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This article is a review of important material requirements for hip biomaterials including their response to the body environment (biocompatibility), mechanical properties, wear resistance, fretting corrosion and availability as well as the price. The application of proper biomaterials for hip implants is one of the major focal points in this article. Background information is also provided on metals used in other prosthetic devices and implant components. Titanium and its alloys, cobalt base alloys and stainless steels (bio-steels) are used for load-bearing hip implants. These three groups of metallic materials will be introduced and discussed in detail. Metals and their alloys are crystalline materials since their properties depend on the crystal lattice, chemical and phase compositions, grain size, lattice defects, crystalline texture and residual microand macro-stresses. All these features of biomaterials are formed during technological manufacturing, such as metallurgical process, solidification, plastic deformation (rolling and forging), machining, heat treatment and coating. All these technological processes work in optimal conditions in order to achieve the optimal microstructure and mechanical, chemical and biological properties. Amongst the above-mentioned particular properties of biomaterials, fretting is a major concern as regards hip implants at the femoral head and neck taper interface. Additional important mechanisms of interaction between the implant and the human body must be taken into account, i.e. diffusion stream of foreign particles and atoms from the implant to body fluids, to the tissue and to the bone. These foreign particles and atoms are released from the implant to the body fluid, to the tissue and to the bone as wear product during use. All together they contribute to the wear, i.e. loss of weight, strength or volume of hip components. Wear rates of ultrahigh molecular weight polyethylene mated against Ti-6Al-4V are significantly greater than the ones for Co-Cr-Mo alloys. Therefore, thermochemical surface treatments like diffusion ion nitriding should be applied to increase the resistance of titanium alloys to wear. Austenitic stainless steels are also used for temporary applications, but they have lower resistance to pitting corrosion than titanium and cobalt alloys. The purpose of the paper is to introduce a group of metallic materials, which is often chosen for surgical hip implants. Conclusions of the paper refer to information which support important medical and patient decisions on hip implants. Also, the development of biomaterials, their treatments, properties, surface layers and coatings are considered. All these features develop over time and need synergy and experience in the progress of the biomedical, mechanical and materials science.
The full postoperative loading of the limb is possible if patients are properly selected and qualified for hip arthroplasty and the requirements as to the proper position of the metaphysial stem are met. The lack of precision, and patient qualification which does not satisfy the fixed criteria may result in stem setting inconsistent with the assumptions. An analysis based on the finite element method (FEM) will enable one to find out how to plan the magnitude of operated joint loading on the basis of the position of the stem in the postoperative radiograph. By analyzing the distribution of bone tissue deformations one can identify the zones where the spongy bone is overloaded and determine the strain level in comparison with the one determined for a model of the bone with the stem in proper position. On the basis of the results obtained one can estimate the range of loads for the operated limb, which will not result in the loss of the stem’s primary stability prior to obtaining secondary stability through osteointegration. Moreover, an analysis of the formation of bone structures around the stem showed that the incorrect setting of a Metha-type stem may lead to the initiation of loosening.
W eksperymencie in vivo zbadano podstawowe cechy dwufazowego kompozytu kościozastępczego tj. biozgodność i osteokonduktywność, a także jego właściwości osteoindukcyjne. Testowany kompozyt, przeznaczony do wypełniania ubytków kostnych, został wykonany z granul hydroksyapatytu węglanowego i polimeru polisacharydowego. Biomateriał został wszczepiony do kości piszczelowych królików na okres 1 lub 3 miesięcy. Po tym czasie zbadano stopień regeneracji kości na podstawie badań makroskopowych (radiologicznych) i mikroskopowych. Stwierdzono zaawansowane procesy osteointegracji i przebudowy kostnej w okolicy implantu, co wskazuje zarówno na osteokonduktywne, jak i osteoindukcyjne właściwości badanego biomateriału.
Basic characteristics of a hydroxyapatite-glucan biomaterial such as biocompatibility, osteoconductivity and osteoinductive properties were tested in in vivo experiment. The two-phase composite, intended for filling bone defects, was made of carbonated hydroxyapatite granules and polysaccharide polymer. The biomaterial was implanted to the tibial metaphysis in rabbits for the 1- or 3-month period. Bone regeneration after that time was evaluated by radiology and histology. Our analysis showed advanced osseointegration and extensive bone remodelling in the direct vicinity of implants indicating osteoinductive and osteoconductive properties of the material studied.
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