Composites in Biomedical Applications

S. M. Sapuan, Y. Nukman, N.A. Abu Osman, R.A. Ilyas, S. M. Sapuan, Y. Nukman, N.A. Abu Osman, R.A. Ilyas

• Publisher: CRC Press
• Year: 2020
• Print ISBN: 9780367271688
• eBook ISBN: 9781000175219
• Topic: Technology & Engineering
• Subtopic: Biotechnology in Medicine
• Index: Technology & Engineering

Composites in Biomedical Applications presents a comprehensive overview on recent developments in composites and their use in biomedical applications. It features cutting-edge developments to encourage further advances in the field of composite research.

• Highlights a completely new research theme in polymer-based composite materials
• Outlines a broad range of different research fields, including polymer and natural fiber reinforcement used in the development of composites for biomedical applications
• Discusses advanced techniques for the development of composites and biopolymer-based composites
• Covers fatigue behavior, conceptual design in ergonomics design application, tissue regeneration or replacement, and skeletal bone repair of polymer composites
• Details the latest developments in synthesis, preparation, characterization, material evaluation, and future challenges of composite applications in the biomedical field

This book is a comprehensive resource for advanced students and scientists pursuing research in the broad fields of composite materials, polymers, organic or inorganic hybrid materials, and nano-assembly.

1The Hip Joint and Total Hip Replacement

N. A. Abu Osman,^1,4 A. Ataollahi,¹ S. M. Sapuan,^2,3 Y. Nukman,¹ and R. A. Ilyas^2,3

¹Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia

²Advanced Engineering Materials and Composites Research Centre, Department of Mechanical and Manufacturing Engineering, Universiti Putra Malaysia, Malaysia

³Laboratory of Biocomposite Technology, Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, Malaysia

⁴The Chancellery, Universiti Malaysia Terengganu, Malaysia

CONTENTS

• 1.1Introduction
• 1.2Implant Fixation Methods
• 1.3Total Hip Replacement Failure
  • 1.3.1Osteolysis
  • 1.3.2Primary Stability
  • 1.3.3Stress Shielding
  • 1.3.4Cement Failure
  • 1.3.5Debonding
  • 1.3.6Implant Fracture
• 1.4Material and Geometry of Artificial Hip Joint Constituents
  • 1.4.1Femoral Head and Acetabular Cup
  • 1.4.2Femoral Prosthesis (STEM)
  • 1.4.3Femoral Prosthesis Geometry
  • 1.4.4Femoral Prosthesis Materials
• 1.5Surface Finishing
• 1.6Materials Utilized in Artificial Hip Joint Components
  • 1.6.1Metals
  • 1.6.2Polymers
  • 1.6.3Ceramics
  • 1.6.4Composites
• 1.7Numerical Methods in Hip Joint Biomechanics and Implant Study
• 1.8Load Transfer in the Proximal Femur
• 1.9Bone
• 1.10Conclusion
• References

1.1Introduction

This chapter presents a brief on hip joint and total hip replacement (THR). The hip joint is composed of soft and hard tissues. A joint comprises the femoral head, acetabulum, cartilage, and ligaments (Figure 1.1). The hip joint is classified as a ball-and-socket joint (Polkowski & Clohisy, 2010). The ball-and-socket joint provides three rotational movements, namely, flexion–extension, abduction–adduction, and internal–external rotation. The femoral head is connected to the femur via the femoral neck. The cartilage supplies a frictionless joint. The stability of the hip joint is supplied by the ligaments and muscles. This structure provides optimal stability for the stance and bipedal locomotion, but the hip joint endures complex dynamic and static loads (Bowman Jr et al., 2010).

FIGURE 1.1The hip joint (Stops et al., 2011).

Mechanical injury, chemical process, and/or their combination can cause degeneration and dysfunction in the articular hip joint (Bougherara et al., 2011). The most common causes of hip joint degeneration are osteoarthritis, fracture of the hip, inflammatory arthritis, femoral head necrosis, and rheumatoid arthritis (Figure 1.2).

FIGURE 1.2Three typical hip joint diseases: (a) osteoarthritis, (b) necrosis, and (c) neck fracture. (Reproduced with permission from Dunne and Ormsby (2011) and Ilesanmi (2010), Creative Commons Attribution 3.0 License 2012, IntechOpen.)

