Mohammed Rafiq Abdul Kadir

Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy

The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.

Effects of different implant–abutment connections on micromotion and stress distribution: Prediction of microgap formation

OBJECTIVES The aim of this study was to analyse micromotion and stress distribution at the connections of implants and four types of abutments: internal hexagonal, internal octagonal, internal conical and trilobe. METHODS A three dimensional (3D) model of the left posterior mandible was reconstructed from medical datasets. Four dental implant systems were designed and analysed independently in a virtual simulation of a first molar replacement. Material properties, contact properties, physiological loading and boundary conditions were assigned to the 3D model. Statistical analysis was performed using one-way analysis of variance (ANOVA) with a 95% confidence interval and Tukeys Honestly Significant Difference (HSD) multiple comparison test. RESULTS The internal hexagonal and octagonal abutments produced similar patterns of micromotion and stress distribution due to their regular polygonal design. The internal conical abutment produced the highest magnitude of micromotion, whereas the trilobe connection showed the lowest magnitude of micromotion due to its polygonal profile. CONCLUSIONS Non-cylindrical abutments provided a stable locking mechanism that reduced micromotion, and therefore reduced the occurrence of microgaps. However, stress tends to concentrate at the vertices of abutments, which could lead to microfractures and subsequent microgap formation.

Polydopamine as an intermediate layer for silver and hydroxyapatite immobilisation on metallic biomaterials surface

Hydroxyapatite (HA) coated implant is more susceptible to bacterial infection as the micro-structure surface which is beneficial for osseointegration, could also become a reservoir for bacterial colonisation. The aim of this study was to introduce the antibacterial effect of silver (Ag) to the biomineralised HA by utilising a polydopamine film as an intermediate layer for Ag and HA immobilisation. Sufficient catechol groups in polydopamine were required to bind chemically stainless steel 316 L, Ag and HA elements. Different amounts of Ag nanoparticles were metallised on the polydopamine grafted stainless steel by varying the immersion time in silver nitrate solution from 12 to 24 h. Another polydopamine layer was then formed on the metallised film, followed by surface biomineralisation in 1.5 Simulated Body Fluid (SBF) solution for 3 days. Several characterisation techniques including X-Ray Photoelectron Spectroscopy, Atomic Force Microscopy, Scanning Electron Microscopy and Contact Angle showed that Ag nanoparticles and HA agglomerations were successfully immobilised on the polydopamine film through an element reduction process. The Ag metallisation at 24 h has killed the viable bacteria with 97.88% of bactericidal ratio. The Ag was ionised up to 7 days which is crucial to prevent bacterial infection during the first stage of implant restoration. The aged functionalised films were considered stable due to less alteration of its chemical composition, surface roughness and wettability properties. The ability of the functionalised film to coat complex and micro scale metal make it suitable for dental and orthopaedic implants application.

Effect of calcium content on the microstructure, hardness and in-vitro corrosion behavior of biodegradable Mg-Ca binary alloy

Effect of calcium addition on microstructure, hardness value and corrosion behavior of five different Mg-xCa binary alloys (x = 0.7, 1, 2, 3, 4 wt. (%)) was investigated. Notable refinement in microstructure of the alloy occurred with increasing calcium content. In addition, more uniform distribution of Mg 2 Ca phase was observed in α-Mg matrix resulted in an increase in hardness value. The in-vitro corrosion examination using Kokubo simulated body fluid showed that the addition of calcium shifted the fluid pH value to a higher level similar to those found in pure commercial Mg. The high pH value amplified the formation and growth of bone-like apatite. Higher percentage of Ca resulted in needle-shaped growth of the apatite. Electrochemical measurements in the same solution revealed that increasing Ca content led to higher corrosion rates due to the formation of more cathodic Mg 2 Ca precipitate in the microstructure. The results therefore suggested that Mg-0.7Ca with the minimum amount of Mg 2 Ca is a good candidate for bio-implant applications.

Biomechanical and bioactivity concepts of polyetheretherketone composites for use in orthopedic implants : a review

The use of polyetheretherketone (PEEK) composites in the trauma plating system, total replacement implants, and tissue scaffolds has found great interest among researchers. In recent years (2008 afterward), this type of composites has been examined for suitability as substitute material over stainless steel, titanium alloys, ultra high molecular weight polyethylene, or even biodegradable materials in orthopedic implant applications. Biomechanical and bioactivity concepts were contemplated for the development of PEEK orthopedic implants and a few primary clinical studies reported the clinical outcomes of PEEK-based orthopedic implants. This study aims to review and discuss the recent concepts and contribute further concepts in terms of biomechanical and bioactivity challenges for the development of PEEK and PEEK composites in orthopedic implants.

