Outcomes of long retrograde intramedullary nailing for periprosthetic supracondylar femoral fractures following total knee arthroplasty.

PubMed

Lee, Sung-San; Lim, Seung-Jae; Moon, Young-Wan; Seo, Jai-Gon

2014-01-01

The treatment of periprosthetic supracondylar femoral fractures following total knee arthroplasty (TKA) is challenging because of osteopenia and the limited bone available for distal fixation. The purpose of this study was to report the outcomes of periprosthetic supracondylar femoral fractures treated with long retrograde intramedullary nailing. We conducted a retrospective review of 25 patients who were treated with a long retrograde intramedullary nail for periprosthetic supracondylar femoral fractures following TKA. Clinical evaluation included range of motion of knee, Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis (WOMAC) score, and radiologic evaluation including time to union, coronal and sagittal alignment of femoral component, lower limb alignment, and implant loosening. The mean duration of follow-up after the fracture repair was 39 months (range 12-47). All 25 fractures were united with a mean time of 12 weeks (range 8-20). At the last follow-up, the mean knee flexion was 111° (range 60°-130°), the mean KSS was 81.5 (range 50-100), and the mean WOMAC score was 30.2 (range 5-55). Four (16%) of the 25 patients developed malalignment according to Rorabeck and Taylor criteria, but all patients had a knee flexion of more than 90°. Coronal and sagittal alignments of femoral component and lower limb alignment did not differ significantly between before and after the fracture repair. Complications included the loosening or breakage of distal interlocking screws in three patients. No deep infection or prosthesis loosening was detected at the last follow-up. Surgical treatment of periprosthetic supracondylar femoral fractures following TKA with long retrograde intramedullary nailing resulted in high union rates and encouraging functional outcomes.

Compress knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure.

PubMed

Healey, John H; Morris, Carol D; Athanasian, Edward A; Boland, Patrick J

2013-03-01

Compliant, self-adjusting compression technology is a novel approach for durable prosthetic fixation of the knee. However, the long-term survival of these constructs is unknown. We therefore determined the survival of the Compress prosthesis (Biomet Inc, Warsaw, IN, USA) at 5 and 10 actuarial years and identified the failure modes for this form of prosthetic fixation. We retrospectively reviewed clinical and radiographic records for all 82 patients who underwent Compress knee arthroplasty from 1998 to 2008, as well as one patient who received the device elsewhere but was followed at our institution. Prosthesis survivorship and modes of failure were determined. Followup was for a minimum of 12 months or until implant removal (median, 43 months; range, 6-131 months); 28 patients were followed for more than 5 years. We found a survivorship of 85% at 5 years and 80% at 10 years. Eight patients required prosthetic revision after interface failure due to aseptic loosening alone (n = 3) or aseptic loosening with periprosthetic fracture (n = 5). Additionally, five periprosthetic bone failures occurred that did not require revision: three patients had periprosthetic bone failure without fixation compromise and two exhibited irregular prosthetic osteointegration patterns with concomitant fracture due to mechanical insufficiency. Compress prosthetic fixation after distal femoral tumor resection exhibits long-term survivorship. Implant failure was associated with patient nonadherence to the recommended weightbearing proscription or with bone necrosis and fracture. We conclude this is the most durable FDA-approved fixation method for distal femoral megaprostheses. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

[Principles of management of periprosthetic fractures].

PubMed

Röderer, G; Gebhard, F; Scola, A

2016-03-01

The increasing numbers of primary total hip and knee replacements have subsequently led to growing rates of periprosthetic fractures. In many cases geriatric patients with osteopenia or osteoporotic bone quality are affected. The goal of treatment is the retention or reconstruction of joint function using open reduction and internal fixation or a revision prosthesis. The aim of this article is a description of the basic principles of treatment of periprosthetic fractures of the lower extremities. An exact description of the fracture using current classification systems with imaging diagnostics is mandatory. This also includes an assessment of the stability of the prosthesis. In the case of a stable prosthesis and a good bone stock open reduction and internal fixation should be performed. In these cases locking plates are standard procedure. If fracture reduction is possible minimally invasive procedures can be performed which help to reduce the surgical trauma and accelerate rehabilitation. If the prosthesis is loose it has to be exchanged for a revision implant. If vast bony defects result they can be augmented using wedges. Conservative treatment plays only a subordinate role in selected cases. Periprosthetic fractures show an increasing incidence and occur more frequently in the geriatric patient population. Due to comorbidities and poor bone quality surgical treatment is a challenge. The fracture must be exactly classified using the appropriate classification system in order to clarify if the prosthesis can be retained or if it has to be exchanged.

