Saber Amin Yavari

Selective laser melting-produced porous titanium scaffolds regenerate bone in critical size cortical bone defects.

Porous titanium scaffolds have good mechanical properties that make them an interesting bone substitute material for large bone defects. These scaffolds can be produced with selective laser melting, which has the advantage of tailoring the structures architecture. Reducing the strut size reduces the stiffness of the structure and may have a positive effect on bone formation. Two scaffolds with struts of 120‐µm (titanium‐120) or 230‐µm (titanium‐230) were studied in a load‐bearing critical femoral bone defect in rats. The defect was stabilized with an internal plate and treated with titanium‐120, titanium‐230, or left empty. In vivo micro‐CT scans at 4, 8, and 12 weeks showed more bone in the defects treated with scaffolds. Finally, 18.4 ± 7.1 mm3 (titanium‐120, p = 0.015) and 18.7 ± 8.0 mm3 (titanium‐230, p = 0.012) of bone was formed in those defects, significantly more than in the empty defects (5.8 ± 5.1 mm3). Bending tests on the excised femurs after 12 weeks showed that the fusion strength reached 62% (titanium‐120) and 45% (titanium‐230) of the intact contralateral femurs, but there was no significant difference between the two scaffolds. This study showed that in addition to adequate mechanical support, porous titanium scaffolds facilitate bone formation, which results in high mechanical integrity of the treated large bone defects.

Bone regeneration performance of surface-treated porous titanium

The large surface area of highly porous titanium structures produced by additive manufacturing can be modified using biofunctionalizing surface treatments to improve the bone regeneration performance of these otherwise bioinert biomaterials. In this longitudinal study, we applied and compared three types of biofunctionalizing surface treatments, namely acid-alkali (AcAl), alkali-acid-heat treatment (AlAcH), and anodizing-heat treatment (AnH). The effects of treatments on apatite forming ability, cell attachment, cell proliferation, osteogenic gene expression, bone regeneration, biomechanical stability, and bone-biomaterial contact were evaluated using apatite forming ability test, cell culture assays, and animal experiments. It was found that AcAl and AnH work through completely different routes. While AcAl improved the apatite forming ability of as-manufactured (AsM) specimens, it did not have any positive effect on cell attachment, cell proliferation, and osteogenic gene expression. In contrast, AnH did not improve the apatite forming ability of AsM specimens but showed significantly better cell attachment, cell proliferation, and expression of osteogenic markers. The performance of AlAcH in terms of apatite forming ability and cell response was in between both extremes of AnH and AsM. AcAl resulted in significantly larger volumes of newly formed bone within the pores of the scaffold as compared to AnH. Interestingly, larger volumes of regenerated bone did not translate into improved biomechanical stability as AnH exhibited significantly better biomechanical stability as compared to AcAl suggesting that the beneficial effects of cell-nanotopography modulations somehow surpassed the benefits of improved apatite forming ability. In conclusion, the applied surface treatments have considerable effects on apatite forming ability, cell attachment, cell proliferation, and bone ingrowth of the studied biomaterials. The relationship between these properties and the bone-implant biomechanics is, however, not trivial.

Additively Manufactured Open-Cell Porous Biomaterials Made from Six Different Space-Filling Unit Cells: The Mechanical and Morphological Properties

It is known that the mechanical properties of bone-mimicking porous biomaterials are a function of the morphological properties of the porous structure, including the configuration and size of the repeating unit cell from which they are made. However, the literature on this topic is limited, primarily because of the challenge in fabricating porous biomaterials with arbitrarily complex morphological designs. In the present work, we studied the relationship between relative density (RD) of porous Ti6Al4V EFI alloy and five compressive properties of the material, namely elastic gradient or modulus (Es20–70), first maximum stress, plateau stress, yield stress, and energy absorption. Porous structures with different RD and six different unit cell configurations (cubic (C), diamond (D), truncated cube (TC), truncated cuboctahedron (TCO), rhombic dodecahedron (RD), and rhombicuboctahedron (RCO)) were fabricated using selective laser melting. Each of the compressive properties increased with increase in RD, the relationship being of a power law type. Clear trends were seen in the influence of unit cell configuration and porosity on each of the compressive properties. For example, in terms of Es20–70, the structures may be divided into two groups: those that are stiff (comprising those made using C, TC, TCO, and RCO unit cell) and those that are compliant (comprising those made using D and RD unit cell).

