Squeaking and microcracks in a delta-delta ceramic coupling: pin-on-disc study.

There is a rising concern about squeaking in ceramic-on-ceramic total hip arthroplasty (THA). In pin-on-disc testing of a delta-delta coupling, we reproduced squeaking and observed microcracks on worn surfaces. We used a pin-on-disc machine and made discs and pins by cutting delta ceramic to a diameter of 40 mm (D-D). Cross-linked polyethylene was used for a comparison disc (D-P). We performed the same test using another D-D coupling specimen to confirm reproducibility. Squeaking in the D-D specimen was reproduced in wet conditions, though it was not found in the D-P specimen. Fast Fourier transform analysis showed a peak frequency for squeaking of 2794 Hz. The noise occurred at about 6.6 km of sliding distance. Scanning electron microscopy revealed that the worn surface of the pin in D-D at 10.8 km of sliding distance had some microcracks. However, there was no obvious damage to the worn surface of the pin in D-P at the same sliding distance. We confirmed the reproducibility of these findings, obtaining similar results, including squeaking, from another D-D coupling specimen. Our findings show that squeaking may occur in THA using delta ceramic bearings even if implants are placed to avoid extra-articular impingement of the femoral neck. Although the clinical relevance of microcracks is unknown, they may affect long-term outcomes in THA using delta ceramic bearings.

Relationship between the Surface Roughness of Material and Bone Cement: An Increased "Polished" Stem May Result in the Excessive Taper-Slip.

Although some reports suggest that taper-slip cemented stems may be associated with a higher periprosthetic femoral fractures rate than composite-beam cemented stems, few studies have focused on the biomaterial effect of the polished material on the stem-cement interface. The purpose of this study was to investigate the relationship between surface roughness of materials and bone cement. Four types of metal discs-cobalt-chromium-molybdenum alloy (CoCr), stainless steel alloy 316 (SUS), and two titanium alloys (Ti-6Al-4V and Ti-15Mo-5Zr-3Al)-were prepared. Five discs of each material were produced with varying degrees of surface roughness. In order to evaluate surface wettability, the contact angle was measured using the sessile drop method. A pin was made using two bone cements and the frictional coefficient was assessed with a pin-on-disc test. The contact angle of each metal increased with decreasing surface roughness and the surface wettability of metal decreased with higher degrees of polishing. With a surface roughness of Ra = 0.06 µm and moderate viscosity bone cement, the frictional coefficient was significantly lower in CoCr than in SUS (p = 0.0073). In CoCr, the low adhesion effect with low frictional coefficient may result in excessive taper-slip, especially with the use of moderate viscosity bone cement.

Bone formation at Ti-6Al-7Nb scaffolds consisting of 3D honeycomb frame and diamond-like carbon coating implanted into the femur of beagles.

We fabricated Ti-6Al-7Nb bone scaffolds with 5 mm diameter and 20 mm length comprise of a three-dimensional (3D) honeycomb frame structure of truncated octahedra created by selective laser sintering 3D printing. The honeycomb frame was then coated with 0.1 µm thick diamond-like carbon (DLC) to increase biocompatibility. A round rod of Ti-6Al-7Nb alloy (ASTM F1295) was as a control material. They were implanted into the femur bones of beagles to evaluate bone morphometrics and to investigate changes in the transcriptome of the new bone tissue using DNA microarray analysis and real-time polymerase chain reaction (PCR). In the present report, the 3D honeycomb material with and without DLC film consisting of a-C:H is referred to as 3D_a-C:H and 3D_non, respectively. At 3 weeks after implantation, the 3D_non had more contact between the new and artificial bones compared with the control, and the 3D_a-C:H had more contact between the new and artificial bones compared with the control and 3D_non. Furthermore, 3D_a-C:H showed even more new bone compared with the control and 3D_non. At 8 weeks after implantation, more appeared lamellar bone with the 3D_a-C:H implant than those with the control and 3D_non. The real-time PCR results at 1 week of implantation revealed higher expression levels of VEGF, RANKL, and NOTCH2 expression with 3D_a-C:H than with 3D_non and control. As a result of real-time PCR at 2 weeks of implantation, OPN and CTSK expressions were found to be higher with 3D_a-C:H and 3D_non than that with the control.

