Retrospective Study of Implant Failure in Orthopaedic Surgery

Sharma, Alok; Kumar, Ashok; Joshi, GR; John, John T

doi:10.1016/s0377-1237(06)80164-4

Cited by 27 publications

(14 citation statements)

References 4 publications

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“…The breakage of metallic osteosynthesis devices in clinical use, namely, bone plates [11,12,13], intramedullary nail rods [14,15,16,17,18,19], spinal rods [20,21], compression hip screws (CHSs) [22], short femoral nails [23,24,25,26,27,28,29], and metaphyseal plates [22,30], due to fatigue fracture in the stress concentration region has been reported. In particular, the stress concentration region around a hole leads to crack initiation, resulting in fatigue fracture.…”

Section: Introductionmentioning

confidence: 99%

Strength–Durability Correlation of Osteosynthesis Devices Made by 3D Layer Manufacturing

2019

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To develop orthopedic implants that are optimized for each patient’s needs or skeletal structure (custom-made implants), evaluations of the bending strength, bending stiffness, and durability of various types of conventional osteosynthesis devices have become important. Four-point bending tests and compression bending tests of osteosynthesis devices (bone plates, intramedullary nail rods, spinal rods, compression hip screws (CHSs), short femoral nails, and metaphyseal plates) were carried out to measure their bending stiffness, bending strength, and durability. The bending stiffness of bone plates, intramedullary nails, spinal rods, CHSs, short femoral nails, and metaphyseal plates increased with increasing bending strength. The durability limit of various types of osteosynthesis devices linearly increased with increasing bending strength. The relationship (durability limit at 106 cycles) = 0.67 × (bending strength) (N·m) (R2 = 0.85) was obtained by regression. The relationship for the highly biocompatible Ti-15Zr-4Nb-4Ta alloy was also linear. The mechanical strength and ductility of specimens that were cut from various osteosynthesis devices were excellent and their microstructures consisted of fine structures, which were considered to be related to the excellent durability. These results are expected to be useful for the development of implants suitable for the skeletal structure of patients using three-dimensional (3D) layer manufacturing technologies.

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Section: Introductionmentioning

confidence: 99%

Strength–Durability Correlation of Osteosynthesis Devices Made by 3D Layer Manufacturing

2019

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“…Fatigue is a type of damage often observed in implanted metals and is regarded as an important cause of orthopedic metal implant failure [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. To summarize the literature on causes of failure, prosthetic fracture occurs owing to fatigue due to stress concentration that develops near holes of plates and rods, screws, spinal implants, and junctions of artificial hip stems.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Fatigue Properties and Fatigue Crack Growth Rates of Various Implantable Metals

Okazaki

2012

Materials

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The fatigue strength, effects of a notch on the fatigue strength, and fatigue crack growth rate of Ti-15Zr-4Nb-4Ta alloy were compared with those of other implantable metals. Zr, Nb, and Ta are important alloying elements for Ti alloys for attaining superior long-term corrosion resistance and biocompatibility. The highly biocompatible Ti-15Zr-4Nb-4Ta alloy exhibited an excellent balance between strength and ductility. Its notched tensile strength was much higher than that of a smooth specimen. The strength of 20% cold-worked commercially pure (C.P.) grade 4 Ti was close to that of Ti alloy. The tension-to-tension fatigue strength of an annealed Ti-15Zr-4Nb-4Ta rod at 107 cycles was approximately 740 MPa. The fatigue strength of this alloy was much improved by aging treatment after solution treatment. The fatigue strengths of C.P. grade 4 Ti and stainless steel were markedly improved by 20% cold working. The fatigue strength of Co-Cr-Mo alloy was markedly increased by hot forging. The notch fatigue strengths of 20% cold-worked C.P. grade 4 Ti, and annealed and aged Ti-15Zr-4Nb-4Ta, and annealed Ti-6Al-4V alloys were less than those of the smooth specimens. The fatigue crack growth rate of Ti-15Zr-4Nb-4Ta was the same as that of Ti-6Al-4V. The fatigue crack growth rate in 0.9% NaCl was the same as that in air. Stainless steel and Co-Cr-Mo-Ni-Fe alloy had a larger stress-intensity factor range (ΔK) than Ti alloy.

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“…26 Sharma et al in a retrospective study of 41 failed upper and lower limb implants found that plate failure was more common than nail failure in the lower limb. 27 Hardware removal surgeries are mainly performed by registrars and post graduates use to assist them followed by consultants in our institute as this is looked as straight forward or there is less struggle due to incision is taken over the old surgical scar and no obvious fear of likelihood of complication. Surgeons believe on his skills of performing the skilled operation and this do not significantly contribute to operation duration (p>0.05).…”

Section: Discussionmentioning

confidence: 99%

Indications for implant removal: a prospective study

Jain¹,

Patel²,

Jayaswal³

et al. 2019

Int J Res Orthop

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Background: The implants removal after fracture healing has always been an issue of controversy. After union, the implant ceases to be important and can be removed. Nevertheless, some patients require metallic implant removal due to various implant-related difficulties. Our study was aimed to identify the most common causes for removal of implant.Methods: The patients admitted for implant removal in our department were consented and included in the study. Pre-operative radiological images collected and evaluated. Post-operatively, images were taken and followed for resolution of symptoms or appearance of new problems.Results: A total of 60 patients were studied. Of these, 47 were males and 13 were females. Mean age was 33.7 years (range 4-70 years). Patient request (35% of patients) was the main indication for removal of implants. Reasons were found to be discomfort due to implant, infection, failure of implants and others.Conclusions: Belief regarding hardware removal has been set and most of them are agreed that routine removal should not be performed unless obviously indicated. In our attempt to fill this gap, we trust that routine removal should not be performed in ‘asymptomatic’ patients. The procedure should not need a big procedure than the implant fixation surgery. Procedure should be sought also as a risk like refracture, bleeding, infection, neurovascular injury and prior to surgery, proper consent to be taken and patient should be well explained. Sometimes indicated results expected after surgery can’t be fulfilled, and instead, complication can results.

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Retrospective Study of Implant Failure in Orthopaedic Surgery

Cited by 27 publications

References 4 publications

Strength–Durability Correlation of Osteosynthesis Devices Made by 3D Layer Manufacturing

Strength–Durability Correlation of Osteosynthesis Devices Made by 3D Layer Manufacturing

Comparison of Fatigue Properties and Fatigue Crack Growth Rates of Various Implantable Metals

Indications for implant removal: a prospective study

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