Additively manufactured porous tantalum implants

The medical device industrys interest in open porous, metallic biomaterials has increased in response to additive manufacturing techniques enabling the production of complex shapes that cannot be produced with conventional techniques. Tantalum is an important metal for medical devices because of its good biocompatibility. In this study selective laser melting technology was used for the first time to manufacture highly porous pure tantalum implants with fully interconnected open pores. The architecture of the porous structure in combination with the material properties of tantalum result in mechanical properties close to those of human bone and allow for bone ingrowth. The bone regeneration performance of the porous tantalum was evaluated in vivo using an orthotopic load-bearing bone defect model in the rat femur. After 12 weeks, substantial bone ingrowth, good quality of the regenerated bone and a strong, functional implant-bone interface connection were observed. Compared to identical porous Ti-6Al-4V structures, laser-melted tantalum shows excellent osteoconductive properties, has a higher normalized fatigue strength and allows for more plastic deformation due to its high ductility. It is therefore concluded that this is a first step towards a new generation of open porous tantalum implants manufactured using selective laser melting.

Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants.

Experimental Validation Of Finite Element Model For Proximal Composite Femur Using Optical Measurements

Patient-specific finite element models have been used to predict femur strength and fracture risk in individuals. Validation of the adopted finite element modelling procedure against mechanical testing data is a crucial step when aiming for clinical applications. The majority of the works available in literature used data from strain gages to validate the model, thus having up to 15 experimental measurements. Optical techniques, such as digital image correlation, can help to improve the models by providing a continuous field of deformation data over a femoral surface. The main objective of this study was to validate finite element models of six composite femora against strain data from digital image correlation, obtained during fracture tests performed in quasi-axial loading configuration. The finite element models were obtained from CT scans, by means of a semi-automatic segmentation. The principal strains both during the elastic phase and close to the fracture were compared, and showed a correlation coefficient close to 0.9. In the linear region, the slope and intercept were close to zero and unity, while for the case when fracture load was simulated, the slope decreased somewhat. The accuracy of the obtained results is comparable with the state-of-the-art literature, with the significant improvement of having around 50,000 data points for each femur. This large number of measurements allows a more comprehensive validation of the predictions by the finite element models, since thousand of points are tracked along the femoral neck and trochanter region, i.e., the sites that are most critical for femur fracture. Moreover, strain measurement biases due to the strain gage reinforcement effect, were avoided. The combined experimental-numerical approach proved to be ready for application to in-vitro tests of human cadaver femurs, thus helping to develop a suitable mechanistic fracture risk criterion.

Repeatability of digital image correlation for measurement of surface strains in composite long bones

Digital image correlation (DIC) can measure full-field surface strains during mechanical testing of hard and soft tissues. When compared to traditional methods, such as strain gauges, DIC offers larger validation data (∼50,000 points) for, e.g., finite element models. Our main aim was to evaluate the repeatability of surface strain measurements with DIC during compressive testing of composite femurs mimicking human bones. We also studied the similarity of the composite femur samples using CT. Composite femurs were chosen as test material to minimize the uncertainties associated with the use of cadaveric tissues and to understand the variability of the DIC measurement itself. Six medium-sized fourth generation composite human proximal femora (Sawbones) were CT imaged and mechanically tested in stance configuration. The force-displacement curves were recorded and the 3D surface strains were measured with DIC on the anterior surface of the femurs. Five femurs fractured at the neck-trochanter junction and one at the site below the minor trochanter. CT image of this bone showed an air cavity at the initial fracture site. All femurs fractured through a sudden brittle crack. The fracture force for the composite bones was 5751±650N (mean±SD). The maximum von Mises strain during the fractures was 2.4±0.8%. Noise in one experiment was 5-30µε. When applied loads were equalized the variation in strains between the bones was 20-25%, and when the maximum strains were equalized, variation in the other regions was 5-10%. DIC showed that the ability of nominally identical composite bones to bear high strains and loads before fracturing may vary between the samples.

