Early failure of a press-fit carbon fiber hip prosthesis with a smooth surface

Adam, Frank; Hammer, Dietrich S.; Pfautsch, Steffen; Westermann, K.

doi:10.1054/arth.2002.30285

Cited by 58 publications

(40 citation statements)

References 26 publications

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“…Achieving a stable bone-implant interface by osseointegration has been a longstanding problem with carbon-fiber-reinforced polymer materials, including CFR/PEEK. 17,18 To date, studies have focused on wear reduction 4,19 or secure implant fixation 20-27 to develop cementless CFR/PEEK prostheses. Given that CFR/PEEK is bio-inert, the addition of bioactive material coatings has been considered to improve osseointegration.…”

mentioning

confidence: 99%

Interfacial shear strength of bioactive‐coated carbon fiber reinforced polyetheretherketone after in vivo implantation

Nakahara

Takao

Goto

et al. 2012

Journal Orthopaedic Research

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Despite the excellent osseointegration of carbon-fiber-reinforced polyetheretherketone (CFR/PEEK) with a surface hydroxyapatite (HA) coating, the bone-implant interfacial shear strength of HA-coated CFR/PEEK after osseointegration is unclear. We examined the interfacial shear strength of HA-coated CFR/PEEK implants after in vivo implantation in a rabbit femur-implant pullout test model. HA coating was performed by a newly developed method. Uncoated CFR/PEEK, HA-coated blasted titanium alloy, and uncoated blasted titanium alloy were used as control implants. The implants were inserted into drilled femoral cortex, and pull-out tests were conducted after 6 and 12 weeks of implantation to determine maximum interfacial shear strength. The HA-coated CFR/ PEEK (15.7 AE 4.5 MPa) and HA-coated titanium alloy (14.1 AE 6.0 MPa) exhibited significantly larger interfacial shear strengths than the uncoated CFR/PEEK (7.7 AE 1.8 MPa) and the uncoated titanium alloy (7.8 AE 2.1 MPa) at 6 weeks. At 12 weeks, only the uncoated CFR/PEEK (8.3 AE 3.0 MPa) exhibited a significantly smaller interfacial shear strength, as compared to the HA-coated CFR/PEEK (17.4 AE 3.6 MPa), HA-coated titanium alloy (14.2 AE 4.8 MPa), and uncoated titanium alloy (15.0 AE 2.6 MPa). Surface analysis of the removed implants revealed detachment of the HA layer in both the HA-coated CFR/PEEK and titanium alloy implants Keywords: carbon-fiber-reinforced PEEK; interfacial shear strength; hydroxyapatite; coating adhesion; osseointegration Carbon-fiber-reinforced polyetheretherketone (CFR/ PEEK) is attractive for use in orthopedic implants, 1-4 due to high fatigue strength, high chemical stability, no metal ion release, and excellent biocompatibility with direct cell attachment. 5,6 Moreover, mechanical properties, including strength, toughness, and stiffness, can be easily modified by the arrangement of reinforcing fiber volume and orientation. In cementless hip prostheses, tailoring stiffness can minimize bone resorption of the proximal femur due to stress shielding by designing CFR/PEEK stems with elasticity similar to surrounding cortical bone. 7-10 The fatigue resistance and toughness could minimize the risk of implant fracture. 11-13 The metal-free nature of CFR/PEEK prostheses eliminate metal allergy concerns 14 and problems passing through security gates with metal detectors. 15 Furthermore, CT and MRI of areas around the implants can be achieved without artifacts. 16 Despite these theoretical advantages, CFR/PEEK cementless hip prostheses are not yet practical for clinical applications. In vivo wear resistance and subsequent immunoreaction have not been established when used as a bearing surface. Another issue is implant fixation. Achieving a stable bone-implant interface by osseointegration has been a longstanding problem with carbon-fiber-reinforced polymer materials, including CFR/PEEK. 17,18 To date, studies have focused on wear reduction 4,19 or secure implant fixation 20-27 to develop cementless CFR/PEEK prostheses.Given that CFR/PEEK is...

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mentioning

confidence: 99%

Interfacial shear strength of bioactive‐coated carbon fiber reinforced polyetheretherketone after in vivo implantation

Nakahara

Takao

Goto

et al. 2012

Journal Orthopaedic Research

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“…However they did not succeed at the clinical level. In fact, a human clinical study of a press-fit carbon fiber hip prosthesis with a smooth surface [33] concluded that insufficient bone fixation of the prosthesis caused early loosening of the implant, although the composite stem had the mechanical properties to resist the physiological stress of a hip joint.…”

Section: Previous Attempts To Solve Stress Shieldingmentioning

confidence: 99%

CF/PA12 composite femoral stems: Manufacturing and properties

Campbell

Denault

Yahia

et al. 2008

Composites Part A: Applied Science and Manufacturing

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“…The corrosion resistance, mechanical reliability and tailorability of thermoplastic polymer-based composites make them a potential substitute for metallic materials, with a wider range of bone-matching properties. In fact employing advanced composite materials has become a common trend in the development of novel hip stems [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies on polymer composite materials designed for hip prostheses include the work from Reinhardt et al [4], Simoes and Marques [5][6][7] as well as many other investigators [8][9][10][11]. Reinhardt et al designed a thermosetting polymer-based composite hip prosthesis made by resin transfer molding (RTM).…”

Section: Introductionmentioning

confidence: 99%

“…Further studies were conducted concerning the clinical validity of composite stems. Adam et al [10] conducted a human clinical study of a press-fit carbon fiber hip prosthesis with a smooth surface. The modulus of a carbon fiber-reinforced carbon stem is about three times lower compared with metal stems and closer to the modulus of cortical bone (ranging from 12GPa to 20 GPa).…”

Section: Introductionmentioning

confidence: 99%

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