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Joint replacement technology

Edited by P A Revell, University College London, UK

Woodhead Publishing Series in Biomaterials No. 11

 - reviews joint biomechanics and tribology
 - considers the use of metals and ceramics as joint replacement materials, joint design and bone cements
 - summarises research on prosthetic interaction with the body
 - discusses drug delivery systems to enhance joint replacement
 - analyses key issues in paticular joint replacements including the hip, knee, ankle and shoulder

Joint replacement has been one of the major successes of modern medicine. Its continued success depends on effective collaboration between clinicians and researchers across many different areas in science and medicine. This important book brings together the wide range of research in this area and its implications for clinical practice.

The book sets the scene with introductory chapters on joint biomechanics and tribology, materials for joint replacement and their interactions with the body, and regulatory issues. Part two reviews the use of metals and ceramics as joint replacement materials, joint design, bone cements and cementless fixation techniques, failure mechanisms and ways of predicting the lifetime of replacement joints. The third part of the book summarises research on how prosthetic joints interact with the body, including biological causes of joint failure, sterilisation techniques and the use of drug delivery systems to enhance joint replacement. The final group of chapters reviews key issues in replacing particular joints including the hip, knee, ankle, shoulder and elbow as well as developments in intervertebral disc and tempero-mandibular joint replacement technology.

With its distinguished editor and international team of contributors, Joint replacement technology is a standard reference for the engineering and materials scientific communities, as well as surgeons seeking the best treatment for their patients.

ISBN 1 84569 245 4
ISBN-13: 978 1 84569 245 2
July 2008
696 pages  234 x 156mm  hardback  
£190.00 / US$325.00 / €230.00

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An e-book version of this title is available to purchase as part of a Collection or Pick n Mix or by Chapter. Visit Woodhead Publishing Online

About the editor

Dr Peter A. Revell is Emeritus Professor at University College London. Formerly Professor of Histopathology at the Royal Free and University College Medical School, he is a past President of the European Society of Biomaterials. Professor Revell is a Fellow both of The Royal College of Pathologists and the International Union of Societies for Biomaterials Science and Engineering.

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Contents

PART 1 INTRODUCTION
PART 2 MATERIAL AND MECHANICAL ISSUES
PART 3 THE DEVICE BIOLOGICAL ENVIRONMENT
PART 4 SPECIFIC JOINTS

PART 1 INTRODUCTION

Biomechanics of joints
G R Johnson, Newcastle University, UK
 - Introduction
 - Introduction to biomechanics
 - Key aspects of biomechanics of major joints
 - The upper limb
 - Summary
 - Sources of further information and advice
 - References

Tribology in joint replacement
Z Jin and J Fisher, University of Leeds, UK
 - Introduction
 - Theoretical tribological studies
 - Experimental tribological studies
 - Issues of tribology for joint replacements and future trends
 - Sources of further information and advice
 - References and further reading

Biomaterials and the chemical environment of the body
K J Bundy, Tulane University, USA
 - Introduction
 - Chemical environment for joint replacement
 - Surfaces and interfaces
 - Corrosion
 - Conclusion
 - Sources of further information and advice
 - References

Materials for joint replacement
K S Katti, D Verma and D R Katti, North Dakota State University, USA
 - Introduction
 - Materials criteria for total joint replacement
 - History of materials used in joint replacement
 - Traditional materials
 - Bone cement materials
 - Composite materials and new nanocomposite systems
 - Natural materials
 - Summary
 - Acknowledgements
 - References

Regulatory issues affecting joint replacement: the case of the UK
E Damien, MHRA, B Paul, Kyiv Medical Academy, S M Damien and C S Damien, QMUL, UK
 - Introduction and background
 - The regulatory process
 - Planning for the regulatory approval of a product
 - Summary
 - References and useful websites for further information

