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The design improvement of hip implant for total hip replacement (THR)

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4YPICALLYTHESEIMPLANTSBEGINTOLOOSENOR OTHERWISEFAILAFTERYEARSATWHICHPOINT THE IMPLANT NEEDS TO BE SURGICALLY REPLACED 4HIS PROCEDURE IS KNOWN AS 2EVISION4OTAL (IP 2EPLACEMENT3URGERY24(2 !CTUALLYREVISIONOF PROSTHESESISANEXPENSIVESOMETIMESDANGEROUS ANDALWAYSPSYCHOLOGICALLYCOSTLYFORTHEPATIENT HENCE THE PROCEDURE HAS TO BE AVOIDED IF POSSIBLE -OSTLY IMPLANT WILL FAIL BECAUSE OF THESEFEWEFFECTSLIKECORROSIONWEARFATIGUEAND OTHERDESIRABLEAGENTS)NTHISSURGERYTHEFAILING ORTHOPEDICHIPIMPLANTISREPLACEDWITHANEW ONEBYREMOVINGTHEOLDIMPLANTREMOVINGTHE BONECEMENTENLARGINGTHEIMPLANTCAVITYAND INSERTINGTHENEWIMPLANT24(2ISMORECOMPLEX THAN04(2ITREQUIRESMORECAPABILITIESANDHAS MORE UNCERTAINTY ASSOCIATED WITH IT 3URGEONS MUSTPLANFORANDREMOVETHEOLDIMPLANTANDTHE OLDCEMENTBEFORECUTTINGTHENEWCANALCAVITY 4HEYMUSTPLANFORTHENEWCAVITYINTHEPRESENCE OFTHEOLDIMPLANTANDCEMENT4HISRESULTSINA LONGERSURGERYWITHGREATERRISKTOTHEPATIENTS 3OANEWDESIGNOFHIPIMPLANTWILLBECARRIED OUT WITH HIGHER RELIABILITY AND DURABILITY &EW DESIGNPARAMETERSALSOWILLBEADDEDTOINCREASE ITSSTABILITY

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!LTHOUGH4(2HASBEENSUCCESSFULOVERYEARS COMPLICATIONS DUE TO INTERFACE LOOSENING AND BONE RESORPTION IN THE CALCAR REGION STILL EXIST /NEOFTHEMAJORISSUESISTHEEFFECTOFIMPLANT MATERIALPROPERTIESONBONELOSSANDINTERFACE LOOSENING IN4(2 +ATOOZIAN ET AL 3O IMPLANTMATERIALSAREONEOFTHEMOSTIMPORTANT COMPONENTOFAHIPIMPLANTDESIGNTHATCANLAST LONG

-OST COMMONLY THE LONG FEMORAL ELEMENT IS MADE OF STAINLESS STEEL #OBALT #HROMIUM

#O#R ALLOYS OR 4ITANIUM 4I ALLOYS &OR A BETTER PERFORMANCE4I ALLOYS IS SUGGESTED DUE TO ITS IMPROVEMENT IN WEAR PROPERTIES IN4(2 COMPARED WITH OTHERS MATERIALS )N ADDITION TO THAT4I ALLOYS ARE ALSO FAVORABLE FOR THEIR IMPRESSIVE BIOCOMPATIBILITY HIGH CORROSION RESISTANCE AND SPECIlC MECHANICAL PROPERTIES 0OHLER "ESIDESTHATTITANIUMIMPLANTSARE NOTFERROMAGNETICANDDONOTCAUSEHARMTOTHE PATIENTINMAGNETRESONANCEIMAGING-2) UNITS

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4I ALLOYS HAVE LOWER MODULUS OF ELASTICITY WHEN COMPARED TO #O#R-O ALLOYS 3AMIENTO ET AL HAS COMPARED THE LONG TERM PERFORMANCE OF THESE TWO DIFFERENT ALLOYS AS FEMORALCOMPONENTS7ITHLOWERMODULUSSTEM THEREWASASIGNIlCANTLYLOWERINCIDENCEOFSTRESS SHIELDING(OWEVERTHISWASATTHEEXPENSEOFA SIGNIlCANTLY HIGHER INCIDENCE OF BONECEMENT INTERFACERADIOLUCENCY

4HE APPLICATION OF BIOACTIVE COATINGS TO 4I BASED ALLOYS ENHANCE THE ADHESION OF4I BASEDIMPLANTTOTHEEXISTINGBONERESULTINGIN

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SIGNIlCANTLYBETTERIMPLANTLIFETIMETHATCANBE ACHIEVEDWITHMATERIALSINUSETODAY3LOTENET AL

:IRCONIA OR ZIRCONIUM OXIDE IS THE MATERIAL OFCHOICECURRENTLYFORBALLHEADSBECAUSEOFITS HIGHSTRENGTHANDLOWWEARRATE!FFATATOETAL

