Mechanical Analysis of Explanted Telescopic Rods in the Management of Osteogenesis Imperfecta: A Multicenter Study.

BACKGROUND: Telescopic rods in the management of osteogenesis imperfecta fail frequently. This could be attributed to technical errors, rod design, and rod structure. We aimed to analyze the mechanical properties and tribology of explanted male and female components to identify effects of in vivo telescoping that may relate to observed patterns of successful telescoping or failure. METHODS: Recruitment took place at 3 of the 4 English centers for osteogenesis imperfecta. Twenty-five rods explanted for growth or failure during revision to a new rod were analyzed in terms of clinical indication and prerevision imaging to identify if there was a technical mode of failure. Laboratory analysis was performed using optical and scanning electrical microscopy, radiograph diffraction analysis, hardness test, bending test, and energy-dispersive x-ray spectroscopy. RESULTS: All implants tested were of high-grade stainless steel. Female components had inferior strength [mean Vickers hardness property (HV0.3) at 0.3 to 313 kg] in comparison to male components (HV0.3 406) due to different techniques of manufacture. Female rods also had a higher wear coefficient (7.89×10-12 m3/N/m3) than the male rods (6.46×10-12 m3/N/m3). Abrasive wear, shear deformation, scratches, and wear debris were identified in all rods. Male and female components displayed corrosion contributing to adhesive wear. Intraoperatively cut rods, particularly the female components, had irregular ends leading to more wear. CONCLUSIONS: Current manufacturing techniques result in inferior material strength in female components compared with males, which combined with wear patterns is likely to lead to implant failure. Intraoperative cutting of rods may increase risk of failure due to wear. Considering techniques to improve strength as well as design in new implants may lead to better outcomes. LEVELS OF EVIDENCE: Level IV-cross-sectional study.

Microhardness, Indentation Size Effect and Real Hardness of Plastically Deformed Austenitic Hadfield Steel.

Microhardness testing is a widely used method for measuring the hardness property of small-scale materials. However, pronounced indentation size effect (ISE) causes uncertainties when the method is used to estimate the real hardness. In this paper, three austenitic Hadfield steel samples of different plastic straining conditions were subjected to Vickers microhardness testing, using a range of loads from 10 to 1000 g. The obtained results reveal that the origin of ISE is derived from the fact, that the indentation load P and the resultant indent diagonal d do not obey Kick's law (P = A · d2). Instead, the P and d parameters obey Meyer's power law (P = A · dn) with n < 2. The plastically strained samples showed not only significant work hardening, but also different ISE significance, as compared to the non-deformed bulk steel. After extensive assessment of several theoretical models, including the Hays-Kendall model, Li-Bradt model, Bull model and Nix-Gao model, it was found that the real hardness can be determined by Vickers microhardness indentation and subsequent analysis using the Nix-Gao model. The newly developed method was subsequently utilised in two case studies to determine the real hardness properties of sliding worn surfaces and the subsurface hardness profile.