PART 2 MATERIAL AND MECHANICAL ISSUES

Metals for joint replacement
Y T Konttinen, Helsinki University Central Hospital, Finland, I Milošev, Jožef Stefan Institute, Slovenia, R Trebše, Orthopaedic Hospital Valdoltra, Slovenia, P Rantanen and R Linden, National Agency of Medicines, Finland, V Tiainen, ORTON Orthopaedic Hospital of the Invalid Foundation, Finland and S Virtanen, University of Erlangen-Nuremberg, Germany
 - Introduction
 - General requirements for biomaterials
 - Examples of currently valid European Union standards
 - Overview of metals
 - Biomechanical properties
 - Corrosion
 - Corrosion testing
 - Metals used in joint replacements
 - Particle disease
 - Clinical success of metals used in joint replacement surgery
 - Future trends
 - Acknowledgements
 - Sources of further information and advice: useful websites
 - References

Ceramics for joint replacement
D Kluess, W Mittelmeier and R Bader, University of Rostock, Germany
 - Introduction
 - Material and mechanical properties of ceramics
 - Ceramics in total hip replacement
 - Ceramics in total knee replacement
 - Summary
 - Reference

Joint bearing surfaces and replacement joint design
R Lappalainen and M Selenius, University of Kuopio, Finland
 - Introduction
 - Articulating surfaces in natural joints
 - Demands for the bearing surfaces
 - Different solutions available
 - Special concepts and designs for bearing surfaces
 - Comparison of bearing surface solutions
 - Future trends
 - References

Cementless fixation techniques in joint replacement
M Cross and J Spycher, The Australian Institute of Musculoskeletal Research, Australia
 - Introduction
 - Cementless fixation
 - Initial stability
 - Osseous integration of cementless implants
 - Mechanical properties of the implant
 - Why do you still use cement? Future trends
 - References

Bone cement fixation: acrylic cements
J S Wang, Lund University, Sweden and N Dunne, Queen’s University of Belfast, UK
 - Introduction
 - Acrylic bone cements - history and evolution
 - Clinical application and function
 - Composition
 - Polymer powder/liquid monomer ratio
 - Polymerisation reaction
 - Polymerisation heat
 - Polymerisation shrinkage
 - Molecular weight and sterilisation
 - Residual monomer and monomer release
 - Viscosity and handling properties
 - Antibiotics in poly(methylmethacrylate) bone cement
 - Radiopacifier in poly(methylmethacrylate) bone cement
 - Mechanical properties
 - Mixing methods
 - Joint replacement cementing technique
 -  Problems with acrylic cements
 - Summary
 - References

Bone cement fixation: glass-ionomer cements
P V Hatton, V Kearns and I M Brook, University of Sheffield, UK
 - Introduction
 - Structure and properties of glass-ionomer cements
 - Biological evaluation
 - Further trends
 - References

Failure mechanisms in joint replacement
M Burke and S Goodman, Stanford University Medical Center, USA
 - Introduction
 - Wear and debris
 - Implant or bone fracture
 - Dislocation
 - Stress shielding
 - Comment on surgical failure
 - Summary
 - Future trends
 - References

Predicting the lifetime of joints: clinical results
L Ryd, Karolinska University Hospital/Huddinge, Sweden
 - Introduction
 - National joint replacement registries
 - Radiostereometric analysis
 - Future trends
 - References

PART 3 THE DEVICE BIOLOGICAL ENVIRONMENT

The healing response to implants used in joint replacement
P A Revell, University College London, UK
 - Introduction
 - Immediate response to prosthesis placement
 - Remodelling of bone around implants
 - The cemented joint prosthesis
 - The uncemented prosthetic joint component
 - Bioactive surfaces on prostheses
 - Adjunctive methods or treatments and their effects
 - Summary
 - References

Biological causes of prosthetic joint failure
P A Revell, University College London, UK
 - Introduction
 - Infection
 - Aseptic loosening
 - The isolation and characterisation of wear particles
 - The cellular reaction to particulate wear debris
 - The role of macrophages and multinucleate giant cells
 - Bone resorption and wear debris: osteoclasts, macrophages and multinucleate giant cells
 - Lymphocytes, sensitisation and aseptic loosening
 - Evidence for immunological processes in loosening
 - Wear particles and corrosion products in distant organs: systemic effects
 - Summary and conclusions
 - References