Intramedullary Stabilization of Periprosthetic Fractures of the Femur Taking Special Account of Bone Defects.

PubMed

Eingartner, Christoph; Volkmann, Rüdiger; Ochs, Uwe; Egetemeyr, Daniel; Weise, Kuno

2007-10-01

Healing of the periprosthetic fracture and area of defective bone by the bone healing mechanisms of intramedullary stabilization. Reconstruction of the correct length, axial alignment, and rotation of the fractured femoral shaft by anchoring a revision stem in the intact femoral diaphysis. Periprosthetic femoral shaft fracture in the region of the prosthetic stem combined with preexistent loosening and/or defect in the periprosthetic bone bed (Vancouver classification type B2 and B3). General contraindications, local infection. Lateral transmuscular approach to the femoral shaft. Longitudinal osteotomy of the proximal femur taking the geometry of the fracture into account. Opening of an anterior "bone shell". Removal of the loose prosthetic stem and cement. Debridement. Preparation of the femoral diaphysis and insertion of a distally anchored revision stem. Distal locking. Repositioning of the "bone shell", reduction of the fracture, and retention with cerclage wires. Bed rest for approximately 1 week, mobilization with 20 kg partial weight bearing for 12 weeks, gradual increase in weight bearing with radiologic checks on progress, removal of the distal locking bolts after 12-24 months at the earliest. 21 patients (13 women, eight men) aged between 43 and 86 years (mean age: 71.2 years) with periprosthetic fracture of the femur, additional loosening of the stem in eight cases (Vancouver B2) and additional bone loss in 13 cases (Vancouver B3). Postoperative complications: two fractures following another fall (repeat operations: one replacement, one plate), four revisions due to subsidence of the stem (three replacements involving change to a standard stem with healed proximal femur, one replacement with another interlocked revision stem). Bone healing occurred for all fractures after a mean 5.6 months (3-11 months). Follow- up examination after a mean 4.5 years: all patients were able to walk, average Harris Score 70.5 points (29- 95 points).

Intramedullary stabilization of periprosthetic fractures of the femur taking special account of bone defects.

PubMed

Eingartner, Christoph; Volkmann, Rüdiger; Ochs, Uwe; Egetemeyr, Daniel; Weise, Kuno

2006-10-01

Healing of the periprosthetic fracture and area of defective bone by the bone healing mechanisms of intramedullary stabilization. Reconstruction of the correct length, axial alignment, and rotation of the fractured femoral shaft by anchoring a revision stem in the intact femoral diaphysis. Periprosthetic femoral shaft fracture in the region of the prosthetic stem combined with preexistent loosening and/or defect in the periprosthetic bone bed (Vancouver classification type B2 and B3). General contraindications, local infection. Lateral transmuscular approach to the femoral shaft. Longitudinal osteotomy of the proximal femur taking the geometry of the fracture into account. Opening of an anterior "bone shell". Removal of the loose prosthetic stem and cement. Debridement. Preparation of the femoral diaphysis and insertion of a distally anchored revision stem. Distal locking. Repositioning of the "bone shell", reduction of the fracture, and retention with cerclage wires. Bed rest for approximately 1 week, mobilization with 20 kg partial weight bearing for 12 weeks, gradual increase in weight bearing with radiologic checks on progress, removal of the distal locking bolts after 12-24 months at the earliest. 21 patients (13 women, eight men) aged between 43 and 86 years (mean age: 71.2 years) with periprosthetic fracture of the femur, additional loosening of the stem in eight cases (Vancouver B2) and additional bone loss in 13 cases (Vancouver B3). Postoperative complications: two fractures following another fall (repeat operations: one replacement, one plate), four revisions due to subsidence of the stem (three replacements involving change to a standard stem with healed proximal femur, one replacement with another interlocked revision stem). Bone healing occurred for all fractures after a mean 5.6 months (3-11 months). Follow-up examination after a mean 4.5 years: all patients were able to walk, average Harris Score 70.5 points (29-95 points).

The use of interlocking prostheses for both temporary and definitive management of infected periprosthetic femoral fractures.