[Preparation of PLGA microspheres encapsulating highly concentrated glycyrrhizin and the bile elimination of glycyrrhizin after subcutaneous administration in rats].

The aim of this study was to prepare poly (lactide-co-glycolide) (PLGA) microspheres encapsulating highly concentrated glycyrrhizin (GZ), a hydrophilic drug, and to compare the release characteristics of GZ in in vitro experiments and GZ elimination into bile after subcutaneous administration in rats. The preparation was carried out based on water drying using a (w/o)/w emulsion. The encapsulation rate of GZ in microspheres was 76% when the GZ concentration in the outer water phase was equal to that in the inner water phase for the preparation of (w/o)/w emulsion. The release of GZ from the microspheres showed a biphasic zero-order profile, that is, the behavior boundary was approximately 12 h. The release of GZ from the microspheres at the periods of 0.5-8 h and 12-672 h was 0.18 mg/h and 0.0012 mg/h, respectively. On the other hand, 0.25% of GZ administered (5.0 mg) was eliminated into bile by 12 h, and the bile clearance rate (1.13 ml/h) of GZ after the subcutaneous administration of the microspheres was the same as that (1.13 ml/h) after the administration of GZ solution. From the results, it is suggested that the initial controlled release (0.18 mg/h) of GZ from microspheres may be beneficial for the hepatic bioavailability of GZ.

Evaluation of Antibacterial and Cytotoxic Properties of a Fluorinated Diamond-Like Carbon Coating for the Development of Antibacterial Medical Implants.

Peri-implant infection is a serious complication in surgical procedures involving implants. We conducted an in vitro study to determine whether the use of a fluorinated diamond-like carbon (F-DLC) coating on a titanium alloy surface can prevent peri-implant infection. After applying the F-DLC, we evaluated its antibacterial and cytotoxic properties. The coating groups, containing controlled fluorine concentrations of 5.44%, 17.43%, 24.09%, and 30%, were examined for the presence of Staphylococcus aureus and Escherichia coli according to ISO 22196 for the measurement of antibacterial activity on plastics and other nonporous surfaces. Biological toxicity was evaluated using Chinese hamster V79 cells according to ISO 10993-5 for the biological evaluation of medical devices. In the control group, populations of S. aureus and E. coli substantially increased from 2.4 × 104 to (1.45 ± 1.11) × 106 colony-forming units (CFUs) and from 2.54 × 104 to (4.04 ± 0.44) × 106 CFUs, respectively. However, no bacteria colonies were detected in any F-DLC group with a fluorine concentration of ≥ 17.43%. In the biological toxicity study, an F-DLC coating with a fluorine concentration of 30% showed a colony formation rate of 105.8 ± 24.1%, which did not differ significantly from the colony formation rate of 107.5 ± 31.1% in the nontoxic control group. An F-DLC coating on titanium alloy discs showed excellent in vitro antibacterial activity with no biological toxicity.

Cytotoxic evaluation of cubic boron nitride in human origin cultured cells.

The aim of this study was to evaluate the cytotoxicity of cubic boron nitride (cBN), a component of surgical cutting tools. The small quantities of cBN that typically remain on implants as a result of the manufacturing process may act as abrasives, injuring tissues surrounding the implant. To determine how cBN affects cells, we treated human neuroblastoma cells (NB-1) and human articular chondrocytes (nHAC-kn) with different concentrations of cBN powder and assessed cell growth and cell survival using the methyl-thiazol-tetrazolium (MTT) assay and a fluorescence probe assay. We also assessed the effects of tungsten carbide (WC) and cobalt (Co), two common components of joint implants, on cell growth and cell survival. Both cBN and WC moderately inhibited NB-1 and nHAC-kn cell growth. However, cBN and WC did not affect cell survival, even at high concentrations (40 microg/ml). By contrast, Co affected cell survival, inducing cell death in both cell types at increasing concentrations. These results suggest that cBN may be less toxic than WC alloys containing Co.