Effect of fluoride treatment on corrosion behavior of MG-CA binary alloy for implant application

Abstract The influence of hydrofluoric acid (HF) treatment on the corrosion behavior of the Mg-0.5Ca alloys was investigated by immersion specimen in sodium hydroxide and HF solutions with various concentrations and durations at room temperature. Microstructural evolutions of the specimens were characterized by atomic force microscopy, X-ray diffraction, field-emission scanning electron microscopy. The corrosion resistance was examined through potentiodynamic polarization and immersion test in Kokubo solution. The results revealed that the fluoride treated Mg-0.5Ca alloys produced by immersion in 40% HF provided more uniform, dense and thicker coating layer (12.6 μm) compared with the 35% HF treated specimen. The electrochemical test showed that the corrosion resistance of fluoride treated specimen was 35 times higher compared with the untreated Mg-0.5Ca alloy specimen in Kokubo solution. In vitro degradation rate of the fluoride treated specimens was much lower than untreated Mg-0.5Ca alloy in Kokubo solution. After immersion test the surface of 40% HF treated sample showed a few corrosion dots, while untreated specimens were fully covered by corrosion products and delamination. Fluoride treated Mg-0.5Ca alloy with 40% HF is a promising candidate as biodegradable implants due to its low degradation kinetics and good biocompatibility.

Permeability studies of artificial and natural cancellous bone structures

In the development of artificial cancellous bones, two major factors need to be considered: the integrity of the overall structure and its permeability. Whilst there have been many studies analysing the mechanical properties of artificial and natural cancellous bones, permeability studies, especially those using numerical simulation, are scarce. In this study, idealised cancellous bones were simulated from the morphological indices of natural cancellous bone. Three different orientations were also simulated to compare the anisotropic nature of the structure. Computational fluid dynamics methods were used to analyse fluid flow through the cancellous structures. A constant mass flow rate was used to determine the intrinsic permeability of the virtual specimens. The results showed similar permeability of the prismatic plate-and-rod model to the natural cancellous bone. The tetrakaidecahedral rod model had the highest permeability under simulated blood flow conditions, but the plate counterpart had the lowest. Analyses on the anisotropy of the virtual specimens showed the highest permeability for the horizontal orientation. Linear relationships were found between permeability and the two physical properties, porosity and bone surface area.

Controlling the degradation kinetics of porous iron by poly(lactic-co-glycolic acid) infiltration for use as temporary medical implants

Iron and its alloy have been proposed as biodegradable metals for temporary medical implants. However, the formation of iron oxide and iron phosphate on their surface slows down their degradation kinetics in both in vitro and in vivo scenarios. This work presents new approach to tailor degradation behavior of iron by incorporating biodegradable polymers into the metal. Porous pure iron (PPI) was vacuum infiltrated by poly(lactic-co-glycolic acid) (PLGA) to form fully dense PLGA-infiltrated porous iron (PIPI) and dip coated into the PLGA to form partially dense PLGA-coated porous iron (PCPI). Results showed that compressive strength and toughness of the PIPI and PCPI were higher compared to PPI. A strong interfacial interaction was developed between the PLGA layer and the iron surface. Degradation rate of PIPI and PCPI was higher than that of PPI due to the effect of PLGA hydrolysis. The fast degradation of PIPI did not affect the viability of human fibroblast cells. Finally, this work discusses a degradation mechanism for PIPI and the effect of PLGA incorporation in accelerating the degradation of iron.

Mechanical and functional assessment of the wrist affected by rheumatoid arthritis: A finite element analysis

Understanding the pathomechanics involved in rheumatoid arthritis (RA) of the wrist provides valuable information, which will invariably allow various therapeutic possibilities to be explored. The computational modelling of this disease permits the appropriate simulation to be conducted seamlessly. A study that underpins the fundamental concept that produces the biomechanical changes in a rheumatoid wrist was thus conducted through the use of finite element method. The RA model was constructed from computed tomography datasets, taking into account three major characteristics: synovial proliferation, cartilage destruction and ligamentous laxity. As control, a healthy wrist joint model was developed in parallel and compared. Cartilage was modelled based on the shape of the articulation while the ligaments were modelled with linear spring elements. A load-controlled analysis was performed simulating physiological hand grip loading conditions. The results demonstrated that the diseased model produced abnormal wrist extension and stress distribution as compared to the healthy wrist model. Due to the weakening of the ligaments, destruction of the cartilage and lower bone density, the altered biomechanical stresses were particularly evident at the radioscaphoid and capitolunate articulations which correlate to clinical findings. These results demonstrate the robust finding of the developed RA wrist model, which accurately predicted the pathological process.

Evidences of in vivo bioactivity of Fe-bioceramic composites for temporary bone implants.

Iron-bioceramic composites have been developed as biodegradable implant materials with tailored degradation behavior and bioactive features. In the current work, in vivo bioactivity of the composites was comprehensively studied by using sheep animal model. Five groups of specimens (Fe-HA, Fe-TCP, Fe-BCP composites, and pure-Fe and SS316L as controls) were surgically implanted into medio proximal region of the radial bones. Real-time ultrasound analysis showed a decreased echo pattern at the peri-implant biodegradation site of the composites indicating minimal tissue response during the wound healing process. Peripheral whole blood biomarkers monitoring showed a normal dynamic change of blood cellular responses and no stress effect was observed. Meanwhile, the released Fe ion concentration was increasing along the implantation period. Histological analysis showed that the composites corresponded with a lower inflammatory giant cell count than that of SS316L. Analysis of the retrieved implants showed a thicker degradation layer on the composites compared with pure-Fe. It can be concluded that the iron-bioceramic composites are bioactive and induce a preferable wound healing process.