Elastic modulus in the selection of interbody implants

Heary, Robert F.; Parvathreddy, Naresh K; Sampath, Sujitha; Agarwal, Nitin

doi:10.21037/jss.2017.05.01

Cited by 117 publications

(76 citation statements)

References 20 publications

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“…The other geometrical pore sizes shown in Figure 16a and c has a negligible effect on bone growth. Implant failure due to Young's Moduli mismatch between the host bone is well documented (27,34). One of the most important challenges in this field is to tailor the desirable mechanical properties to minimise this failure.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Ti64 sheathed cellular anatomical structure as a tibia implant

Vance

Bari

Arjunan

2019

Biomed. Phys. Eng. Express

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In order to reduce stress shielding following a segmental bone replacement surgery requires stiffness matching strategies between the host bone and the implant are required. Carefully engineered implant geometry that can mimic the mechanical performance of the host bone is required to achieve this. The development of Additive Layer Manufacturing (ALM) techniques such as Direct Metal Laser Sintering (DMLS) allows for the fabrication of complex geometries that can achieve targeted mechanical performance. Consequently, this work introduces a sheathed Ti6Al4V additively manufactured tibial implant that mimics the circumferential anatomy of the host bone. Performance evaluation of the implant was carried using experimental and numerical technique under axial compression. Furthermore, the influence of sheathing strategy and sheath thickness on the compressive performance of the implant is parametrically analysed. The results of this study shows a promising sheathed implant that can replace a defective tibia bone segment. The implant is superior to conventional porous implants as it allows for easy implantation in surgical operation and allows for the reduction of stress shielding.

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Section: Discussionmentioning

confidence: 99%

Investigation of Ti64 sheathed cellular anatomical structure as a tibia implant

Vance

Bari

Arjunan

2019

Biomed. Phys. Eng. Express

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“…One important property is elastic modulus, the measure of resistance to deformation in response to applied stress. Mismatches in the elastic modulus between the surrounding vertebral bodies and an implant may lead to issues such as subsidence and stress shielding [40]. Clinically, these issues can cause complications such as pseudarthrosis and non-unions.…”

Section: Engineering Studies Of Peek and Allograftmentioning

confidence: 99%

“…Thus, it is ideal for an implant to have a similar elastic modulus as native bone. Heary et al measured the elastic modulus and stiffness of various spinal interbody implants including neat and carbon-reinforced PEEK and cancellous and cortical bone [40]. The authors found that the elastic modulus of neat PEEK was similar to cancellous allograft bone, 3.84 and 3.78 GPa, respectively (Figure 1).…”

Section: Engineering Studies Of Peek and Allograftmentioning

confidence: 99%

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Allograft Structural Interbody Spacers Compared to PEEK Cages in Cervical Fusion: Benchtop and Clinical Evidence

Carter¹,

Gianulis²,

Moore³

2021

Clinical Implementation of Bone Regeneration and Maintenance

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Cervical degenerative disc disease (CDDD) can lead to radiculopathy and myelopathy, resulting in pain, lack of function, and immobility. Anterior cervical discectomy and fusion (ACDF) is a common surgical treatment modality for advanced CDDD. ACDF involves removal of the affected disc(s) followed by replacement with a bone or synthetic graft. Historically, autograft has been considered the gold standard for interbody fusion. However, it is often associated with limitations, including donor site morbidity and limited quality and supply, prompting surgeons to seek alternatives. Two of the most common alternatives are structural bone allografts and polyetheretherketone (PEEK) synthetic cages. Both, advantageously, have similar mechanical properties to autologous bone, with comparable elastic modulus values. However, a lack of osseointegration of PEEK cages has been reported both pre-clinically and clinically. Reported fusion rates assessed radiographically are higher with the use of structural bone allografts compared to PEEK cages, while having a lower incidence of pseudarthrosis. This book chapter will discuss in detail the pre-clinical and clinical performance of structural allografts in comparison to conventional PEEK cages.

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“…However, the characteristics of these crystalline alloys, instance of high elastic modulus, relative low abrasion resistance, and stress corrosion cracking lead to bone stress shielding. Compared with traditional crystalline metals, metallic glass has an amorphous structure, higher strength, lower Young's modulus, better wear resistance, higher corrosion resistance, and anti-fatigue performance for some Ti-, Zr-, Fe-base systems [5,6]. Over the course of the decades, many metallic glassy alloys have been developed using a wide range of components, including Pd-, Pt-, Zr-, Mg-, Ti-, Co-, and Au-base systems.…”

Section: Introductionmentioning

confidence: 99%

Preparation and Characterization of Mg-RE Alloy Sheets and Formation of Amorphous/Crystalline Composites by Twin Roll Casting for Biomedical Implant Application

Wang

2019

Metals

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A new type of Mg-based metallic glass has attracted extensive attention due to its excellent corrosion resistance and favorable biocompatibility. In this study, an amorphous/crystalline composite Mg-RE alloy sheet was prepared by a vertical type twin roll caster (VTRC) method, and its microstructure was characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), and electron probe micro-analysis (EPMA) and transmission electron microscopy (TEM); furthermore, the corrosion behaviors of the Mg-RE alloy sheet were investigated in PBS solution using electrochemical techniques and immersion testing in a simulated physiological condition. Furthermore, it was implanted into the femur of rats to explore its prospect as biological transplantation material. Its microscopic characterization experiments show that the crystal structure is crystalline phase containing amorphous phase. Electrochemical experiments and immersion testing both showed that Mg-RE(La,Ce) sheet with VTRC has a better corrosion resistance than master alloy, and a uniform corrosion layer on the surface. In vivo, as an implant material, tests show that Mg-RE alloy sheets have better biocompatibility and induce new bone formation, and they can be expected to be utilized as implant materials in the future.

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Elastic modulus in the selection of interbody implants

Abstract: The data generated in this paper may facilitate surgeons to make informed decisions on their choices of interbody implants with specific attention to the stiffness of the implant chosen.

Cited by 117 publications

References 20 publications

Investigation of Ti64 sheathed cellular anatomical structure as a tibia implant

Investigation of Ti64 sheathed cellular anatomical structure as a tibia implant

Allograft Structural Interbody Spacers Compared to PEEK Cages in Cervical Fusion: Benchtop and Clinical Evidence

Preparation and Characterization of Mg-RE Alloy Sheets and Formation of Amorphous/Crystalline Composites by Twin Roll Casting for Biomedical Implant Application

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