Biomaterials: An Introduction

399 Pages·1992·9.653 MB·English

by  Joon B. Park, Roderic S. Lakes (auth.)

BIOMATERIALS
An Introduction
SECOND EDITION
BIOMATERIALS
An Introduction
SECOND EDITION
Joon B. Park
and
Roderic S. Lakes
The University of Iowa
Iowa City, Iowa
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Pack, Joon 8u.
B10materlals all Introduct1on I Joan B. Park and Rnderle S.
Lakes. -- 2nd ed.
p. em.
Includes bibllograohlcal references and Index.
ISBN 978-1-4757-2158-4 ISBN 978-1-4757-2156-0 (eBook)
DOI 10.1007/978-1-4757-2156-0
1. Biomedlcal materials. I. Lakes, Roderlc S. II. Tltle.
R857.M3P37 1992
610' .28--dc20 92-23214
CIP
10 9 8 7 6 5 4 3 2
© 1992, 1979 Springer Science+Business Media New Yark
Originally published by Plenum Press, New York in 1992
Sof'tcover reprint of the hardcover 2nd edition 1992
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
PREFACE
This book is intended as a general introduction to the uses of artificial materials
in the human body for the purposes of aiding healing, correcting deformities,
and restoring lost function. It is an outgrowth of an undergraduate course for
senior students in biomedical engineering, and it is offered as a text to be used
in such courses. Topics include biocompatibility, techniques to minimize cor
rosion or other degradation of implant materials, principles of materials science
as it relates to the use of materials in the body, and specific uses of materials in
various tissues and organs. It is expected that the student will have successively
completed elementary courses in the mechanics of deformable bodies and in
anatomy and physiology, and preferably also an introductory course in materials
science prior to undertaking a course in biomaterials.
Many quantitative examples are included as exercises for the engineering
student. We recognize that many of these involve unrealistic simplifications and
are limited to simple mechanical or chemical aspects of the implant problem.
We offer as an apology the fact that biomaterials engineering is still to a great
extent an empirical discipline that is complicated by many unknowns associated
with the human body. In recognition of that fact, we have endeavored to describe
both the successes and the failures in the use of materials in the human body.
Also included are many photographs and illustrations of implants and devices
as an aid to visualization.
Any errors of commission or omission that have remained in spite of our efforts
at correction are our responsibility alone.
We thank Bea Park and Diana Lakes for their patience and support during a
lengthy undertaking.
Joon B. Park
Roderic S. Lakes
Iowa City, Iowa
v
CONTENTS
Chapter 1 • INTRODUCTION TO BIOMATERIALS................ 1
1.1. Historical Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.2. Performance of Biomaterials .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Problems .............................. " . . .. . . . . . .. . . . . . . . . . . .. . 5
Symbols/ Definitions .............................................. 6
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Chapter 2 • THE STRUCTURE OF SOLIDS...................... 7
2.1. Atomic Bonding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.2. Crystal Structure ............................................. 9
2.2.1. Atoms of the Same Size. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.2.2. Atoms of Different Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.3. Imperfections in Crystalline Structures .......................... 13
2.4. Long-Chain Molecular Compounds (Polymers) . . . . . . . . . . . . . . . . . . . 15
2.5. Supercooled and Network Solids ............................... 19
2.6. Composite Material Structure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Problems ........................................................ 26
Symbols/ Definitions .............................................. 26
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Chapter 3 • CHARACTERIZATION OF MATERIALS I............. 29
3.1. Mechanical Properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.1.1. Stress-Strain Behavior. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.1.2. Mechanical Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3.1.3. Viscoelasticity.......................................... 39
3.2. Thermal Properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3.3. Phase Diagrams. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
vii
viii CONTENTS
3.4. Strengthening by Heat Treatments .............................. 55
3.4.1. Metals................................................. 55
3.4.2. Ceramics and Glasses ................................... 56
3.4.3. Polymers and Elastomers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
3.5. Surface Properties and Adhesion ............................... 56
Problems ........................................................ 59
Symbols/Definitions .............................................. 60
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Chapter 4 • CHARACTERIZATION OF MATERIALS II ............ 63
4.1. Electrical Properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
4.2. Optical Properties ............................................ 67
4.3. X-Ray Absorption ............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
4.4. Density and Porosity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
4.5. Acoustic and Ultrasonic Properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
4.6. Diffusion Properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Symbols/Definitions .............................................. 76
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Chapter 5 • METALLIC IMPLANT MATERIALS................... 79
5.1. Stainless Steels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
5.1.1. Types and Compositions of Stainless Steels. . . . . . . . . . . . . . . . . 80
5.1.2. Properties of Stainless Steel .............................. 80
5.1.3. Manufacturing of Implants Using Stainless Steel. . . . . . . . . . . . 81
5.2. Co-Based Alloys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
5.2.1. Types and Compositions of Co-Based Alloys. . . . . . . . . . . . . . . 83
