Joint Replacement Technology

Increasing numbers of joint revision and replacement operations drive the demand for improved prostheses. This book reviews developments in joint replacement technology, covering the most pertinent materials science and engineering issues as well as specific joints, clinical trial results and sterilization techniques. It discusses biomechanics, tribology, and the chemical environment of the body. The text surveys materials and engineering of joint replacement. The second part of the book reviews specific materials, bearing surfaces and bone cements, in addition to the failure mechanisms and lifetime prediction of joints. It also discusses the biological environment and interaction of replacement joints.

Table of Contents:
PART 1 INTRODUCTION Biomechanics of Joints G R Johnson, Newcastle University, UK Introduction. Introduction to biomechanics. Key aspects of biomechanics of major joints. The upper limb. Summary. Sources of further information and advice. References. Tribology in Joint Replacement Z Jin and J Fisher, University of Leeds, UK Introduction. Theoretical tribological studies. Experimental tribological studies. Issues of tribology for joint replacements and future trends. Sources of further information and advice. References and further reading. Biomaterials and the Chemical Environment of the Body K J Bundy, Tulane University, USA Introduction. Chemical environment for joint replacement. Surfaces and interfaces. Corrosion. Conclusion. Sources of further information and advice. References. Materials for Joint Replacement K S Katti, D Verma and D R Katti, North Dakota State University, USA Introduction. Materials criteria for total joint replacement. History of materials used in joint replacement. Traditional materials. Bone cement materials. Composite materials and new nanocomposite systems. Natural materials. Summary. Acknowledgements. References. Regulatory Issues Affecting Joint Replacement: The Case of The UK E Damien, MHRA, B Paul, Kyiv Medical Academy, S M Damien and C S Damien, QMUL, UK Introduction and background. The regulatory process. Planning for the regulatory approval of a product. Summary. References and useful websites for further information. PART 2 MATERIAL AND MECHANICAL ISSUES Metals For Joint Replacement Y T Konttinen, Helsinki University Central Hospital, Finland, I Milošev, Jožef Stefan Institute, Slovenia, R Trebše, Orthopaedic Hospital Valdoltra, Slovenia, P Rantanen and R Linden, National Agency of Medicines, Finland, V Tiainen, ORTON Orthopaedic Hospital of the Invalid Foundation, Finland and S Virtanen, University of Erlangen-Nuremberg, Germany Introduction. General requirements for biomaterials. Examples of currently valid European Union standards. Overview of metals. Biomechanical properties. Corrosion. Corrosion testing. Metals used in joint replacements. Particle disease. Clinical success of metals used in joint replacement surgery. Future trends. Acknowledgements. Sources of further information and advice: useful websites. References. Ceramics for Joint Replacement D Kluess, W Mittelmeier and R Bader, University of Rostock, Germany Introduction. Material and mechanical properties of ceramics. Ceramics in total hip replacement. Ceramics in total knee replacement. Summary. References Joint Bearing Surfaces and Replacement Joint Design R Lappalainen and M Selenius, University of Kuopio, Finland Introduction. Articulating surfaces in natural joints. Demands for the bearing surfaces. Different solutions available. Special concepts and designs for bearing surfaces. Comparison of bearing surface solutions. Future trends. References. Cementless Fixation Techniques in Joint Replacement M Cross and J Spycher, The Australian Institute of Musculoskeletal Research, Australia Introduction. Cementless fixation. Initial stability. Osseous integration of cementless implants. Mechanical properties of the implant. Why do you still use cement? Future trends. References. Bone Cement Fixation: Acrylic Cements J S Wang, Lund University, Sweden and N Dunne, Queen’s University of Belfast, UK Introduction. Acrylic bone cements - history and evolution. Clinical application and function. Composition. Polymer powder/liquid monomer ratio. Polymerisation reaction. Polymerisation heat. Polymerisation shrinkage. Molecular weight and sterilisation. Residual monomer and monomer release. Viscosity and handling properties. Antibiotics in poly(methylmethacrylate) bone cement. Radiopacifier in poly(methylmethacrylate) bone cement. Mechanical properties. Mixing methods. Joint replacement cementing technique. Problems with acrylic cements. Summary. References. Bone Cement Fixation: Glass-Ionomer Cements P V Hatton, V Kearns and I M Brook, University of Sheffield, UK Introduction. Structure and properties of glass-ionomer cements. Biological evaluation. Further trends. References. Failure Mechanisms In Joint Replacement M Burke and S Goodman, Stanford University Medical Center, USA Introduction. Wear and