Materials Sciences and Implant Orthopedic Surgery PDF
Preview Materials Sciences and Implant Orthopedic Surgery
Materials Sciences and Implant Orthopedic Surgery NATO ASI Series Advanced Science Institutes Series A Series presenting the results of activities sponsored by the NA TO Science Committee, which aims at the dissemination of advanced scientific and technological knowledge, with a view to strengthening links between scientific communities. The Series is published by an international board of publishers in conjunction with the NATO Scientific Affairs Division A Life Sciences Plenum Publishing Corporation B Physics London and New York C Mathematical and D. Reidel Publishing Company Physical Sciences Dordrecht and Boston D Behavioural and Martinus Nijhoff Publishers Social Sciences DordrechtlBoston/Lancaster E Applied Sciences F Computer and Springer-Verlag Systems Sciences Berlin/Heidelberg/New York G Ecological Sciences Series E: Applied Sciences - No. 116 Materials Sciences and Implant Orthopedic Surgery edited by Ram Kossowsky Pennsylvania State University Applied Research Laboratory State College Pennsylvania 16804 USA and Nir Kossovsky Department of Pathology The New York Hospital Cornell University Medical Center New York, NY 10021 USA 1986 Martinus Nijhoff Publishers Dordrecht I Boston I Lancaster Published in cooperation with NATO Scientific Affairs Division Proceedings of the NATO Advanced Study Institute on "Applications of the Materials Sciences to the Practice of Implant Orthopedic Surgery", Marbella, Spain, July 14-22, 1984 Library of Congress Cataloging in Publication Data ISBN-13: 978-94-010-8492-5 e-ISBN: 978-94-009-4474-9 001: 10.1007/978-94-009-4474-9 Distributors for the United States and Canada: Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park, Norwell MA 02061, USA Distributors for the UK and Ireland: Kluwer Academic Publishers, MTP Press Ltd, Falcon House, Queen Square, Lancaster LA 1 1R N, UK Distributors for all other countries: Kluwer Academic Publishers Group, Distribution Center, P.O. Box 322, 3300 AH Dordrecht, The Netherlands All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publishers, Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht, The Netherlands Copyright © 1986 by Martinus Nijhoff Publishers, Dordrecht v PREFACE Combining experts from the medical and materials sciences, the Institute considered current concepts in medical and materials sciences as they relate to implantable prostheses in orthopedic surgical practice. The syllabus included theory and applications of materials properties, physiological function, and host response to metal and non-metal materials. Total hip prostheses are the most common orthopedic device implanted today involved in over 200,000 operations. Failures occur at the rate of at 10~-40~ ~ to 10 years. Failures are due to loosening, infection, fracture of femoral components, or destruction of the pe 1v i c components .' All these, and other problems related to the implantation of the devices, the surgical procedures, and device pathology, were. discussed in light of current, as well as, emerging technologies and scientific knowledge. Repeatedly, scientists designing prostheses became aware of a lack of understanding of physiological phenomena associated with biocompatibility; the interchange among practising physicians, basic scientists, and pathologists at this Institute was appreciated. We thank all the contributors and participants for their effort. Thanks are also due to the personnel of the Scientific Affairs Division of NATO. The daily routines of running the Institute were greatly facilitated by the efforts of Pedro Cuevas, M.D, Jose Gutierrez Diaz, M.D, and Dr. Hanita Kossowsky. The devoted help of Nir Kossovsky, M.D, in setting the conference and in editing this book, is sincerely appreci ated. Dr. Ram Kossowsky Manuel Dujovny, M.D THE PROGRAMME IX Sunday, July 15, 9:30 -12:30 Session I: Implications of Implant Utilization Chairman: Dr. Ram Kossowsky Bioengineering and Implant Surgery (Invited) Prof. 1. Lawrance Katz W.H.O. Experience with Implantable Devices: Problems Faced by Developing Countries (Invited) Dr. B. Sankaran FDA Regulation of Orthopedic Implants (Invited) Dr. Carl A. Larson Monday, July 16, 9:30 -12:30 Session II: Clinical Aspects of Implant Surgery Chairman: Jose Gutierrez·Diaz, M.D. Utilization of Implants in Clinical Orthopedics (Invited) R. Ling, M.D. Clinical Aspects of Orthopedic Implant Surgery (Invited) Pascal Christel, M.D. Magnetic Sensitivity of Microvascular Clips: NMR And X-Ray Studies M. Dujovny, M.D. Monday, July 16, 17:00 -20:00 Session II: Clinical Aspects of Implant Surgery (Continued) Chairman: Manuel Dujovny, M.D. Biology of Primary Fracture Healing. From the Animal Investigation to the Clinical Application. (Invited) Prof. P. Gallinaro Evaluation of Joint Loadings in the Use of Walking Aids in Total Hip Replacement Patients Karen A. Opila A New Total Ankle Joint Prosthesis Hakon Kofoed, M.D. Biomechanical and Biochemical Adaptation of Skeletal Implants (Clinical and Experimental Results) A. Engelhardt, M.D. Discussion: Clinical Issues Discussion leaders: P. Christel, P. Gallinaro, l. Katz X Wednesday. July 18. 9:30 - 12:30 Session III: Metallic Materials Chairman: Dr. Ram Kossowsky Mechanical Behavior of Implant Materials and Devices (Invited) Dr. R.M. Pilliar The Biological Applications of Ti and Ti Alloys (Invited) Dr. David Williams Application of the Memory Alloy NiTi as Implant Material Dr. Jorg Haasters Wednesday. July 18. 17:00 -20:00 Session IV: Metallurgy of Metallic Implants Chairman: Dr. Jonathan Black Principles of Materials Characterization Techniques (Invited) Dr. Ram Kossowsky Metallurgy of Orthopedic Implants (Invited) Dr. Denes Bardos Stem Fractures in Total Hip Prosthesis Dr. Jorg Haasters Role of Finite Element Modeling and Material Characterization in Orthopedic Surgery Dr. Harcharan Singh Ranu Thursday. July 19. 9:30 - 12:30 Session V: Surface and Interfaces Phenomena Chairman: Nir Kossovsky. M.D. Electrochemical Phenomena: In Vitro Principles and In Vivo Observations (Invited) Dr. Jonathan Black Surface Phenomena in In Vh,o Environments (Invited) Dr. Robert E. Baier High Resolution Electron Microscopy Evidence for the Direct Bonding of Bone to Hydroxylapatite Dr. Bryan M. Tracy Quantitative Microscopy in the Evaluation of Implant Materials Dr. Rosemary Wilkinson XI Thursday. July 19. 17:00 -20:00 Session V: Surface and Interfaces Phenomena (Continued) Chairman: Nir Kossovsky. M.D. lOT: Nonporous and Noncemented Stepped-Surface Total Hip Prosthesis James Pugh. M.D. Electrical Polarization and Metal Corrosion Dr. Harcharan Singh Ranu The Eccentric Polyethylene Acetabular Cup - The Role of the Cup Wall Thickness and Design in Implant Loosening Dr. Thomas Mitt/meier Bone In-Growth and Porous Implant Stability with Bioactive Substances s. Reger, M.D. Bone Implant Surfaces with Coatings Containing Surface-Reactive Particles Ulrich Gross, M.D. Discussion: III Vil,o Behavior and Interfaces Discussion Leaders: J. Black, R. Baier, D. Williams Friday, July 20. 9:30 -12:30 Session VI: Non-Metallic Materials Chairman: Dr. J. Lawrance Katz Carbon and Plastic Materials for Orthopedic Implants (Invited) Dr. G. W. Hastings Delayed Hypersensitivity to Silicone Products (Invited) Nir Kossovsky, M.D. Properties of Ceramics and Osteophilic Materials (Invited) Dr. Paul Ducheyne XII Friday, July 20, 17:00 -20:00 Session VI: Non-Metallic Materials (Continued) Chairman: Dr. S. Reger Does the Trunnion Bearing Total Hip Prosthesis Imply Reduced Wear Rates? Dr. Thomas Mitt/meier Use of Allogenic Perforated Demineralized Bone Matrix for Osteoinduction and Stimulation of Bone Regeneration Dr. EI Gendler The Role of Carbon in Orthopedic Implants: A Review John Lipka Degradation of UHMW Polyethylene in Joint Endoprosthesis Dr. Peter Eyerer Saturday, July 21, 9:30 -12:30 Session VI: Non-Metallic Materials (Continued) Chairman: .D r. Paul Ducheyne A High Strength Absorbable Polymer for Internal Bone Fixation Dr. Deger C. Tunc Effect of Ionizing Radiation on the Mechanical Properties of Soft and Hard Tissue Dr. Harcharan Singh Ranu Collagen: Structure, Function, Biosynthesis and Biomaterial Properties Dr. Marcel E. Nimni Fracture, Fatigue and Aging Behavior of Carbon Fibre Reinforced Plastics Dr. Uwe Soltesz Biological Behavior of Polytetrafluoroethylene (PTFE) as Microvascular Graphs Jose A. Gutierrez Diaz, M.D. Saturday. July 21, 17:00 -20:00 Session VII: Discussion: Ceramics, Polymers and Biocompatibility Discussion Leaders: L. Katz, N. Kossovsky. P. Ducheyne
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