Full-field strain measurement and fracture analysis of rat femora in compression test

There is a growing interest in studying the fracture behavior of bones, primarily due to the increasing societal burden of osteoporotic fractures. In addition, bone is one of the most important biological materials whose fracture behavior is not yet well understood. This is partly due to the fact that bone is a complex hierarchical material, and exhibits heterogeneous, anisotropic, and viscoelastic mechanical behavior. Understanding the fracture behavior of such a complex material requires application of a full-field strain measurement technique. Digital image correlation (DIC) is a relatively new full-field strain measurement technique that can be used for measurement of 3D surface strains during mechanical testing of different types of bones. In this study, we use the DIC technique to measure the surface strains during compression testing of two groups of rat femora. The first group of femora was harvested from young animals (12 weeks), while the second group was harvested from more mature animals (26 weeks). The surface strains are measured both in the linear range and close to the fracture. Using the measured data, we assess two strain-based fracture prediction criteria, namely equivalent strain fracture criterion and fracture limit diagram, to determine whether they can consistently predict the onset of fracture. The maximum load is measured to be 296±22 N (mean±SD) for young animals and 670±123 N for mature animals. It is shown that fracture in the vast majority of cases occurs in the area of maximum tensile strain. The equivalent strain fracture criterion predicts that the fracture occurs when the equivalent strain reaches 1.04±0.02% (average±SD) for young animals and 1.39±0.24% for mature animals. The fracture limit diagram predicts that the fracture occurs once the sum of major and minor principal surface strains reaches 0.63±0.23% for young animals and -0.63±0.30% for mature animals. Based on these numbers and consistency of the criteria with the strain values recorded at the fracture locations, it is concluded that the equivalent strain fracture criterion tends to be more consistent among the tested specimens.

Full-Field Strain Measurement During Mechanical Testing of the Human Femur at Physiologically Relevant Strain Rates

Understanding the mechanical properties of human femora is of great importance for the development of a reliable fracture criterion aimed at assessing fracture risk. Earlier ex vivo studies have been conducted by measuring strains on a limited set of locations using strain gauges (SGs). Digital image correlation (DIC) could instead be used to reconstruct the full-field strain pattern over the surface of the femur. The objective of this study was to measure the full-field strain response of cadaver femora tested at a physiological strain rate up to fracture in a configuration resembling single stance. The three cadaver femora were cleaned from soft tissues, and a white background paint was applied with a random black speckle pattern over the anterior surface. The mechanical tests were conducted up to fracture at a constant displacement rate of 15 mm/s, and two cameras recorded the event at 3000 frames per second. DIC was performed to retrieve the full-field displacement map, from which strains were derived. A low-pass filter was applied over the measured displacements before the crack opened in order to reduce the noise level. The noise levels were assessed using a dedicated control plate. Conversely, no filtering was applied at the frames close to fracture to get the maximum resolution. The specimens showed a linear behavior of the principal strains with respect to the applied force up to fracture. The strain rate was comparable to the values available in literature from in vivo measurements during daily activities. The cracks opened and fully propagated in less than 1 ms, and small regions with high values of the major principal strains could be spotted just a few frames before the crack opened. This corroborates the hypothesis of a strain-driven fracture mechanism in human bone. The data represent a comprehensive collection of full-field strains, both at physiological load levels and up to fracture. About 10,000 points were tracked on each bone, providing superior spatial resolution compared to ∼15 measurements typically collected using SGs. These experimental data collection can be further used for validation of numerical models, and for experimental verification of bone constitutive laws and fracture criteria.

Effect of Alkali-Acid-Heat Chemical Surface Treatment on Electron Beam Melted Porous Titanium and Its Apatite Forming Ability

Advanced additive manufacturing techniques such as electron beam melting (EBM), can produce highly porous structures that resemble the mechanical properties and structure of native bone. However, for orthopaedic applications, such as joint prostheses or bone substitution, the surface must also be bio-functionalized to promote bone growth. In the current work, EBM porous Ti6Al4V alloy was exposed to an alkali acid heat (AlAcH) treatment to bio-functionalize the surface of the porous structure. Various molar concentrations (3, 5, 10M) and immersion times (6, 24 h) of the alkali treatment were used to determine optimal parameters. The apatite forming ability of the samples was evaluated using simulated body fluid (SBF) immersion testing. The micro-topography and surface chemistry of AlAcH treated samples were evaluated before and after SBF testing using scanning electron microscopy and energy dispersive X-ray spectroscopy. The AlAcH treatment successfully modified the topographical and chemical characteristics of EBM porous titanium surface creating nano-topographical features ranging from 200–300 nm in size with a titania layer ideal for apatite formation. After 1 and 3 week immersion in SBF, there was no Ca or P present on the surface of as manufactured porous titanium while both elements were present on all AlAcH treated samples except those exposed to 3M, 6 h alkali treatment. An increase in molar concentration and/or immersion time of alkali treatment resulted in an increase in the number of nano-topographical features per unit area as well as the amount of titania on the surface.