PubMed

Konan, Sujith; Rayan, Faizal; Manketelow, Andrew R J; Haddad, Fares S

2011-12-01

Infected periprosthetic fractures around total hip arthroplasties are an extremely challenging problem. We describe our experience of managing infected periprosthetic femoral fractures using interlocking long-stem femoral prostheses either as temporary functional spacers or as definitive implants. The Cannulock (Orthodesign, Christchurch, United Kingdom) uncoated stem was used in 12 cases, and the Kent hip prosthesis (Biomet Merck, Bridgend, United Kingdom), in 5 cases. Satisfactory outcome was noted in all cases, and in 11 cases, revision to a definitive stem has been undertaken after successful control of infection and fracture union. The use of interlocking stems offers a relatively appealing solution for a complex problem and avoids the complications that would be associated with resection of the entire femur or the use of large quantities of bone cement. Copyright © 2011 Elsevier Inc. All rights reserved.

Validation of a new classification for periprosthetic shoulder fractures.

PubMed

Kirchhoff, Chlodwig; Beirer, Marc; Brunner, Ulrich; Buchholz, Arne; Biberthaler, Peter; Crönlein, Moritz

2018-06-01

Successful treatment of periprosthetic shoulder fractures depends on the right strategy, starting with a well-structured classification of the fracture. Unfortunately, clinically relevant factors for treatment planning are missing in the pre-existing classifications. Therefore, the aim of the present study was to describe a new specific classification system for periprosthetic shoulder fractures including a structured treatment algorithm for this important fragility fracture issue. The classification was established, focussing on five relevant items, naming the prosthesis type, the fracture localisation, the rotator cuff status, the anatomical fracture region and the stability of the implant. After considering each single item, the individual treatment concept can be assessed in one last step. To evaluate the introduced classification, a retrospective analysis of pre- and post-operative data of patients, treated with periprosthetic shoulder fractures, was conducted by two board certified trauma surgery consultants. The data of 19 patients (8 male, 11 female) with a mean age of 74 ± five years have been analysed in our study. The suggested treatment algorithm was proven to be reliable, detected by good clinical outcome in 15 of 16 (94%) cases, where the suggested treatment was maintained. Only one case resulted in poor outcome due to post-operative wound infection and had to be revised. The newly developed six-step classification is easy to utilise and extends the pre-existing classification systems in terms of clinically-relevant information. This classification should serve as a simple tool for the surgeon to consider the optimal treatment for his patients.

The Unified Classification System (UCS): improving our understanding of periprosthetic fractures.

PubMed

Duncan, C P; Haddad, F S

2014-06-01

Periprosthetic fractures are an increasingly common complication following joint replacement. The principles which underpin their evaluation and treatment are common across the musculoskeletal system. The Unified Classification System proposes a rational approach to treatment, regardless of the bone that is broken or the joint involved. ©2014 The British Editorial Society of Bone & Joint Surgery.

Cement-in-cement stem revision for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty. A 3-year follow-up of 23 cases.

PubMed

Briant-Evans, Toby W; Veeramootoo, Darmaraja; Tsiridis, Eleftherios; Hubble, Matthew J

2009-10-01

Revision surgery for periprosthetic femoral fractures around an unstable cemented femoral stem traditionally requires removal of existing cement. We propose a new technique whereby a well-fixed cement mantle can be retained in cases with simple fractures that can be reduced anatomically when a cemented revision is planned. This technique is well established in femoral stem revision, but not in association with a fracture. We treated 23 Vancouver type B periprosthetic femoral fractures by reducing the fracture and cementing a revision stem into the pre-existing cement mantle, with or without supplementary fixation. 3 patients died in the first 6 months for reasons unrelated to surgery. In addition, 1 was too frail to attend follow-up and was therefore excluded from the study, and 1 patient underwent revision surgery for a nonunion. The remaining 18 cases all healed with radiographic union after an average time of 4.4 (2-11) months. There was no sign of loosening or subsidence of the revision stems within the old cement mantle in any of these cases at the most recent follow-up after an average of 3 (0.3-9) years. Our results support the use of the cement-in-cement revision in anatomically reducible periprosthetic fractures with a well-preserved pre-existing cement mantle. This technique is particularly useful for the elderly patient and for those who are not fit for prolonged surgical procedures.

High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem.