5.2.2. Properties of Co-Based Alloys. . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
5.2.3. Manufacturing of Implants Using Co-Based Alloys. . . . . . . . . . 86
5.3. Ti and Ti-Based Alloys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
5.3.1. Compositions of Ti and Ti-Based Alloys. . . . . . . . . . . . . . . . . . . 89
5.3.2. Structure and Properties of Ti and Ti Alloys. . . . . . . . . . . . . . . . 89
5.3.3. Manufacturing of Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
5.4. Dental Metals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
5.4.1. Dental Amalgam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
5.4.2. Gold .................................................. 94
5.4.3. Nickel-Titanium Alloys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
5.5. Other Metals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
5.6. Corrosion of Metallic Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
5.6.1. Electrochemical Aspects ................................. 100
5.6.2. Pourbaix Diagrams in Corrosion . . . . . . . . . . . . . . . . . . . . . . . . .. 102
5.6.3. Rates of Corrosion and Polarization Curves. . . . . . . . . . . . . . .. 105
CONTENTS ix
5.6.4. Corrosion of Available Metals ........................... , 106
5.6.5. Minimization of Corrosion: Case Studies. . . . . . . . . . . . . . . . . .. 107
Problems ........................................................ 111
Symbols/Definitions .............................................. 113
Bibliography .................................................... , 114
Chapter 6 • CERAMIC IMPLANT MATERIALS................... 117
6.1. Structure-Property Relationship of Ceramics..................... 117
6.1.1. Atomic Bonding and Arrangement ........................ 117
6.1.2. Physical Properties ..................................... , 118
6.2. Aluminum Oxides ............................................ 121
6.3. Calcium Phosphate ........................................... 122
6.3.1. Structure of Calcium Phosphate. . . . . . . . . . . . . . . . . . . . . . . . . .. 122
6.3.2. Properties of Hydroxyapatite. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 123
6.3.3. Manufacturing of Hydroxyapatite. . . . . . . . . . . . . . . . . . . . . . . .. 123
6.4. Glass-Ceramics........... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 126
6.4.1. Formation of Glass-Ceramics. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 126
6.4.2. Properties of Glass-Ceramics ............. . . . . . . . . . . . . . . .. 129
6.5. Other Ceramics .............................................. , 130
6.6. Carbons..................................................... 131
6.6.1. Structure of Carbons .................................... 131
6.6.2. Properties of Caroon .................................... 132
6.6.3. Manufacturing of Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 134
6.7. Deterioration of Ceramics ..................................... 135
Problems ............................................ . . . . . . . . . . .. 139
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 140
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 140
Chapter 7 • POLYMERIC IMPLANT MATERIALS................. 141
7.1. Polymerization............................................... 141
7.1.1. Condensation or Step Reaction Polymerization ............. 141
7.1.2. Addition or Free Radical Polymerization. . . . . . . . . . . . . . . . . .. 142
7.2. Effect of Structural Modification and Temperature on Properties ... 144
7.2.1. Effect of Molecular Weight and Composition. . . . . . . . . . . . . .. 145
7.2.2. Effect of the Side-Chain Substitution, Cross-Linking,
and Branching .......................................... 146
7.2.3. Effect of Temperature on Properties. . . . . . . . . . . . . . . . . . . . . .. 146
7.3. Polymeric Implant Materials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 147
7.3.1. Polyamides (Nylons) .................................... 148
7.3.2. Polyethylene............................................ 150
7.3.3. Polypropylene.......................................... 151
7.3.4. Polyacrylates ........................................... 152
x CONTENTS
7.3.5. Fluorocarbon Polymers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 157
7.3.6. Rubbers ............................................... 157
7.4. High-Strength Thermoplastics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 159
7.5. Deterioration of Polymers ..................................... 161
7.5.1. Chemical Effects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 161
7.5.2. Sterilization Effects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 162
7.5.3. Mechanochemical Effects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 162
7.5.4. In Vivo Environmental Effects. . . . . . . . . . . . . . . . . . . . . . . . . . .. 163
Problems ........................................................ 165
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 167
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 167
Chapter 8 • COMPOSITES AS BIOMATERIALS.................. 169
8.1. Structure .................................................... 169
8.2. Mechanics of Composites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 170
8.3. Applications of Composite Biomaterials . . . . . . . . . . . . . . . . . . . . . . . .. 174
8.3.1. Dental Filling Composites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 175
8.3.2. Porous Implants ........................................ 177
8.3.3. Fibrous and Particulate Composites in Orthopedic
Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 180
Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 182
Symbols/Definitions .............................................. 182
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 183
Chapter 9 • STRUCTURE-PROPERTY RELATIONSHIPS
OF BIOLOGICAL MATERIALS...................... 185
9.1. Proteins ..................................................... 186
9.1.1. Collagen............................................... 186
9.1.2. Elastin................................................. 187
9.2. Polysaccharides .............................................. 190
9.2.1. Hyaluronic Acid and Chondroitin. . . . . . . . . . . . . . . . . . . . . . . .. 191
