simulation of Metal-on-Metal Total Hip Arthroplasty during Normal Walking Activity.

The selection of biomaterials for bearing in total hip arthroplasty is very important to avoid various risks of primary postoperative failure for patients. The current investigation attempts to analyze the Tresca stress of metal-on-metal bearings with three different materials, namely, cobalt chromium molybdenum (CoCrMo), stainless steel 316L (SS 316L), and titanium alloy (Ti6Al4V). We used computational simulations using a 2D axisymmetric finite element model to predict Tresca stresses under physiological conditions of the human hip joint during normal walking. The simulation results show that Ti6Al4V-on-Ti6Al4V has the best performance to reduce Tresca stress by 45.76% and 39.15%, respectively, compared to CoCrMo-on-CoCrMo and SS 316L-on-SS 316L.

The Effect of Bottom Profile Dimples on the Femoral Head on Wear in Metal-on-Metal Total Hip Arthroplasty.

Wear and wear-induced debris is a significant factor in causing failure in implants. Reducing contact pressure by using a textured surface between the femoral head and acetabular cup is crucial to improving the implant's life. This study presented the effect of surface texturing as dimples on the wear evolution of total hip arthroplasty. It was implemented by developing finite element analysis from the prediction model without dimples and with bottom profile dimples of flat, drill, and ball types. Simulations were carried out by performing 3D physiological loading of the hip joint under normal walking conditions. A geometry update was initiated based on the patient's daily routine activities. Our results showed that the addition of dimples reduced contact pressure and wear. The bottom profile dimples of the ball type had the best ability to reduce wear relative to the other types, reducing cumulative linear wear by 24.3% and cumulative volumetric wear by 31% compared to no dimples. The findings demonstrated that surface texturing with appropriate dimple bottom geometry on a bearing surface is able to extend the lifetime of hip implants.

Study of an Additional Layer of Cement Mantle Hip Joints for Reducing Cracks.

Failure of the cement mantle in total hip arthroplasty is not a simple phenomenon. Cracking, which can be caused by crack initiation and repeated loading, can cause loosening of the acetabular liner component. A previous study showed that addition of a metal layer between the liner and acetabular could reduce the stress at the contact surface of the cement mantle. This study elaborates on the performance of the additional layer. Several material properties of the layer were simulated using finite element analysis for maximum performance. A static contact analysis was used to simulate the stresses at the contact surface of the cement mantle. The results show that an additional layer of cobalt chrome produced the best performance.

Initial Response of Human Bone Marrow-Derived Stem Cells after Contact with Ultrahigh-Molecular-Weight Polyethylene (UHMWPE) Material: An In Vitro Study on Cell Viability and Interleukin-6 Expression.

INTRODUCTION: Ultrahigh-molecular-weight polyethylene (UHMWPE) is a thermoplastic polymer useful in biomaterial applications, especially in orthopedic field. Yet, little is known concerning its initial effect on human bone marrow stem cells (hBMSCs) after implantation. MATERIALS AND METHODS: A cytotoxicity analysis was performed with a 3-(4,5-dimethylthiazol 2-yl)-2,5-diphenyltetrazolium assay after 24, 48, and 72h of incubation of hBMSC culture. Expression of interleukin-6 (IL-6) was measured using enzyme-linked immunosorbent assay. Cell viability was measured with Inhibitory concentration 50% (IC50) formula. RESULTS: All treatment groups showed a cell viability of >50% ranging from 78% to >100%. Lower expression of IL-6 of hBMSC compared to control group was found in 48h of incubation period. CONCLUSION: hBMSC showed high cell viability after initial contact with UHMWPE material. Modulation of IL-6 expression was present at the initial stage as a response to foreign material.

Influence of suture size on the frictional performance of surgical suture evaluated by a penetration friction measurement approach.

The frictional performances of surgical sutures have been found to play a vital role in their functionality. The purpose of this paper is to understand the frictional performance of multifilament surgical sutures interacting with skin substitute, by means of a penetration friction apparatus (PFA). The influence of the size of the surgical suture was investigated. The relationship between the friction force and normal force was considered, in order to evaluate the friction performance of a surgical suture penetrating a skin substitute. The friction force was measured by PFA. The normal force applied to the surgical suture was estimated based on a Hertzian contact model, a finite element model (FEM), and a uniaxial deformation model (UDM). The results indicated that the penetration friction force increased as the size of the multifilament surgical suture increased. In addition, when the normal force was predicted by UDM, it was found that the ratio between the friction force and normal force decreased as the normal force increased. A comparison of the results suggested that the UDM was appropriate in predicting the frictional behavior of surgical suturing.

Study on the tribological behavior of surgical suture interacting with a skin substitute by using a penetration friction apparatus.

