Multi-length scale strengthening and cytocompatibility of ultra high molecular weight polyethylene bio-composites by functionalized carbon nanotube and hydroxyapatite reinforcement.

The mechanical properties, such as hardness and elastic modulus, of ultra-high molecular weight polyethylene (UHMWPE) composites for acetabular cup liner are improved by adding hydroxyapatite (HAp) and carbon nanotubes (CNT). However, the weak adhesion of HAp (H) and CNT (C) with UHMWPE (U) limits the enhancement of mechanical properties. Thus, the surface of these reinforcements is silane-treated to improve the adhesion with polymer via Si-O and C=O bonds, as evidenced from spectroscopy techniques. An increased dispersion and interfacial adhesion of functionalized HAp (fH) and CNT (fC) with the polymer matrix is confirmed by nearly two-fold increased reinforcement fraction (Rf: 0.55) of U-10 wt% fHAp-2 wt.% fCNT (U10fH2fC) in comparison to U-10 wt% HAp-2 wt.% CNT (U10H2C). Additionally, Voronoi Tessellation (VT) on SEM micrographs of U10H2C and U10fH2fC revealed the dispersion of functionalized CNTs in U10fH2fC with a center-to-center distance of 0.076 µm, which is 74% higher for unfunctionalized CNT in U10H2C. The multilength scale strengthening of the UHMWPE matrix is confirmed from atomic level modification via functionalization of fillers which effectively adhered to the polymer chain on a micro-scale level. A uniform distribution of CNTs rendered increased crystallinity (+28%) of U10fH2fC, which in turn resulted in significant improvement in bulk mechanical properties (18%, 49%, and 12% increased hardness (148.1 MPa), elastic modulus (3.51 GPa) and tensile elastic modulus (219.8 MPa), respectively) in comparison to that of U10H2C. Functionalized-HAp/CNT reinforced UHMWPE composites maintained its cytocompatibility in the MTT test and fluorescence microscopy, affirming their potential employment as acetabular cup liners for hip joint arthroplasty.

Contact stress and sliding wear damage tolerance of hydroxyapatite and carbon nanotube reinforced polyethylene cup liner against zirconia femoral head.

A finite element modeling (FEM) approach is carried out to estimate the contact stresses such as von-Mises and shear stress on the acetabular cup liner, made up of ultra-high molecular weight polyethylene (UHMWPE)-hydroxyapatite (HAp)-carbon nanotubes (CNT) based composites. The highlights of this work include the effects of liners' material (UHMWPE-HAp-CNT composites), radial clearance (0.05 to 1 mm), and liners' wall thickness (3 to 8 mm) on contact stresses. The thick liner (thickness: 8 mm) with conformal geometry (radial clearance 0.05 mm) produced the lowest contact stresses (von-Mises: 13.8-17.5 MPa and shear stress: 2.3-3.3 MPa). In contrast, the thin liner (thickness: 3 mm) with higher radial clearance (1 mm) showed the highest von-Mises stress (78.6-131.0 MPa) and shear stress (17.0-23.3 MPa). According to ISO 7206-1, nearly 6-7 times reduced contact stresses were observed because of the wider articulating contact area provided by thick cup liner and its conformity with respect to the femoral head. The UHMWPE-2 wt % CNT composite (UC) showed low von-Mises stress (16.1 MPa) and lowest shear stress (2.3 MPa); thus, it is the most damage tolerant material (wear rate: 2.6 × 10-7 mm3/Nm). The excellent mechanical properties such as hardness (165 MPa), elastic modulus (2.28 GPa), and tensile strength (36.7 MPa) are reasoned to elicit an increased sliding-wear resistance of UC. Thus, CNT-based UHMWPE composite can be the potential acetabular cup liner with a thickness of 8 mm and clearance of 0.05 mm without plastic deformation.

Multifunctional Hydroxyapatite Composites for Orthopedic Applications: A Review.

Being a bioactive material, hydroxyapatite (HAp) is regarded as one of the most attractive ceramic biomaterials for bone and hard-tissue replacement and regeneration. Despite its substantial biocompatibility, osteoconductivity, and compositional similarity to that of bone, the employment of HAp is still limited in orthopedic applications due to its poor mechanical (low fracture toughness and bending strength) and antibacterial properties. These significant challenges lead to the notion of developing novel HAp-based composites via different fabrication routes. HAp, when efficaciously combined with functionally graded materials and antibacterial agents, like Ag, ZnO, Co, etc., form composites that render remarkable crack resistance and toughening, as well as enhance its bactericidal efficacy. The addition of different materials and a fabrication method, like 3D printing, greatly influence the porosity of the structure and, in turn, control cell adhesion, thereby enabling biological fixation of the material. This article encompasses an elaborate discussion on different multifunctional HAp composites developed for orthopedic applications with particular emphasis on the incorporation of functionally graded materials and antibacterial agents. The influence of 3D printing on the fabrication of HAp-based scaffolds, and the different in vitro and in vivo studies conducted on these, have all been included here. Furthermore, the present review not only provides insights and broad understanding by elucidating recent advancements toward 4D printing but also directs the reader to future research directions in design and application of HAp-based composite coatings and scaffolds.