PubMed

Brodén, Cyrus; Mukka, Sebastian; Muren, Olle; Eisler, Thomas; Boden, Henrik; Stark, André; Sköldenberg, Olof

2015-04-01

Postoperative periprosthetic femoral fracture (PPF) after hip arthroplasty is associated with considerable morbidity and mortality. We assessed the incidence and characteristics of periprosthetic fractures in a consecutive cohort of elderly patients treated with a cemented, collarless, polished and tapered femoral stem (CPT). In this single-center prospective cohort study, we included 1,403 hips in 1,357 patients (mean age 82 (range 52-102) years, 72% women) with primary osteoarthritis (OA) or a femoral neck fracture (FNF) as indication for surgery (367 hips and 1,036 hips, respectively). 64% of patients were ASA class 3 or 4. Hip-related complications and need for repeat surgery were assessed at a mean follow-up time of 4 (1-7) years. A Cox regression analysis was used to evaluate risk factors associated with PPF. 47 hips (3.3%) sustained a periprosthetic fracture at median 7 (2-79) months postoperatively; 41 were comminute Vancouver B2 or complex C-type fractures. The fracture rate was 3.8% for FNF patients and 2.2% for OA patients (hazard ratio (HR) = 4; 95% CI: 1.3-12). Patients > 80 years of age also had a higher risk of fracture (HR = 2; 95% CI: 1.1-4.5). We found a high incidence of early PPF associated with the CPT stem in this old and frail patient group. A possible explanation may be that the polished tapered stem acts as a wedge, splitting the femur after a direct hip contusion. Our results should be confirmed in larger, registry-based studies, but we advise caution when using this stem for this particular patient group.

High risk of early periprosthetic fractures after primary hip arthroplasty in elderly patients using a cemented, tapered, polished stem

PubMed Central

Brodén, Cyrus; Mukka, Sebastian; Muren, Olle; Eisler, Thomas; Boden, Henrik; Stark, André; Sköldenberg, Olof

2015-01-01

Background and purpose Postoperative periprosthetic femoral fracture (PPF) after hip arthroplasty is associated with considerable morbidity and mortality. We assessed the incidence and characteristics of periprosthetic fractures in a consecutive cohort of elderly patients treated with a cemented, collarless, polished and tapered femoral stem (CPT). Patients and methods In this single-center prospective cohort study, we included 1,403 hips in 1,357 patients (mean age 82 (range 52–102) years, 72% women) with primary osteoarthritis (OA) or a femoral neck fracture (FNF) as indication for surgery (367 hips and 1,036 hips, respectively). 64% of patients were ASA class 3 or 4. Hip-related complications and need for repeat surgery were assessed at a mean follow-up time of 4 (1–7) years. A Cox regression analysis was used to evaluate risk factors associated with PPF. Results 47 hips (3.3%) sustained a periprosthetic fracture at median 7 (2–79) months postoperatively; 41 were comminute Vancouver B2 or complex C-type fractures. The fracture rate was 3.8% for FNF patients and 2.2% for OA patients (hazard ratio (HR) = 4; 95% CI: 1.3–12). Patients > 80 years of age also had a higher risk of fracture (HR = 2; 95% CI: 1.1–4.5). Interpretation We found a high incidence of early PPF associated with the CPT stem in this old and frail patient group. A possible explanation may be that the polished tapered stem acts as a wedge, splitting the femur after a direct hip contusion. Our results should be confirmed in larger, registry-based studies, but we advise caution when using this stem for this particular patient group. PMID:25280133

Periprosthetic Occult Fractures of the Acetabulum Occur Frequently During Primary THA.

PubMed

Hasegawa, Kazuhiro; Kabata, Tamon; Kajino, Yoshitomo; Inoue, Daisuke; Tsuchiya, Hiroyuki