4HElRSTPAPERTOREPORTTHEUSEOFZIRCONIA IN BIOMEDICAL APPLICATIONS WAS IN AND THElRSTPAPERILLUSTRATINGTHEUSEOFZIRCONIATO MANUFACTUREBALLHEADSFOR4(2WASREPORTEDIN (ELMER AND $RISKELL #ONSIDERABLE RESEARCH HAS FOCUSED ON ZIRCONIA AND YTTRIA CERAMICSTHATARECHARACTERIZEDBYlNEGRAINED MICROSTRUCTURES4HEREAREAUTHORSWHOPROPOSE CERAMICSBALLHEADMADEOFAMIXOFZIRCONIUM OXIDEANDALUMINIUMOXIDECLAIMINGAGAINHIGHER

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4HERE ARE FOUR DESIGN PARAMETERS THAT HAVE TO BE CONSIDERED IN DESIGNING THE STEM OF HIP IMPLANT NAMELY SHAPES STEPS FLUTES AND SLOTS4O INCREASE STEM ROTATIONAL STABILITY DISTAL mUTES HAVE BEEN INCORPORATED INTO THE STEM DESIGN 2OTATIONAL STABILITY REMAINS THE PRIMARY CONCERN OF ANY FEMORAL COMPONENT 4HESESLOTSSERVETOREDUCEDISTALSTEMSTIFFNESS ALLOWINGTHESTEMTOmEXWITHTHEFEMURDURING NORMALDAILYACTIVITY4HISFEATUREHASHISTORICALLY DEMONSTRATEDREDUCEDTHIGHPAIN#AMERONET AL )NADDITIONITHELPSTOREDUCECHANCES

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&%ANALYSISWASPERFORMEDONTHEDESIGNED MODELFORITSSTRESSDISTRIBUTIONANDDEFORMATION -ODELS WERE GENERATED ANALYZED AND POST PROCESSEDUSING#/3-/37ORKS

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-ANN ET AL HAVE CARRIED OUT SOME RESEARCH ON LOADING CASES IN PEOPLE WALKING ESPECIALLY DURING TWO CONDITIONS NAMELY STRENUOUS LOADING CASE AND POSTOPERATIVE LOADING CASES 3TRENUOUS LOADING CASE WAS ESTIMATEDBASEDONLOADINGINANACTIVEINDIVIDUAL WHEREAS POSTOPERATIVE LOADING WAS BASED ON LOADINGDURINGPATIENTREHABILITATIONPERIOD4HE LOADSAPPLIEDAREASSHOWNIN4ABLE!BODYOF

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WEIGHTOF.WASUSED4HESTRENUOUSLOADING DATAWASOBTAINEDFROM0AUL ANDWOULD REPRESENTGAITINANACTIVEANDHEALTHYINDIVIDUAL 4HE POSTOPERATIVE LOADING CASES WERE BASED ONCRUTCHASSISTEDGAITDATAINAPOSTOPERATIVE SITUATIONANDWEREBASEDONINVIVOJOINTREACTION FORCE$AVYETAL

"ESIDES IN ORDER TO MAKE SURE THAT THE DESIGNED MODEL CAN FUNCTION WELL IN ANY

CONDITION SO THE DESIGNED MODEL IS ANALYZED IN STUMBLING CONDITION )N THIS CASE RESEARCH DONEBY%L3HEIKHETAL ONlNITEELEMENT SIMULATIONOFTHEHIPJOINTDURINGSTUMBLINGWAS REFERRED4HE STUMBLING CONDITION WAS CHOSEN SIMPLY BECAUSE IT PRODUCES PEAK LOAD DURING HUMANACTIVITY

&OR STATIC ANALYSIS THE MAXIMUM STUMBLING RESULTANTFORCE&ONTHEHEADOFTHEFEMURIS TIMESTHEBODYWEIGHT"7KG ATOF THEGAITCYCLE"ESIDES%L3HEIKHETAL ALSO CONSIDEREDTHEMUSCLELOADMAGNITUDEAPPLIED TOTHE&%MODELASSHOWNIN4ABLE

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MAXIMUMSTEMWASABOUT-0A&ROMSTRESS DISTRIBUTION IT WAS SEEN THAT THE MAXIMUM STRESS OF THE PROPOSED DESIGN REACHED -0A IN THE NECK PART4HIS VALUE HOWEVER CAN NOTBECOMPAREDWITH-ANNETAL MODEL BECAUSEITDIDNOTINCLUDETHENECKPARTDURING THESIMULATIONANALYSIS4HEREFOREONLYTHESTRESS ATTHEEDGEOFTHESTEMCANBECOMPARED4HE RESULTS SHOW THAT THE STRESSES IN THE PROPOSED

DESIGNAREMUCHLESSERTHAN-ANNETAL MODEL4HIS MEANS THAT FURTHER IMPROVEMENTS ARENECESSARYINDESIGNINGTHEHIPIMPLANT &OR STUMBLING CONDITION THE RESULTS FROM SIMULATIONARESHOWNIN&IGURES

