A B S T R A C TFor over ten years, metallic skeletal endoprostheses have been produced in select cases by additive manufacturing (AM) and increasing awareness is driving demand for wider access to the technology. This review brings together key stakeholder perspectives on the translation of AM research; clinical application, ongoing research in the field of powder bed fusion, and the current regulatory framework. The current clinical use of AM is assessed, both on a mass-manufactured scale and bespoke application for patient specific implants. To illuminate the benefits to clinicians, a case study on the provision of custom cranioplasty is provided based on prosthetist testimony. Current progress in research is discussed, with immediate gains to be made through increased design freedom described at both meso-and macro-scale, as well as long-term goals in alloy development including bioactive materials. In all cases, focus is given to specific clinical challenges such as stress shielding and osseointegration. Outstanding challenges in industrialisation of AM are openly raised, with possible solutions assessed. Finally, overarching context is given with a review of the regulatory framework involved in translating AM implants, with particular emphasis placed on customisation within an orthopaedic remit. A viable future for AM of metal implants is presented, and it is suggested that continuing collaboration between all stakeholders will enable acceleration of the translation process. fection or surgical complications [11][12][13].Currently, the majority of skeletal endoprostheses are produced from titanium (Ti) or cobalt chromium (CoCr) based alloys, which meet the criteria of durability, strength, corrosion resistance and a low immune response [14,15]. These characteristics however come at the cost of the high stiffness of these alloys in comparison to bone. Mismatch between the mechanical properties of bone and orthopaedic materials

This study investigated changes in metal-on-metal (MOM) hip wear and wear particle characteristics arising from a more aggressive patient activity level compared with normal walking. The test hypothesis was that 'severe'-gait conditions will change wear, wear particle sizes, and morphology owing to a decline in joint lubrication. Four carbon MOM hip bearings 40 mm high were subjected to normal-walking and fast-jogging simulations in an orbital hip joint simulator with 25 per cent alpha-calf serum as a lubricant. Co-Cr-Mo wear particles were extracted using an enzymatic method, and prolate ellipsoid equations were used to estimate particle volume and surface area. Fast-jogging simulations generated a sevenfold increase in volumetric wear, a 33 per cent increase in mean wear particle size, and a threefold increase in the number of larger (needle) particles compared with walking. This resulted in a twentyfold increase in total wear particle surface area per 10(6) cycles compared with walking, thereby confirming our hypothesis. The clinical significance of this result suggests that highly active MOM patients may exhibit greater ion release than less active patients.

Ultra-high temperature ceramic composites based on carbon fibre, Cf, preforms impregnated with hafnium diboride, HfB 2 , powder and then densified with carbon by chemical vapour infiltration, CVI, have been mechanically tested to measure the room temperature flexural, interlaminar shear, compressive and tensile strengths.

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The thermophysical properties of carbon fiber‐based ultra‐high temperature ceramic matrix composites have been determined to aid designers who need these properties when considering using the composites in ultra‐high temperature aerospace applications. The coefficient of thermal expansion (CTE) and thermal diffusivity of the composites were measured parallel and perpendicular to the ply direction; the thermal conductivity was measured using the laser‐flash method and the heat capacity calculated from the relationship between the thermal diffusivity, density, and thermal conductivity. Both the CTE and thermal conductivity showed higher values across the ply and increased with increasing temperature as expected, whilst the thermal diffusivity showed higher values parallel to the ply and increased smoothly with temperature. In addition, two different but related oxyfuel torch tests, based on oxyacetylene and oxypropane, were used to evaluate the thermo‐ablation behavior of the composites. The tests showed how good the composites were at withstanding the ultra‐high temperatures, high heat fluxes, and gas velocities involved.