2017-02-01

Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery. In this study, using routine CT scans that were obtained as part of another primary hip arthroplasty study protocol, we retrospectively assessed (1) the prevalence of occult fractures of the acetabulum occurring during primary THA, (2) the location of occult fractures of the acetabulum during THA, and (3) risk factors contributing to such occult fractures. Between 2004 and 2013, our institute performed 585 primary THAs (cementless or hybrid) in 494 patients with DICOM pre- and postoperative CT; during the period in question, all patients undergoing THA underwent CT before and after surgery. Preoperative CT images were taken as part of a CT-based three-dimensional templating software and navigation system. Postoperative CT images were taken an average of 1 week after surgery as part of a different protocol to evaluate cup position, restoration of leg length and offset, volume of postoperative hematoma to assess anticoagulation effects after THA, and fractures that were not found on routine postoperative radiographs (which we defined as occult fractures). Patients with a history of prior pelvic osteotomy, trauma, and infection were excluded (88 patients/99 hips); 406 patients (102 males and 304 females; 486 hips) form the basis of this report. The mean age of the patients was 60 ± 11 years, with a mean BMI of 23 ± 4 kg/m 2 . The mean followup of the patients with periprosthetic fracture of the acetabulum was 58 ± 28 months (range, 12-131 months). Potential risk factors for occult acetabular fracture including age, sex, BMI, preoperative diagnosis, additional dome screw fixation, composition and size of each cup, and acetabular design were examined in multivariate analysis. Acetabular component designs were categorized as true hemispheric, peripheral self-locking, and elliptical; during the period in question the indications for each cup design were based on the brand of stem used. Comparison between preoperative and postoperative CT images was done to detect the fractures. Patients with fractures identified during surgery were treated with additional dome screw fixation and a 3-week period of nonweightbearing. Patients with occult fractures in this series did not receive additional treatment as we had confirmed secure fixation of the cup during surgery. Occult fractures occurred in 41 hips (8.4%); periprosthetic fractures of the acetabulum were seen during surgery in an additional two hips (0.4%). The superolateral wall was the most frequent location for occult fractures of the acetabulum. After controlling for relevant confounding variables, only the use of peripheral self-locking cups was associated with an increased risk of occult fracture (odds ratio [OR], 2.6 compared with hemispheric cups; 95% CI, 1.2-5.6; p < 0.05). All patients with occult fractures showed bone ingrowth fixation at the final followup, without any additional surgical intervention. Periprosthetic occult fractures of the acetabulum may occur relatively frequently during press-fit impaction. We observed a higher rate of fractures associated with the use of peripheral self-locking components. Occult acetabular fractures not detected on routine postoperative plain films may be ignored if secure fixation of the cup has been confirmed during the operation. Level III, therapeutic study.

Biomechanical evaluation of fracture fixation constructs using a variable-angle locked periprosthetic femur plate system.

PubMed

Hoffmann, Martin F; Burgers, Travis A; Mason, James J; Williams, Bart O; Sietsema, Debra L; Jones, Clifford B

2014-07-01

In the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1-4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct. Fifteen medium adult synthetic femurs were implanted with a hip prosthesis and were osteotomized in an oblique plane at the level of the implant tip to simulate a Vancouver type B1 periprosthetic fracture. Fractures were fixed with a non-contact bridging periprosthetic proximal femur plate (Zimmer Inc., Warsaw, IN). Three proximal fixation methods were used: Group 1, bicortical screws; Group 2, unicortical screws and one cerclage cable; and Group 3, three cerclage cables. Distally, all groups had bicortical screws. Biomechanical testing was performed using an axial-torsional testing machine in three different loading modalities (axial compression, lateral bending, and torsional/sagittal bending), next in axial cyclic loading to 10,000 cycles, again in the three loading modalities, and finally to failure in torsional/sagittal bending. Group 1 had significantly greater load to failure and was significantly stiffer in torsional/sagittal bending than Groups 2 and 3. After cyclic loading, Group 2 had significantly greater axial stiffness than Groups 1 and 3. There was no difference between the three groups in lateral bending stiffness. The average energy absorbed during cyclic loading was significantly lower in Group 2 than in Groups 1 and 3. Bicortical screw placement achieved the highest load to failure and the highest torsional/sagittal bending stiffness. Additional unicortical screws improved axial stiffness when using cable fixation. Lateral bending was not influenced by differences in proximal fixation. To treat periprosthetic fractures, bicortical screw placement should be attempted to maximize load to failure and torsional/sagittal bending stiffness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Early experience with a novel nonmetallic cable in reconstructive hip surgery.