Surgical sutures have different sizes, structures, whereas they are being used for various surgeries. The high friction performance of surgical sutures in the suturing process may cause inflammation and pain, leading to a longer recovery time. This paper presents an understanding of the tribological behavior of surgical suture with monofilament and multifilament structures, by means of a penetration friction apparatus (PFA). The results indicated that structure and surface topography of the surgical suture had a pronounced effect on the tribological interactions. It was found that the friction force and abrasion area of skin substitute with the penetration of polyglycolic acid (PGA) multifilament surgical suture were larger than that of Nylon monofilament surgical suture. Meanwhile, more abrasion at the pull-in boundary of skin substitute was observed compared with that at the pull-out boundary.

Human Bone Marrow-Derived Mesenchymal Cell Reactions to 316L Stainless Steel: An in Vitro Study on Cell Viability and Interleukin-6 Expression.

Purpose: Human bone marrow-derived mesenchymal cell (hBMC) reactions to 316L stainless steel (316L-SS) have never been evaluated. The objective of this study was to assess cell viability and interleukin-6 expression of hBMC cultures upon treatment with a 316L-SS implant. Methods: A cytotoxicity analysis was conducted with a 3-(4,5-dimethylthiazol 2-yl)-2,5-diphenyltetrazolium (MTT) assay after a period of 24, 48 and 72 hours of incubation. Expression of interleukin-6 was measured using enzyme-linked immunosorbent assay (ELISA). Results: Cell viability measurement was performed via IC50 formula. All treatment group showed a > 50 % cell viability with a range of 56,5 - 96,9 % at 24 hours, 51,8-77,3% at 48 hours and 70,1- 120 % at 72 hours. Interleukin-6 expression was downregulated subsequent to treatment with 316L-SS compared to the control group. Conclusion: We found that 316L-SS did not exhibit toxicity towards hBMC culture.

Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture.

Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their functionality. The high friction force of surgical sutures in the suturing process may cause inflammation and pain to the person, leading to a longer recovery time, and the second trauma of soft or fragile tissue. Thus, the investigation into the frictional performance of surgical suture is essential. Despite the unquestionable fact, little is actually known on the friction performances of surgical suture-tissue due to the lack of appropriate test equipment. This study presents a new penetration friction apparatus (PFA) that allowed for the evaluation of the friction performances of various surgical needles and sutures during the suturing process, under different contact conditions. It considered the deformation of tissue and can realize the puncture force measurements of surgical needles as well as the friction force of surgical sutures. The developed PFA could accurately evaluate and understand the frictional behaviour of surgical suture-tissue in the simulating clinical conditions. The forces measured by the PFA showed the same trend as that reported in literatures.

Range of Motion Simulation of Hip Joint Movement During Salat Activity.

BACKGROUND: Impingement of an artificial hip joint because of limited range of motion (RoM) during human activity is one of the main sources of hip joint failure. The aim of this article is to simulate the RoMs of hip joints during salat, the practice of formal worship in Islam. METHODS: Salat consists of several stages which can be represented with a cycle (raka'ah). Every raka'ah consists of standing, bowing (ruku'), straightening up (i'tidal), transition of standing toward prostrating, prostrating (sujud), and sitting. A virtual skeleton model was used to analyze the motion during salat for the possibility of the impingement occurrence. RESULTS: The results of the simulation were presented in terms of maximum flexion, abduction, and internal or external rotation. The results also showed that the prostration position is similar in RoM with the Japanese zarei position and similar in RoM to pick up an object while sitting on a chair. CONCLUSION: Specific aspects of salat such as the difference in position of the 2 legs at the last sitting position create an extreme RoM which in turn results in a high risk of impingement.

Biological and Tribological Assessment of Poly(Ethylene Oxide Terephthalate)/Poly(Butylene Terephthalate), Polycaprolactone, and Poly (L\DL) Lactic Acid Plotted Scaffolds for Skeletal Tissue Regeneration.

Additive manufactured scaffolds are fabricated from three commonly used biomaterials, polycaprolactone (PCL), poly (L\DL) lactic acid (P(L\DL)LA), and poly(ethylene oxide terephthalate)/poly(butylene terephthalate) (PEOT/PBT). Scaffolds are compared biologically and tribologically. Cell-seeded PEOT/PBT scaffolds cultured in osteogenic and chondrogenic differentiation media show statistical significantly higher alkaline phosphatase (ALP) activity/DNA and glycosaminoglycans (GAG)/DNA ratios, followed by PCL and P(L\DL)LA scaffolds, respectively. The tribological performance is assessed by determining the friction coefficients of the scaffolds at different loads and sliding velocities. With increasing load or decreasing sliding velocity, the friction coefficient value decreases. PEOT/PBT show to have the lowest friction coefficient value, followed by PCL and P(L\DL)LA. The influence of the scaffold architecture is further determined with PEOT/PBT. Reducing of the fiber spacing results in a lower friction coefficient value. The best and the worst performing scaffold architecture are chosen to investigate the effect of cell culture on the friction coefficient. Matrix deposition is low in the cell-seeded scaffolds and the effect is, therefore, undetermined. Taken together, our studies show that PEOT/PBT scaffolds support better skeletal differentiation of seeded stromal cells and lower friction coefficient compared to PCL and P(L/DL)A scaffolds.