Comparison of Different Materials and Proximal Coatings Used for Femoral Components in One-Stage Bilateral Total Hip Arthroplasty.

To evaluate the mid-term effects of different materials and coatings used for femoral components, we prospectively performed 21 one-stage bilateral total hip arthroplasties using 2 anatomical stems which have identical geometries, randomized to side. One stem was made of Ti6Al4V alloy and had a hydroxyapatite coating on grit-blasted surface proximally, and the other was made of TMZF™ alloy and had a proximal coating of hydroxyapatite in addition to an arc-deposited titanium surface coating. Although we found extensions of radiopaque lines to the surface of coatings of seven grit-blasted stems whereas we found none in the case of the arc-deposited titanium stems, all hips showed excellent clinical and radiological outcomes as shown by radiographs and bone mineral density at the final follow-up, average 5.5 years postoperatively.

In vitro evaluation of a novel nanostructured Ti-36Nb-6Ta alloy for orthopedic applications.

Aim: To evaluate the impact of a nanostructured surface created on ß-titanium alloy, Ti-36Nb-6Ta, on the growth and differentiation of human mesenchymal stem cells. Materials & methods: The nanotubes, with average diameters 18, 36 and 46 nm, were prepared by anodic oxidation. Morphology, hydrophilicity and mechanical properties of the nanotube layers were characterized. The biocompatibility and osteogenic potential of the nanostructured surfaces were established using various in vitro assays, scanning electron microscopy and confocal microscopy. Results: The nanotubes lowered elastic modulus close to that of bone, positively influenced cell adhesion, improved ALP activity, synthesis of type I collagen and osteocalcin expression, but diminished early cell proliferation. Conclusion: Nanostructured Ti-36Nb-6Ta with nanotube diameters 36 nm was the most promising material for bone implantation.

Comparison of the Microstructure and Biocorrosion Properties of Additively Manufactured and Conventionally Fabricated near ß Ti-25Nb-3Zr-3Mo-2Sn Alloy.

The microstructure and biodegradability of a near ß Ti-25Nb-3Zr-3Mo-2Sn alloy produced by laser engineered net shaping have been compared to those of alloys produced via casting and cold rolling in order to identify the key effects of processing pathways on the development of microstructure and biocorrosion properties. Results confirm the significant influence of processing technique on microstructure and concomitant biocompatibility of the alloy. Tests using mesenchymal stem cells confirm the ability of the additively manufactured alloy to support cell adhesion and spreading.

Mechanical stability of custom-made implants: Numerical study of anatomical device and low elastic Young's modulus alloy.

The advent of new manufacturing technologies such as additive manufacturing deeply impacts the approach for the design of medical devices. It is now possible to design custom-made implants based on medical imaging, with complex anatomic shape, and to manufacture them. In this study, two geometrical configurations of implant devices are studied, standard and anatomical. The comparison highlights the drawbacks of the standard configuration, which requires specific forming by plastic strain in order to be adapted to the patient's morphology and induces stress field in bones without mechanical load in the implant. The influence of low elastic modulus of the materials on stress distribution is investigated. Two biocompatible alloys having the ability to be used with SLM additive manufacturing are considered, commercial Ti-6Al-4V and Ti-26Nb. It is shown that beyond the geometrical aspect, mechanical compatibility between implants and bones can be significantly improved with the modulus of Ti-26Nb implants compared with the Ti-6Al-4V.

In situ elaboration of a binary Ti-26Nb alloy by selective laser melting of elemental titanium and niobium mixed powders.

Ti-Nb alloys are excellent candidates for biomedical applications such as implantology and joint replacement because of their very low elastic modulus, their excellent biocompatibility and their high strength. A low elastic modulus, close to that of the cortical bone minimizes the stress shielding effect that appears subsequent to the insertion of an implant. The objective of this study is to investigate the microstructural and mechanical properties of a Ti-Nb alloy elaborated by selective laser melting on powder bed of a mixture of Ti and Nb elemental powders (26 at.%). The influence of operating parameters on porosity of manufactured samples and on efficacy of dissolving Nb particles in Ti was studied. The results obtained by optical microscopy, SEM analysis and X-ray microtomography show that the laser energy has a significant effect on the compactness and homogeneity of the manufactured parts. Homogeneous and compact samples were obtained for high energy levels. Microstructure of these samples has been further characterized. Their mechanical properties were assessed by ultrasonic measures and the Young's modulus found is close to that of classically elaborated Ti-26 Nbingot.

The titanium PV I endosteal implant from beta-titanium alloy Ti 38Nb 6Ta.

AIM: The aim of this study was to use the beta-titanium alloy Ti38Nb6Ta for production of a new construction line of implants, perform testing on animals and preclinical tests. MATERIALS AND METHODS: Within this study, a new PV I implant with five construction variants was developed. The implant includes three types of threads - microthreads and flat threads of two types with a different depth. Further, the PV I implant was tested on minipigs. Subsequently, preclinical tests of 150 implants were performed and assessed. The age interval of patients was from 18 to 74 years. RESULTS: Beta titanium alloy exhibited higher strength than titanium alloys. Anti-corrosion resistance was also higher. The implant from beta-alloy was inserted in the tibias of minipigs. Sections showed good osseointegration of the PV I implant. During the preclinical tests, 150 implants were inserted with the success rate of 99.33% after the two year assessment. The assessment also included handicapped patients who are not usually assessed in classical studies. Finally, the implantation protocol and documentation of a new implantation system PV I was designed. At the same time the industrial sample of this implant was formed and accepted. CONCLUSION: A new anti-rotation PV I implant with microthreads and conical anchorage of the abutment into the fixture was formed. The beta-titanium alloy Ti38Nb6Ta used for the implant was biocompatible and had higher mechanical and physical properties than the existing titanium alloys. The PV I implant was recommended for clinical application.

