Table Of ContentSynthesis Lectures on Biomedical Engineering
Armando Reyes Rojas · Alfredo Aguilar Elguezabal ·
Alessandro Alan Porporati · Miguel Bocanegra Bernal ·
Hilda Esperanza Esparza Ponce
Performance of Metals
and Ceramics in Total
Hip Arthroplasty
Synthesis Lectures on Biomedical
Engineering
Series Editor
John Enderle, Storr, USA
This series consists of concise books on advanced and state-of-the-art topics that span
the field of biomedical engineering. Each Lecture covers the fundamental principles in
a unified manner, develops underlying concepts needed for sequential material, and pro-
gresses to more advanced topics and design. The authors selected to write the Lectures
are leading experts on the subject who have extensive background in theory, application,
and design. The series is designed to meet the demands of the 21st century technology
and the rapid advancements in the all-encompassing field of biomedical engineering.
Armando Reyes Rojas ·
Alfredo Aguilar Elguezabal ·
Alessandro Alan Porporati ·
Miguel Bocanegra Bernal ·
Hilda Esperanza Esparza Ponce
Performance of Metals
and Ceramics in Total Hip
Arthroplasty
Armando Reyes Rojas Alfredo Aguilar Elguezabal
Laboratorio Nacional de Nanotecnologia Laboratorio Nacional de Nanotecnologia
Centro de Investigación en Materiales Centro de Investigación en Materiales
Avanzados S.C. Avanzados S.C.
Chihuahua, Mexico Chihuahua, Mexico
Alessandro Alan Porporati Miguel Bocanegra Bernal
Medical Products Division Laboratorio Nacional de Nanotecnologia
CeramTec GmbH Centro de Investigación en Materiales
Plochingen, Germany Avanzados S.C.
Chihuahua, Mexico
Department of Engineering and Architecture
University of Trieste
Trieste, Italy
Hilda Esperanza Esparza Ponce
Laboratorio Nacional de Nanotecnologia
Centro de Investigación en Materiales
Avanzados S.C.
Chihuahua, Mexico
ISSN 1930-0328 ISSN 1930-0336 (electronic)
Synthesis Lectures on Biomedical Engineering
ISBN 978-3-031-25419-2 ISBN 978-3-031-25420-8 (eBook)
https://doi.org/10.1007/978-3-031-25420-8
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG
2023
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Preface
Joint replacement using different materials has been in use over the past 50 years with
outstanding success. Millions of people throughout the world have benefited from total
hip arthroplasty THA surgery, extending their mobility and quality of life by years. How-
ever, a clear conclusion can be the one reported by Kuncická et al. [1] pointing out that
there are opportunities to improve joint replacements by improving the materials from
which they are made. Materials such as metals, ceramics, and polymers serve critical
functions in implant systems, and therefore their respective roles and properties are fre-
quently shifting with the advancements in each category and the introduction of hybrid
material systems. After reviewing different metallic, ceramic, polymeric, and composite
materials used nowadays in THA, there remain issues that must be solved to ensure good
pain relief, increasing more and more the activity levels in young patients undergoing hip
replacement, as well as longevity of the prosthesis, reaching a higher range of motion
as well as stability in those ranges. It was observed that the mechanical, material, and
processing issues are imperative in the design, selection, and improvement in the fabrica-
tion of hip replacements. For a specific application such as THA, a correct choice of the
defined material to fulfill the requirements of different standards for a particular total hip
arthroplasty system component is necessary. The proper selection of metallic, ceramic,
polymeric, or composite material plays a crucial role in getting the combination of prop-
erties such as high strength, wear, and corrosion resistance, as well as biocompatibility.
With the passage of time and balancing the pros and cons of the various materials used
for applications in THA, it could be determined that the use of ceramic materials (alumina
matrix composite mainly) is best suited as bearing material for example.
In conclusion, the innovations in the design and fabrication processes for the different
materials for THA are raising the great reality of being able to obtain, in the medium term,
implants with improved performance to match both the biocompatibility and mechanical
complexity of the hip implants. However, to achieve this, surgeons in close alliance with
biologists and engineers cannot be ignored. They must be persuaded of the long-term
durability and reliability of the available biomaterials. Everything mentioned leads to
v
vi Preface
the future to see novel biomaterials being developed that will increase the lifespan of
orthopedic implants. Today it is not possible to fully ensure which material is the one that
will dominate orthopedics.