4HERE ARE THREE MAIN MATERIALS THAT ARE GENERALLYUSEDINTHEFABRICATIONOFTHESTEMPART OFHIPIMPLANT&ORTHESAMEFORCEAPPLIEDTHE RESULTSOFDISPLACEMENTDISTRIBUTIONANDFACTOR OFSAFETY&/3 FORTHESETHREEKINDSOFMATERIAL NAMELY4ITANIUMALLOY4I!L6 3TAINLESS3TEEL , AND #OBALT #HROME #O.I#R-O WILL BE COMPARED&IGURESSHOWSTHEDISPLACEMENTFOR THREE DIFFERENT MATERIALS WHERE THE MAXIMUM AND THE MINIMUM DISPLACEMENT ARE SHOWN

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ULTIMATE TENSILE STRENGTH OF THE4ITANIUM ALLOY MATERIALS

&IGURESHOWSTHATTHEMINIMUM&/3ISAT THE CRITICAL PART WHICH IS AROUND 'ENERALLY FOR DESIGN PURPOSES THE VALUE OF &/3 WILL BE IN THE RANGE OF 4HIS IS TO ENSURE THAT THEREARESOMETOLERANCESONIT&IGURESHOWS THATTHEMAXIMUMDISPLACEMENTISMM AND IT OCCURS ON THE SURFACE WHERE THE LOADS WEREAPPLIED4HATVALUEWASCONSIDEREDSMALL THEREFOREITCANBENEGLECTED2ESULTSOF&IGURES WERESUMMARIZEDIN4ABLE

4HEOVERALLRESULTSSHOWTHATTHE&/3ISALMOST THE SAME FOR THESE THREE KINDS OF MATERIALS 4HE VALUE OF &/3 FOR #OBALT #HROME IS DOUBLE THAT OF THE 3TAINLESS 3TEEL AND4ITANIUM ALLOY

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#EMENTLESSHIPIMPLANTHASBEENCHOSENASTHE MAINFACTORINDESIGNINGTHEIMPLANTlXATION)T ISBELIEVEDTHATITCANBELONGLASTINGCOMPARED TOTHECEMENTEDHIPIMPLANTlXATIONDUETOTHE BREAKINGUPOFCEMENTPARTICLES!NOTHERBENElT OFUSINGCEMENTLESSHIPIMPLANTISTHATITISSAFER DURINGREVISIONSURGERYFORHIPREPLACEMENT 4O AVOID LOOSENING OF HIP IMPLANT FEW CONCEPTS HAVE BEEN ADDED IN THE NEW DESIGN MODELINORDERTOINCREASEITSSTABILITY&LUTESAND STEPSAREADDEDTOPREVENTTHEMOVEMENTOFHIP IMPLANTANDINCREASETHElXATIONOFHIPIMPLANT 3LOTSAREADDEDTOREDUCEBENDINGSTIFFNESSOF THEIMPLANT

4O ENSURE THAT THE DESIGNED IMPLANT WORK VALIDATION HAS BEEN MADE BY COMPARING THE RESULTSWITHEARLIERRESEARCH"YAPPLYINGTHESAME BOUNDARYCONDITIONTHERESULTSSHOWEDTHATTHE STRESS DEVELOPED ON THE DESIGNED IMPLANT ARE MUCHMORELESSTHAN-ANNETAL MODEL 4HISPROVESTHATTHEREARESOMEIMPROVEMENTS INTHEDESIGNEDIMPLANT

!NALYSIS HAS ALSO BEEN DONE ON DIFFERENT MATERIALUSEDINIMPLANT"YAPPLYINGTHESAME CONDITIONOFLOADINGTHEMAXIMUMDISPLACEMENT VALUESARETOOSMALLUNTILCANBENEGLECTED/NLY FORTHEVALUEOF&/3THE#OBALT#HROMEHASTHE VALUEASHIGHAS

&ORALLTHESTUDYANDDESIGNTHATHAVEDONE IT IS BELIEVED THAT THERE ARE IMPROVEMENT OF PERFORMANCE FOR THE DESIGNED HIP IMPLANT IN THECASEOFDURABILITYANDRELIABILITY(OWEVERIN THISPROJECTTHECONCLUSIONONLYCANMAKEFROM THEORETICALRESULTS4HEMAINFACTORTHATINmUENCES THEPERFORMANCEOFHIPIMPLANTSUCHASWEARRATE CANNOT BE DETERMINED IN THIS PROJECT )N ORDER TODETERMINETHEWEARRATETHEBESTMETHODIS BYFABRICATINGAHIPIMPLANTANDINSERTINGITINA PATIENTSBODY5SINGTHISEXPERIMENTALMETHOD THE ACTUAL WEAR RATE OF THE HIP IMPLANT CAN BE CALCULATED IN ORDER FOR THE DURABILITY TO BE KNOWN

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Rujukan

DOKUMEN BERKAITAN

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