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Published in William Bolton, R.A. Higgins, Materials for Engineers and Technicians, 2020
Hip and knee joint replacements are now a relatively common operation. The issues that have to be addresses with such implants are that healthy cartilage surfaces in natural joints have a surface friction approaching zero. Artificial joints have a higher surface friction which subjects the implant components to wear. This, of course, limits the life of the joint replacement but can also result in the release of very small wear particles into the surrounding joint cavity. These particles can induce inflammatory responses in the tissue surrounding the joint, possibly loosening the implant and so making it necessitary to replace it. In a hip joint replacement, the femoral head is removed and replaced by a rigid pin with a ball head installed in the shaft of the femur; the ball head is able to rotate in a cup attached to the ilium. Both the pin and the cup are attached to the surrounding bone by an adhesive.
Analytical review on the biocompatibility of surface-treated Ti-alloys for joint replacement applications
Published in Expert Review of Medical Devices, 2022
Joint replacement is a surgical procedure in which an artificial joint surgically replaces arthritic or damaged joints made up of metals or plastic components. Damage to the joint may be caused due to several reasons such as aging, accident, or osteoarthritis. So, such damage causes orthopedic surgery that generally requires internal fixation of joints to provide stability during the bone healing process. Historically, cemented and cementless implant designs were used for total joint replacement (TJR) [1]. Cementless techniques are achieving more attention and popularity for TJR due to the removal of the second surgery requirement in cemented implants [2]. In cemented technique, initially, implants possess excellent mechanical strength, but later osteolysis causes loosening of implants. The biological response of cementless implants provides long-term mechanical stability. These implants’ stability depends on several parameters, such as corrosion behavior, debris created, and ions released from the implant. So, bone adaptation to implant and stress shielding is the central areas of concern [3].
How might the longer-than-expected lifetimes of hip and knee replacements affect clinical practice?
Published in Expert Review of Medical Devices, 2019
Timothy J. Fowler, Ashley W. Blom, Adrian Sayers, Michael R. Whitehouse, Jonathan T. Evans
Hip and knee replacements are the principal surgical interventions for end-stage degenerative hip and knee conditions, such as osteoarthritis, with the aims of long-term pain relief and restoration of function. Both are effective and generally associated with excellent outcomes [1,2]. Joint replacements are, however, susceptible to failure through various mechanisms including loosening, wear, infection, fracture, and instability. Implant failure often leads to revision surgery, which poses a significant economic burden and typically has worse outcomes than primary arthroplasty [3]. It is estimated that more than 7 million people in the USA are living with either a hip or knee replacement and the incidence of primary hip and knee arthroplasty is increasing [1,2,4]; a trend which will inevitably exacerbate the burden of revision surgery.