Using drug delivery systems to enhance joint replacement
D P Pioletti, Ecole Polytechnique Fédérale de Lausanne, Switzerland
 - Why do we need to improve the outcome of orthopedic implants?
 - What is the clinical situation for orthopedic implant used as drug delivery system?
 - Is the research for orthopedic drug delivery system advanced enough to translate it to clinical applications?
 - Will drug delivery systems be the future for orthopaedic implants?
 - References

Sterilisation of joint replacement technology
A Ianuzzi and S M Kurtz, Exponent, Inc, USA
 - Introduction
 - Sterilization techniques and their suitability
 - Issues with sterilization of joint replacement materials
 - Conclusions
 - References

PART 4 SPECIFIC JOINTS

Hip replacement: tribological principles, materials and engineering
D Dowson, University of Leeds, UK
 - Introduction
 - Millenium prostheses
 - Introduction to the tribology of total hip replacements
 - (Hard-on-hard) total hip joint tribology
 - Wear particles and metal ions
 - Summary
 - References

Hip replacement: clinical perspectives
M Revell and E T Davis, Royal Orthopaedic Hospital, UK
 - Introduction
 - Problems with hip replacement at the beginning of the 21st Century
 - Specific complications
 - Current solutions
 - Computer navigation
 - Conclusions
 - References

Knee replacement: clinical perspectives
J D Blaha, University of Michigan Medical School, USA
 - Introduction
 - Kinematics and knee joint prosthesis design
 - Analysis of the kinematics of total joint prostheses
 - Summary
 - References

Intervertebral disc joint replacement technology
N Hallab, Rush University Medical Center, USA
 - Introduction
 - Orthopedic materials and methodology available for use in intervertebral disc replacements
 - Early intervertebral disc replacement designs
 - Current designs
 - Clinical concerns
 - Conclusions
 - References

Replacing temperomandibular joints
J Van Loon and L De Bont, University of Groningen and G J Verkerke, University of Groningen and University of Twente, The Netherlands
 - Introduction
 - Temperomandibular joint prosthesis criteria
 - Design
 - Development and test procedures
 - First clinical application
 - Conclusions
 - Sources of further information and advice: useful websites
 - References

Replacing ankle joints
H Kofoed, Federiksberg Hospital, Denmark
 - Introduction: short history of ankle replacement
 - Anatomical, biomechanical, and biological features of the normal ankle joint
 - Pathologies leading to degeneration of the ankle joint
 - Indications and contraindications for ankle replacement
 - Material used to replace the ankle
 - Fixation of ankle prostheses
 - The interrelationship between the ankle and the hindfoot
 - Long-term results of uncemented current designs
 - Future trends
 - References

Replacing shoulder joints
L De Wilde, University Hospital of Ghent, Belgium
 - Introduction
 - Biomechanics of total shoulder arthroplasty
 - Indications for total shoulder arthroplasty
 - Surgical technique
 - Complications
 - Prognostic factors for clinical outcome
 - Summary
 - References

Replacing elbow joints
J Sanchez-Sotelo, Mayo Clinic, USA
 - Introduction
 - Materials and device design
 - Indications and contraindications
 - Surgical technique overview
 - Clinical results
 - Complications
 - Revision surgery
 - Summary
 - References

Replacing joints with pyrolytic carbon
J Stanley, J Klawitter and R More, Wrightington Hospital, UK
 - Introduction
 - What is pyrolytic carbon? History of pyrolytic carbon use
 - Review of pyrolytic carbon joint clinical history/performance
 - Design and testing of pyrolytic carbon joint replacement implants
 - Hemi-joint arthroplasty
 - Conclusion
 - Forward looking statement with respect to pyrolytic carbon in orthopedics
 - References