Chihuahua, Mexico Armando Reyes Rojas
Chihuahua, Mexico Alfredo Aguilar Elguezabal
Plochingen, Germany/Trieste, Italy Alessandro Alan Porporati
Chihuahua, Mexico Miguel Bocanegra Bernal
Chihuahua, Mexico Hilda Esperanza Esparza Ponce
Reference
1. Kuncická L, Kocich R, Lowe TC. Advances in metals and alloys for joint replacement. Prog
Mater Sci 2017;88:232–80. https://doi.org/10.1016/j.pmatsci.2017.04.002.
Contents
1 Introduction ........................................................ 1
References .......................................................... 2
2 State of the Art in Orthopaedic Implants .............................. 5
References .......................................................... 12
3 Biocompatibility .................................................... 17
References .......................................................... 20
4 Metals and Alloys Choice for Implants ................................ 23
4.1 Stainless Steels ................................................. 24
4.2 Cobalt Based Alloys ............................................. 26
4.3 Titanium and Its Alloys .......................................... 27
4.4 Tantalum and Its Alloys .......................................... 29
4.5 Niobium and Its Alloys .......................................... 33
4.6 Mg Alloys ..................................................... 34
References .......................................................... 37
5 Metal Implant Allergy ............................................... 49
References .......................................................... 55
6 Ceramics Choice for Implants ........................................ 59
6.1 Bioactive Ceramics .............................................. 60
6.2 Alumina Ceramics .............................................. 62
6.3 Zirconia Ceramics ............................................... 66
6.4 Oxide Ceramic Composites ....................................... 69
6.5 Non-oxide Ceramics ............................................. 75
References .......................................................... 78
7 Immuno-Allergological Compatibility Aspects of Ceramic Materials ..... 89
References .......................................................... 90
vii
viii Contents
8 Mechanical Aspects of Implant Materials .............................. 93
8.1 Metals ......................................................... 93
8.1.1 Strength ................................................. 94
8.1.2 Wear .................................................... 96
8.1.3 Fatigue .................................................. 100
8.1.4 Corrosion ................................................ 109
8.2 Ceramics ....................................................... 122
8.2.1 Hardness ................................................ 123
8.2.2 Flexural Strength ......................................... 125
8.2.3 Fracture Toughness ....................................... 131
8.2.4 Fatigue .................................................. 136
8.2.5 Wear .................................................... 143
8.2.6 Accelerated Ageing Tests .................................. 147
References .......................................................... 153
9 Outlooks and Horizons in Materials and Technologies .................. 181
References .......................................................... 183
10 Conclusions ......................................................... 185
Reference ........................................................... 186
Abbreviations
Al O Alumina
2 3
AMCs Alumina Matrix Composites
ARMD Adverse Reaction to Metallic Debris
ATZ Alumina-Toughened Zirconia
CNB Chevron-Notched Beam
CNTs Carbon Nanotubes
CoC Ceramic-on-Ceramic
CoM Ceramic-on-Metal
CoP Ceramic-on-Polyethylene
CP Ti Commercially Pure Titanium
CPTi Commercially Pure hcp Titanium
CVD Chemical Vapour Deposition
DCM Direct Crack Measurement
DLC Diamond-Like-Carbon
DMLS Direct Metal Laser Sintering
DNA Deoxyribonucleic acid
EBSS Earle’s Balanced Salt Solution
EDS X-Ray Spectroscopy
EIS Electrochemical Impedance Spectroscopy
ESR Electro-Slag Re-melting
FDA American Food and Drug Administration
FEA Finite Element Analysis
Hap Hydroxyapatite
HCA Active Hydroxycarbonate Apatite
HCF High-Cycle Fatigue Lifetime
HDP High-Density Polyethylene
HIP Hot Isostatic Pressing
HIPRBSN Hot Isostatic Pressing Reaction Bonding Silicon Nitride
HIPSN Hot Isostatic Pressing Silicon Nitride
HIPSRBSN Hot Isostatic Pressing Sintered Reaction Bonded Silicon Nitride
ix
