Metallic bone fixation implants: a novel design approach for reducing the stress shielding phenomenon

Al-Tamimi, Abdulsalam Abdulaziz; Fernandes, Paulo R.; Peach, Ceri; Cooper, Glen M.; Diver, Carl; Bartolo, Paulo Jorge Da Silva

doi:10.1080/17452759.2017.1307769

Cited by 69 publications

(42 citation statements)

References 38 publications

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“…By imposing high volume reduction, the effect of material removal becomes the significant contributing factor to an overall reduction in the stiffness of the plates. This was previously reported by the authors with 2D designed plates [23]. Different volume reductions were considered (25%, 45% and 75%) but the obtained volume reduction was not always exactly the same as the imposed value.…”

Section: Discussionsupporting

confidence: 66%

Topology optimised metallic bone plates produced by electron beam melting: a mechanical and biological study

Al-Tamimi

Huang

Vyas

et al. 2019

Int J Adv Manuf Technol

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Metallic bone plates are commonly used as a medical implant to treat bone fractures. The gold standard materials for these implants are biocompatible 316L stainless steel, cobalt chromium, titanium and its alloys (e.g. CoCrMo and Ti6Al4V). However, the main disadvantage of these implants is the material stiffness mismatch between the implant and bone. This mismatch may negatively affect the biological processes in bone healing. This paper investigates topology optimization to produce plates with reduced equivalent stiffness and the fabrication of optimised plate designs using an electron beam melting (EBM) system. Nonpost-processed EBM plates were assessed against commercially available bone fixation plates in terms of mechanical and biological characteristics. Results show that some redesigned produced plates present mechanical properties similar to the cortical bone and that there is no need to post-process the produced plates in order to establish a good biological bonding with the surrounding tissue.

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Section: Discussionsupporting

confidence: 66%

Topology optimised metallic bone plates produced by electron beam melting: a mechanical and biological study

Al-Tamimi

Huang

Vyas

et al. 2019

Int J Adv Manuf Technol

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“…The stiffness of the tested scaffolds varied in the range of 1.6 to 9.0 GPa, which aligns with the stiffness range of the trabecular (0.4 GPa [59,60]) and cortical bones (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)24]). The yield stress values of the scaffolds were in the range of 53 to 392 MPa, which lies in the range of cortical bones MPa [24,61]), but it is not suitable for a replacement of trabecular bone, 2-17 MPa [60].…”

Section: Discussionmentioning

confidence: 99%

Mechanical Properties and In Vitro Behavior of Additively Manufactured and Functionally Graded Ti6Al4V Porous Scaffolds

Onal

Frith

Jurg

et al. 2018

Metals

127

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Abstract:Functionally graded lattice structures produced by additive manufacturing are promising for bone tissue engineering. Spatial variations in their porosity are reported to vary the stiffness and make it comparable to cortical or trabecular bone. However, the interplay between the mechanical properties and biological response of functionally graded lattices is less clear. Here we show that by designing continuous gradient structures and studying their mechanical and biological properties simultaneously, orthopedic implant design can be improved and guidelines can be established. Our continuous gradient structures were generated by gradually changing the strut diameter of a body centered cubic (BCC) unit cell. This approach enables a smooth transition between unit cell layers and minimizes the effect of stress discontinuity within the scaffold. Scaffolds were fabricated using selective laser melting (SLM) and underwent mechanical and in vitro biological testing. Our results indicate that optimal gradient structures should possess small pores in their core (~900 µm) to increase their mechanical strength whilst large pores (~1100 µm) should be utilized in their outer surface to enhance cell penetration and proliferation. We suggest this approach could be widely used in the design of orthopedic implants to maximize both the mechanical and biological properties of the implant.

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“…The modification of implant topography represents one of the most promising approaches for reducing bone integrity loss caused by stress shielding. Strategies to reduce this drawback are reported in the literature [ 31 ], including the modification of implant topography [ 32 ].…”

Section: Scaffolds For Bone Tissue Regenerationmentioning

confidence: 99%

Biodegradable Scaffolds for Bone Regeneration Combined with Drug-Delivery Systems in Osteomyelitis Therapy

et al. 2017

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A great deal of research is ongoing in the area of tissue engineering (TE) for bone regeneration. A possible improvement in restoring damaged tissues involves the loading of drugs such as proteins, genes, growth factors, antibiotics, and anti-inflammatory drugs into scaffolds for tissue regeneration. This mini-review is focused on the combination of the local delivery of antibiotic agents with bone regenerative therapy for the treatment of a severe bone infection such as osteomyelitis. The review includes a brief explanation of scaffolds for bone regeneration including scaffolds characteristics and types, a focus on severe bone infections (especially osteomyelitis and its treatment), and a literature review of local antibiotic delivery by the combination of scaffolds and drug-delivery systems. Some examples related to published studies on gentamicin sulfate-loaded drug-delivery systems combined with scaffolds are discussed, and future perspectives are highlighted.

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Metallic bone fixation implants: a novel design approach for reducing the stress shielding phenomenon

Cited by 69 publications

References 38 publications

Topology optimised metallic bone plates produced by electron beam melting: a mechanical and biological study

Topology optimised metallic bone plates produced by electron beam melting: a mechanical and biological study

Mechanical Properties and In Vitro Behavior of Additively Manufactured and Functionally Graded Ti6Al4V Porous Scaffolds

Biodegradable Scaffolds for Bone Regeneration Combined with Drug-Delivery Systems in Osteomyelitis Therapy

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