debris. Implant or bone fracture. Dislocation. Stress shielding. Comment on surgical failure. Summary. Future trends. References. Predicting The Lifetime Of Joints: Clinical Results L Ryd, Karolinska University Hospital/Huddinge, Sweden Introduction. National joint replacement registries. Radiostereometric analysis. Future trends. References. PART 3 THE DEVICE BIOLOGICAL ENVIRONMENT The Healing Response To Implants Used In Joint Replacement P A Revell, University College London, UK Introduction. Immediate response to prosthesis placement. Remodelling of bone around implants. The cemented joint prosthesis. The uncemented prosthetic joint component. Bioactive surfaces on prostheses. Adjunctive methods or treatments and their effects. Summary. References. Biological Causes Of Prosthetic Joint Failure P A Revell, University College London, UK Introduction. Infection. Aseptic loosening. The isolation and characterisation of wear particles. The cellular reaction to particulate wear debris. The role of macrophages and multinucleate giant cells. Bone resorption and wear debris: osteoclasts, macrophages and multinucleate giant cells. Lymphocytes, sensitisation and aseptic loosening. Evidence for immunological processes in loosening. Wear particles and corrosion products in distant organs: systemic effects. Summary and conclusions. References. Using Drug Delivery Systems to Enhance Joint Replacement D P Pioletti, Ecole Polytechnique Fédérale de Lausanne, Switzerland Why do we need to improve the outcome of orthopedic implants? What is the clinical situation for orthopedic implant used as drug delivery system? Is the research for orthopedic drug delivery system advanced enough to translate it to clinical applications? Will drug delivery systems be the future for orthopaedic implants? References. Sterilisation of Joint Replacement Technology A Ianuzzi and S M Kurtz, Exponent, Inc, USA Introduction. Sterilization techniques and their suitability. Issues with sterilization of joint replacement materials. Conclusions. References. PART 4 SPECIFIC JOINTS Hip Replacement: Tribological Principles, Materials and Engineering D Dowson, University of Leeds, UK Introduction. Millenium prostheses. Introduction to the tribology of total hip replacements. (Hard-on-hard) total hip joint tribology. Wear particles and metal ions. Summary. References. Hip Replacement: Clinical Perspectives M Revell and E T Davis, Royal Orthopaedic Hospital, UK Introduction. Problems with hip replacement at the beginning of the 21st Century. Specific complications. Current solutions. Computer navigation. Conclusions. References. Knee Replacement: Clinical Perspectives J D Blaha, University of Michigan Medical School, USA Introduction. Kinematics and knee joint prosthesis design. Analysis of the kinematics of total joint prostheses. Summary. References. Intervertebral Disc Joint Replacement Technology N Hallab, Rush University Medical Center, USA Introduction. Orthopedic materials and methodology available for use in intervertebral disc replacements. Early intervertebral disc replacement designs. Current designs. Clinical concerns. Conclusions. References. Replacing Temperomandibular Joints J Van Loon and L De Bont, University of Groningen and G J Verkerke, University of Groningen and University of Twente, The Netherlands Introduction. Temperomandibular joint prosthesis criteria. Design. Development and test procedures. First clinical application. Conclusions. Sources of further information and advice: useful websites. References. Replacing Ankle Joints H Kofoed, Federiksberg Hospital, Denmark Introduction: short history of ankle replacement. Anatomical, biomechanical, and biological features of the normal ankle joint. Pathologies leading to degeneration of the ankle joint. Indications and contraindications for ankle replacement. Material used to replace the ankle. Fixation of ankle prostheses. The interrelationship between the ankle and the hindfoot. Long-term results of uncemented current designs. Future trends. References. Replacing Shoulder Joints L De Wilde, University Hospital of Ghent, Belgium Introduction. Biomechanics of total shoulder arthroplasty. Indications for total shoulder arthroplasty. Surgical technique. Complications. Prognostic factors for clinical outcome. Summary. References. Replacing Elbow Joints J Sanchez-Sotelo, Mayo Clinic, USA Introduction. Materials and device design. Indications and contraindications. Surgical technique overview. Clinical results. Complications. Revision surgery. Summary. References. Replacing Joints With Pyrolytic Carbon J Stanley, J Klawitter and R More, Wrightington Hospital, UK Introduction. What is pyrolytic carbon? History of pyrolytic carbon use. Review of pyrolytic carbon joint clinical history/performance. Design and testing of pyrolytic carbon joint replacement implants. Hemi-joint arthroplasty. Conclusion. Forward looking statement with respect to pyrolytic carbon in orthopedics. References.

About the Author :
Eastman Dental Institute, UK