Alumina ceramic heads have been previously shown to reduce polyethylene wear in comparison to cobalt chrome (CoCr) heads in artificial hip joints. However, there are concerns about the brittle nature of ceramics. It is therefore of interest to investigate ceramic-like coatings on metallic heads. The aim of this study was to compare the friction and wear of ultra-high molecular weight polyethylene (UHMWPE) against alumina ceramic, CoCr, and surface-engineered ceramic-like coatings in a friction simulator and a hip joint simulator. All femoral heads tested were 28 mm diameter and included: Biolox Forte alumina, CoCr, arc evaporative physical vapour deposition (AEPVD) chromium nitride (CrN) coated CoCr, plasma-assisted chemical vapour deposition (PACVD) amorphous diamond-like carbon (aDLC) coated CoCr, sputter CrN coated CoCr, reactive gas controlled arc (RGCA) AEPVD titanium nitride (TiN) coated CoCr, and Graphit-iC coated CoCr. These were articulated against UHMWPE acetabular cups in a friction simulator and a hip joint simulator. Alumina and CoCr gave the lowest wear volumes whereas the sputter coated CrN gave the highest. Alumina also had the lowest friction factor. There was an association between surface parameters and wear. This study indicates that surface topography of surface-engineered femoral heads is more important than friction and wettability in controlling UHMWPE wear.

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The issues surrounding raised levels of metal ions in the blood following large head metal-on-metal total hip replacement (THR), such as cobalt and chromium, have been well documented. Despite the national popularity of uncemented metal-on-polyethylene (MoP) THR using a large-diameter femoral head, few papers have reported the levels of metal ions in the blood following this combination. Following an isolated failure of a 44 mm Trident-Accolade uncemented THR associated with severe wear between the femoral head and the trunnion in the presence of markedly elevated levels of cobalt ions in the blood, we investigated the relationship between modular femoral head diameter and the levels of cobalt and chromium ions in the blood following this THR. A total of 69 patients received an uncemented Trident-Accolade MoP THR in 2009. Of these, 43 patients (23 men and 20 women, mean age 67.0 years) were recruited and had levels of cobalt and chromium ions in the blood measured between May and June 2012. The patients were then divided into three groups according to the diameter of the femoral head used: 12 patients in the 28 mm group (controls), 18 patients in the 36 mm group and 13 patients in the 40 mm group. A total of four patients had identical bilateral prostheses in situ at phlebotomy: one each in the 28 mm and 36 mm groups and two in the 40 mm group. There was a significant increase in the mean levels of cobalt ions in the blood in those with a 36 mm diameter femoral head compared with those with a 28 mm diameter head (p = 0.013). The levels of cobalt ions in the blood were raised in those with a 40 mm diameter head but there was no statistically significant difference between this group and the control group (p = 0.152). The levels of chromium ions in the blood were normal in all patients. The clinical significance of this finding is unclear, but we have stopped using femoral heads with a diameter of ≤ 36 mm, and await further larger studies to clarify whether, for instance, this issue particularly affects this combination of components.

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Many benefits can be derived from in situ monitoring of the growth, load response, and condition of human bone. In particular, bone monitoring offers opportunity to advance understanding and designing of osseointegrated mechanical components fixated into bones such as artificial joints and more recently osseointegrated prosthetic limbs. In this study, a bio-compatible wireless inductive strain-sensing system is proposed, which is designed to monitor the growth and strain response of bone-hosting implants. Thin-film circuit fabrication methods based on lithography are adopted to develop a conformable wireless strain sensor designed as a passive resistive-inductive-capacitive circuit. Two forms of strain sensing are designed into the thin-film sensor. First, parallel-plate capacitors fabricated from metal electrodes and a polyimide dielectric layer are introduced to modulate bone strain onto a resonant frequency of the thin-film sensor. A second resonant frequency is introduced in the sensor design to measure circumferential bone growth using a highly nonlinear titanium-resistive element, whose resistance exponentially increases well after 1000 me under monotonic increasing hoop strain. To ensure the possibility for implantation in animal subjects in future study, the thin-film sensing system is fabricated using mainly bio-compatible polymers (e.g. polyimide) and metals (e.g. titanium and gold). Fabricated prototypes inductively coupled using an impedance analyzer are experimentally tested. Results reveal linear response of the first resonant frequency to low levels of strain with a sensitivity of 4.555 Hz per unit microstrain. The second resonant frequency is sensitive to the resistive fuse with nonlinear fuse behavior initiated above 1000 me and impedance phase increasing exponentially thereafter.

Multifunctional thin film materials have opened many opportunities for novel sensing strategies for structural health monitoring. While past work has established methods of optimizing multifunctional materials to exhibit sensing properties, comparatively less work has focused on their integration into fully functional sensing systems capable of being deployed in the field. This study focuses on the advancement of a scalable fabrication process for the integration of multifunctional thin films into a fully integrated sensing system. This is achieved through the development of an optimized fabrication process that can create a broad range of sensing systems using multifunctional materials. A layer-by-layer deposited multifunctional composite consisting of single walled carbon nanotubes (SWNT) in a polyvinyl alcohol and polysodium-4-styrene sulfonate matrix are incorporated with a lithography process to produce a fully integrated sensing system deposited on a flexible substrate. To illustrate the process, a strain sensing platform consisting of a patterned SWNT-composite thin film as a strain-sensitive element within an amplified Wheatstone bridge sensing circuit is presented. Strain sensing is selected because it presents many of the design and processing challenges that are core to patterning multifunctional thin film materials into sensing systems. Strain sensors fabricated on a flexible polyimide substrate are experimentally tested under cyclic loading using standard four-point bending coupons and a partial-scale steel frame assembly under lateral loading. The study reveals the material process is highly repeatable to produce fully integrated strain sensors with linearity and sensitivity exceeding 0.99 and respectively. The thin film strain sensors are robust and are capable of high strain measurements beyond

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