Purpose: Unfavourable distribution of contact stress over the load bearing area is considered a risk factor for early coxarthritis and it is of interest to outline respective biomechanical parameters ...for its prediction. The purpose of the work was to develop a transparent mathematical model which can be used to assess contact stress in the hip from imaged structures of pelvis and proximal femora, in large population studies and in clinical practice. Methods: We upgraded a previously validated three-dimensional mathematical model of the human hip in the one-legged stance HIPSTRESS by introducing parameters independent from the size of the structures in the images. We validated a new parameter – dimensionless peak stress normalized by the body weight and by the radius of the femoral head (p max r 2 /W B ) on the population of 172 hips that were in the childhood subjected to the Perthes disease and exhibited increased proportion of dysplastic hips. Results: The dimensionless parameter p max r 2 /W B exhibited smaller number of indecisive cases of hip dysplasia predicted by the model than the previously used parameter p max /W B (6% vs. 81%, respectively). A threshold for an increased risk of early coxarthritis development by the HIPSTRESS parameter H = p max r 2 /W B was found to be 2. Conclusions: We proposed a dimensionless peak stress on the load bearing area with the border value of 2 as a decisive parameter over which hips are at risk for early development of degenerative processes and presented a method for determination of biomechanical parameters with the use of nomogram.
In this paper, we present the mechanisms of premature fracture of modular neck stems in two case studies: (I) when the neck and stem are both made of the same Ti6Al4V alloy, and (II) when the neck ...and stem are made from two different alloys, CoCrMo and Ti6Al4V alloy. Our study integrates two orthopedic patients who have undergone primary uncemented THA for usual indications in two orthopedic centers (Community Health Centre and University Medical Centre). Both centers are part of the national public health care system. Both surgeries were performed by two skilled orthopedic surgeons with more than 10 years of experience in THA. The survivorship of the modular neck of cast CoCrMo alloy was 24 months. The survivorship of the modular neck from Ti6Al4V alloy was 84 months. Multivariate analyses were performed to assess the differences in the fretting, corrosion, and fatigue of the two prematurely failed modular neck stems: stereo light microscopy (SLM), scanning electron microscopy (SEM), X-ray energy-dispersive spectroscopy (EDS), and electron backscatter diffraction (EBSD). Patient demographic information, including sex, age, body mass index, survivorship of implants, and reason for the revision, was collected from medical records. We found that fretting and fatigue occurred on both neck-stem retrievals due to additional galvanic corrosion, but the CoCrMo/Ti6Al4V alloy system suffered more corrosion due to additional galvanic corrosion and fractured earlier than the Ti6Al4V/Ti6Al4V metal alloy system. Both metallic alloy systems used in this application are known to be highly corrosion-resistant, but the bio-tribo-corrosion processes need to be understood in detail and characterized so that appropriate improvements in design and materials can be made.
We have investigated new and retrieved cementless hip endoprostheses that prematurely failed due to (i) aseptic loosening, (ii) infection and (iii) latent infection. The aim was to better understand ...the physico-chemical phenomena on the surfaces and sub-surfaces of the Ti6Al7Nb alloy implant. The results of our studies should enable us to distinguish the causes of premature failure, optimize the surface modification, achieve optimal osseointegration and extend the useful lifetime of the implants. The surface properties of the Ti6Al7Nb alloys of the hip-stem endoprostheses (30 retrieved and 2 new) were determined by contact-angle measurements and the average surface roughness. The surface chemistry and microstructure were analysed by scanning electron microscopy (SEM) for morphology, energy-dispersive X-ray spectroscopy (EDS) for the chemistry, and electron back-scatter diffraction (EBSD) for the phase analysis; Auger electron spectroscopy (AES) and X-ray photoelectron spectroscopy (XPS) for the surface chemistry; and electrochemical measurements for the corrosion. The improved wettability of the grit-blasted surface of the Ti6Al7Nb stems after autoclaving was measured, as was the super wettability after oxygen-plasma sterilization. The secondary-electron images showed that the morphology and microstructure of the new and retrieved stems (prematurely failed due to aseptic loosening, infection and latent infection) differ slightly, while the EDS analysis revealed corundum contamination of the grit-blasted surface. We found corundum-contaminated Ti6Al7Nb stem surfaces and sub-surfaces for all the investigated new and retrieved implants. These residues are a potential problem, i.e., third-body wear particles, and probably induce the osteolysis and aseptic loosening.
The study area is located in cental Slovenia, and geologically located at the junction between the Alps and the Dinarides. The Middle Triassic of this region is characterised by intense rifting ...manifested by differential subsidence and volcanism. This led to a major paleogeographic reorganisation of the region, where three paleogeographic domains formed in the Upper Triassic: The Julian Carbonate Platform in the north, the intermediate Slovenian Basin, both parts of the Southern Alps, and the Dinaric (Adriatic, Friuli) Carbonate Platform in the south, which today is a part of the External Dinarides that host the area of investigation. Prior to the installation of the Dinaric Carbonate Platfrom, i.e. in the Ladinian, the entire area of the preset-day External Dinarides broke up into numerous tectonic blocks that were exposed to either erosion or continental, shallow-marine, and deep-marine sedimentation. In this study, we analyse at small scale a complex transitional area between a local carbonate platform and the Kobilji curek basin (depositional area dominated by deeper marine sediments), located in the Rute Plateau in central Slovenia south of Ljubljana. During enhanced subsidence, the basin was filled with volcanic material (tuffs and volcanogenic clays and subordinate extrusive material), while the adjacent platform aggraded. The slope was positioned above active paleofaults. During relative sea level lowstand, the platform prograded across the basin. The study area is divided into four major tectonic paleoblocks. The NW paleoblock experienced the most enhanced subsidence, and the platform prograded twice in this area and was submerged again by the rejuvenated subsidence and/or sea-level rise. The second and third paleoblocks subsided only during discrete major subsidence events, and the carbonates of the platform and slope were soon reinstated therein. In the fourth paleoblock to the east the platform persisted during the Ladinian. In the Carnian, the entire study area became emerged, and continental clastics were deposited. These were then replaced by a uniform shallow marine/intertidal Hauptdolomit (Dolomia Principale) formation at the onset of the Norian. This study provides the first detailed reconstruction of the sedimentary evolution of small-scale Ladinian basin and platforms system in the northern External Dinarides.
PDF