In vitro bio-functional performances of the novel superelastic beta-type Ti-23Nb-0.7Ta-2Zr-0.5N alloy.

The materials used for internal fracture fixations and joint replacements are mainly made of metals which still face problems ranging from higher rigidity than that of natural bone to leaching cytotoxic metallic ions. Beta (ß)-type titanium alloys with low elastic modulus made from non-toxic and non-allergenic elements are desirable to reduce stress shielding effect and enhance bone remodeling. In this work, a new ß-type Ti-23Nb-0.7Ta-2Zr-0.5N alloy with a Young's modulus of approximately 50 GPa was designed and characterized. The behavior of MC3T3-E1 pre-osteoblasts on the new alloy, including adhesion, proliferation and differentiation, was evaluated by examining the cytoskeleton, focal adhesion formation, metabolic activity and extracellular matrix mineralization. Results indicated that the pre-osteoblast cells exhibited a similar degree of attachment and growth on Ti-23Nb-0.7Ta-2Zr-0.5N and Ti-6Al-4V. However, the novel alloy proved to be significantly more efficient in sustaining mineralized matrix deposition upon osteogenic induction of the cells than Ti-6Al-4V control. Further, the analysis of RAW 264.7 macrophages cytokine gene and protein expression indicated no significant inflammatory response. Collectively, these findings suggest that the Ti-23Nb-0.7Ta-2Zr-0.5N alloy, which has an increased mechanical biocompatibility with bone, allows a better osteogenic differentiation of osteoblast precursor cells than Ti-6Al-4V and holds great potential for future clinical prosthetic applications.

Interaction of bone-dental implant with new ultra low modulus alloy using a numerical approach.

Although mechanical stress is known as being a significant factor in bone remodeling, most implants are still made using materials that have a higher elastic stiffness than that of bones. Load transfer between the implant and the surrounding bones is much detrimental, and osteoporosis is often a consequence of such mechanical mismatch. The concept of mechanical biocompatibility has now been considered for more than a decade. However, it is limited by the choice of materials, mainly Ti-based alloys whose elastic properties are still too far from cortical bone. We have suggested using a bulk material in relation with the development of a new beta titanium-based alloy. Titanium is a much suitable biocompatible metal, and beta-titanium alloys such as metastable TiNb exhibit a very low apparent elastic modulus related to the presence of an orthorhombic martensite. The purpose of the present work has been to investigate the interaction that occurs between the dental implants and the cortical bone. 3D finite element models have been adopted to analyze the behavior of the bone-implant system depending on the elastic properties of the implant, different types of implant geometry, friction force, and loading condition. The geometry of the bone has been adopted from a mandibular incisor and the surrounding bone. Occlusal static forces have been applied to the implants, and their effects on the bone-metal implant interface region have been assessed and compared with a cortical bone/bone implant configuration. This work has shown that the low modulus implant induces a stress distribution closer to the actual physiological phenomenon, together with a better stress jump along the bone implant interface, regardless of the implant design.

Effect of swaging on Young׳s modulus of ß Ti-33.6Nb-4Sn alloy.

The effect of swaging on the Young's modulus of ß Ti-33.6Nb-4Sn rods was investigated by X-ray diffraction, thermography, microstructural observations, deformation simulator analysis and cyclic tensile deformation. Stress-induced α″ martensite was stabilized by swaging, dependent on the diameter reduction rate during swaging. Thermography and deformation simulator analysis revealed that swaged rods were adiabatically heated, and consequently, stress-induced α″ underwent reverse transformation. Young's modulus, which was measured by the slope of the initial portion of the stress-strain curve, decreased from 56GPa in the hot-forged/quenched rod to 44GPa in the rapidly swaged rod with a high reduction rate and to 45GPa in the gradually swaged rod with a low reduction rate. The tangent modulus, which was measured by the slope of the tangent to any point on the stress-strain curve, decreased with strain even in the linear range of the stress-strain curve of the hot-forged/quenched rod and the rapidly swaged rod, while the tangent modulus remained unchanged for the gradually swaged rod. It was found that Young's moduli in swaged ß Ti-33.6Nb-4Sn rods were affected by stabilized α″ martensite. Low Young's modulus of 45GPa and high strength over 800MPa were obtained when the reverse transformation by adiabatic heating was suppressed and the stress-induced α″ was sufficiently stabilized by gradual swaging to a 75% reduction in cross section area.

Microstructure evolution and mechanical properties of a Ti-35Nb-3Zr-2Ta biomedical alloy processed by equal channel angular pressing (ECAP).

In this paper, an equal channel angular pressing method is employed to refine grains and enhance mechanical properties of a new ß Ti-35Nb-3Zr-2Ta biomedical alloy. After the 4th pass, the ultrafine equiaxed grains of approximately 300 nm and 600 nm are obtained at pressing temperatures of 500 and 600°C respectively. The SEM images of billets pressed at 500°C reveal the evolution of shear bands and finally at the 4th pass intersectant networks of shear bands, involving initial band propagation and new band broadening, are formed with the purpose of accommodating large plastic strain. Furthermore, a unique herringbone microstructure of twinned martensitic variants is observed in TEM images. The results of microhardness measurements and uniaxial tensile tests show a significant improvement in microhardness and tensile strength from 534 MPa to 765 MPa, while keeping a good level of ductility (~16%) and low elastic modulus (~59 GPa). The maximum superelastic strain of 1.4% and maximum recovered strain of 2.7% are obtained in the billets pressed at 500°C via the 4th pass, which exhibits an excellent superelastic behavior. Meanwhile, the effects of different accumulative deformations and pressing temperatures on superelasticity of the ECAP-processed alloys are investigated.