Implant Failures in Orthopaedic Surgery

Abstract

Common orthopaedic implant failures are reviewed in the areas of total joint replacement and fracture fixation. In particular total hip and total knee arthroplasty, intertrochanteric hip fractures and long bone fractures are discussed. Excessive motion of implant bone interfaces, stress concentrations within the implant and stress shielding of bone are implicated in implant failures.

Metallurgical studies of interface bonding on implant alloys

“…They also calculated the stress distributions in the natural bone and found that the Ritter-Grunert prosthesis produced a stress distribution much closer to the physiological state than did the conventional prosthesis. This failure site has also been described by Harris and Tarr (1979).…”

Synthesis of polylactic acid–polyglycolic acid blends using microwave radiation

“…The most popular and structures made of polylactic acid (PLA) and Poly-DL-lacticco-glycolic acid (PLAGA) are being used and are likely to replace metal implants in the near future (Agrawal et al, 1999;Lu et al, 2000). These bioabsorbable products have several advantages over metal implants: (1) no stress-shielding effect, (2) no need for removal after surgery, and (3) no metallic corrosion (Kawahara et al, 1980;Rice et al, 1978;Pilliar, 2003;Harris and Tarr, 1978). However, each of these has some shortcomings that restrict its applications.…”

Does the Time of Postoperative Bisphosphonate Administration Affect the Bone Union in Osteoporotic Intertrochanteric Fracture of Femur?

“…Recently, it has been suggested that surgical technique and implants are possible causative factors for nonunion. Weil et al 25) have attracted attention by advocating that delays in healing may be caused by a decrease in load transfer due to stress shielding 31) . For this reason, early ambulation has been recently recommended, and the wider use of load sharing devices has been suggested 6) .…”