9.2.2. Chondroitin Sulfate ..................................... 191
9.3. Structure-Property Relationship of Tissues. . . . . . . . . . . . . . . . . . . . . .. 192
9.3.1. Mineralized Tissue (Bone and Teeth) . . . . . . . . . . . . . . . . . . . . .. 193
9.3.2. Bone Remodeling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 204
9.3.3. Collagen-Rich Tissues ................................... 207
9.3.4. Elastic Tissues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 212
Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 219
Symbols/Definitions .............................................. 220
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 222
CONTENTS xi
Chapter 10 • TISSUE RESPONSE TO IMPLANTS................ 223
10.1. Normal Wound Healing Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 223
10.1.1. Inflammation......................................... 223
10.1.2. Cellular Response to Repair. . . . . . . . . . . . . . . . . . . . . . . . . . .. 225
10.2. Body Response to Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 230
10.2.1. Cellular Response to Implants. . . . . . . . . . . . . . . . . . . . . . . . .. 231
10.2.2. Systemic Effects of Implants. . . . . . . . . . . . . . . . . . . . . . . . . . .. 234
10.3. Blood Compatibility ......................................... 236
10.3.1. Factors Affecting Blood Compatibility. . . . . . . . . . . . . . . . . .. 237
10.3.2. Nonthrombogenic Surfaces. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 238
10.4. Carcinogenicity.............................................. 240
10.4.1. Testing of Carcinogenicity. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 240
10.4.2. Risk Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 241
Problems ........................................................ 242
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 243
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 244
Chapter 11 • SOFT TISSUE REPLACEMENT I: SUTURES,
SKIN, AND MAXILLOFACIAL IMPLANTS........... 245
11.1. Sutures, Surgical Tapes, and Adhesives. . . . . . . . . . . . . . . . . . . . . . . .. 246
11.1.1. Sutures .............................................. 246
11.1.2. Surgical Tapes and Staples. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 248
11.1.3. Tissue Adhesives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 248
11.2. Percutaneous and Skin Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 250
11.2.1. Percutaneous Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 250
11.2.2. Artificial Skins. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 253
11.3. Maxillofacial and Other Soft-Tissue Augmentation. . . . . . . . . . . . . .. 255
11.3.1. Maxillofacial Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 255
11.3.2. Ear and Eye Implants ................................. 256
11.3.3. Fluid Transfer Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 258
11.3.4. Space-Filling Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 259
Problems ........................................................ 262
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 263
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 264
Chapter 12 • SOFT TISSUE REPLACEMENT II:
BLOOD-INTERFACING IMPLANTS 265
12.1. Vascular Implants ........................................... 265
12.2. Heart Valve Implants ........................................ 272
12.3. Heart and Lung Assist Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 275
xii CONTENTS
12.4. Artificial Organs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 278
12.4.1. Artificial Hearts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 279
12.4.2. Cardiac Pacemaker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 279
12.4.3. Artificial Kidney Dialysis Membrane .................... 283
Problems ........................................................ 289
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 290
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 291
Chapter 13 • HARD TISSUE REPLACEMENT I:
LONG BONE REPAIR............................. 293
13.1. Wires, Pins, and Screws. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 295
13.1.1. Wires................................................ 295
13.1.2. Pins................................................. 296
13.1.3. Screws............................................... 296
13.2. Fracture Plates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 300
13.2.1. Cortical Bone Plates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 300
13.2.2. Cancellous Bone Plate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 302
13.3. Intramedullary Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 306
13.4. Spinal Fixation Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 310
13.5. Fracture Healing by Electrical and Electromagnetic
Stimulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 311
Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 314
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 315
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 316
Chapter 14 • HARD TISSUE REPLACEMENT II:
JOINTS AND TEETH.............................. 317
14.1. Joint Replacements........... . .... ...... . ........ . ... . .... .. 317
14.1.1. Lower Extremity Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 319
14.1.2. Upper Extremity Implants.............................. 331
14.2. Dental Implants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 339
14.2.1. Endosseous Tooth Implants. . . . . . . . . . . . . . . . . . . . . . . . . . .. 339
14.2.2. Subperiosteal and Staple/Transosteal Implants. . . . . . . . . . .. 343
14.3. Interface Problems in Orthopedic Implants ..................... 344
14.3.1. Bone Cement Fixation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 346
14.3.2. Porous Ingrowth (Biological) Fixation. . . . . . . . . . . . . . . . . .. 347
14.3.3. Direct Bonding between Bone and Implant. . . . . . . . . . . . . .. 351
14.3.4. Interference and Passive Fixation ....................... 351
Problems ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 352
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 352
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 352