The final recourse but the most successful procedure to remedy a severely degenerated hip joint is THR (Caeiro et al., 2011). This procedure alleviates the pain and restores hip joint function. In THR, the natural hip joint is replaced with an artificial hip joint, which consists of the femoral head, acetabular cup (acetabular shell and liner), and femoral prosthesis (stem) (Figure 1.3). The artificial hip joint components are formed in a modular or monoblock structure. A femoral head may also be included in a femoral prosthesis in a monoblock structure.

FIGURE 1.3A typical artificial hip prosthesis. (Reproduced with permission from Li et al. (2014), Creative Commons Attribution 3.0 License 2012, IntechOpen.)

1.2Implant Fixation Methods

The implants are fixed inside the bone with or without cement (Figure 1.4). Cemented prosthesis fixation secures an orthopedic cement prosthesis within the bone. An orthopedic cement is made of polymethylmethacrylate, which is a self-curing and nonadhesive polymeric material (Pal et al., 2013). Therefore, interlocking the spongy bone–cement and cement–implant features provides fixation (Pal et al., 2013). However, in a cementless prosthesis, fixation is performed by press fitting or screwing the components in the bone. This procedure guarantees primary stability for the in-growth and on-growth of the bone to the implant surfaces, thus providing secondary fixation and long-term durability. Porous and hydroxyapatite (HA) coatings are applied on the surface of a cementless prosthesis to strengthen primary and secondary fixation.

FIGURE 1.4Typical cemented and uncemented fixation. (Reproduced with permission from Izzo (2012), Creative Commons Attribution 4.0 License 2012, IntechOpen.)

Moreover, a hybrid THR is a process in which cementless and cemented methods are used to fix the artificial hip joint components in THR. Bone quality is the most influential criterion in selecting a fixation procedure. Young and more active patients have better bone quality than old and less active patients. Accordingly, a cementless prosthesis is more appropriate for young patients, whereas a cemented prosthesis is more suitable for older patients. Each implant fixation method has advantages and disadvantages. For example, cement provides instant fixation, but a cementless prosthesis bone must grow to secure the prosthesis in the bone. In addition, a cemented prosthesis requires a bigger hole or more reaming inside the bone than a cementless prosthesis. The revision rate of patients who underwent THR with cemented prosthesis is lower than that of patients with cementless prosthesis.

1.3Total Hip Replacement Failure

Developments in the design, technology, and technical operation increased the success rate of THR. However, THR failure remains a problem, so revision surgery is essential and unpreventable. For example, 10% of all THR surgeries in the USA per year undergo THR revision surgery (Brown & Huo, 2002). Accordingly, the components of the old artificial joint are partially or totally replaced with new components. Mechanical factors are more common causes of THR failure than infection. Aseptic loosening is the most important cause of THR failure (Gross & Abel, 2001). The mechanisms leading to aseptic loosening remain ambiguous. Osteolysis, l...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Preface
• Editors
• Contributors
• Chapter 1 The Hip Joint and Total Hip Replacement
• Chapter 2 A Review of Biocomposites in Biomedical Application
• Chapter 3 Biocomposites in Advanced Biomedical and Electronic Systems Applications
• Chapter 4 Resin-Based Composites in Dentistry—A Review
• Chapter 5 Classifications and Applications of Biocomposite Materials in Various Biomedical Fields
• Chapter 6 Conceptual Design of Composite Crutches
• Chapter 7 Conceptual Design of Kenaf Fiber Reinforced Polymer Composite Chair with Input from Anthropometric Data
• Chapter 8 A Review on Nanocellulose Composites in Biomedical Application
• Chapter 9 Medical Rubber Glove Waste As Potential Filler Materials in Polymer Composites
• Chapter 10 Fabrication and Properties of Polylactic Acid/Hydroxyapatite Biocomposites for Human Bone Substitute Materials
• Chapter 11 Hydrogel-Based Composites in Perfusion Cell Culture/Test Device: Drug Delivery through Diffusion
• Chapter 12 Nanocomposites for Human Body Tissue Repair
• Chapter 13 Advances in Marine Skeletal Nanocomposites for Bone Repair
• Chapter 14 Magnesium Metal Matrix Composites for Biomedical Applications
• Index