PubMed

Ting, Nicholas T; Wera, Glenn D; Levine, Brett R; Della Valle, Craig J

2010-09-01

Metallic wires and cables are commonly used in primary and revision THA for fixation of periprosthetic fractures and osteotomies of the greater trochanter. These systems provide secure fixation and high healing rates but fraying, third-body generation, accelerated wear of the bearing surface, and injury to the surgical team remain concerning. We determined the rate of cable failure, union, and complications associated with a novel, nonmetallic cerclage cable in periprosthetic fracture and osteotomy fixation during THA. We retrospectively reviewed 29 patients who had primary and revision THAs using nonmetallic cables. Indications for use included fixation of an extended trochanteric osteotomy, intraoperative fracture of the proximal femur, strut allograft fixation, and a Vancouver B1 periprosthetic fracture of the femur. All patients were evaluated clinically and radiographically immediately postoperatively, at 3 weeks, 6 weeks, 3 months, and then annually thereafter. The minimum followup was 13 months (mean, 21 months; range, 13-30 months). Two of the 29 patients (7%) developed a nonunion; all remaining osteotomies, fractures and allografts had healed at the time of most recent evaluation. Four patients (14%) dislocated postoperatively; two were treated successfully with closed reduction, while the other two required reoperation. We identified no evidence of breakage or other complications directly attributable to the cables. The nonmetallic periprosthetic cables used in this series provided adequate fixation to allow for both osteotomy and fracture healing. We did not observe any complications directly related to the cables. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Fixation of periprosthetic femur fractures above total knee arthroplasty with the less invasive stabilization system: a midterm follow-up study.

PubMed

Kolb, Werner; Guhlmann, Hanno; Windisch, Christoph; Marx, Frank; Koller, Heiko; Kolb, Klaus

2010-09-01

The complication rate of periprosthetic femoral fractures above well-fixed total knee arthroplasties is high. The Less Invasive Stabilization System (LISS) was introduced to reduce surgical dissections at the fracture site. The purpose of this retrospective study was to evaluate the midterm functional outcome of a group of patients with periprosthetic fractures above well-fixed total knee arthroplasties treated with the LISS. Between January 1999 and June 2004, 23 consecutive patients (all women) with periprosthetic fractures above well-fixed total knee arthroplasties were treated with the LISS. The mean age was 77 years (range, 61-90 years). Nineteen of the patients (83%) were seen after a midterm follow-up of 46 months (range, 26-67 months). Three patients (13%) died, and one patient (4%) was lost to follow-up. A proximal screw pull-out of the internal fixator occurred in one patient (4%). All fractures healed within a mean of 14 weeks (range, 9-21 weeks). No bone graft was required. There were two delayed unions, no nonunions or infections. One patient (4%) had a malalignment with 7° varus. The mean range of motion was 102° (range, 65-120°). The mean knee score of the Knee Society was 81 points (range, 65-90 points), and the mean function score of the Knee Society was 56 points (range, 35-90 points). We found that a minimally invasive, locked plating system permitted stable fixation, early knee motion with good midterm results, and minimal complications. These techniques should be used in place of less stable and more invasive methods.

Biomechanical evaluation of adjunctive cerclage wire fixation for the prevention of periprosthetic femur fractures using cementless press-fit total hip replacement.

PubMed

Christopher, Scott A; Kim, Stanley E; Roe, Simon; Pozzi, Antonio

2016-08-01

Periprosthetic femoral fractures are a common complication associated with cementless press-fit total hip arthroplasty. The use of prophylactic cerclage wire fixation has been advocated to reduce this complication. The objective of this study was to evaluate whether a double loop cerclage wire, used as adjunctive fixation, increased the peak torsional load to failure in femora implanted with press-fit cementless stems. Peak torsional load to failure was compared between femora without adjunctive fixation and femora receiving a 1 mm double loop cerclage wire placed proximally to the lesser trochanter. Femora treated with adjunctive cerclage wire fixation failed at 20% greater peak torque (P = 0.0001). In conclusion, a double loop cerclage wire may aid in the prevention of periprosthetic fractures associated with press-fit cementless femoral stems. Copyright © 2016. Published by Elsevier Ltd.

Thirteen-year outcomes in the Anatomique Benoist Girard II hip prosthesis.

PubMed

Catanach, Michael J M; Sorial, Rami M; Eslick, Guy D

2015-04-01

The Stryker Anatomique Benoist Girard (ABG) hip implant system was a commonly used cementless prosthesis in the early 2000s, which fell from favour after several studies emerged implicating the prosthesis in high rates of revision. This retrospective, single-surgeon clinical study examines the fracture rate, revision rate and reasons for revision in 500 consecutive ABG II primary total conventional hip replacements. Follow-up was conducted by audit of patient notes, patient mailout survey, patient phone contact and audit of the Australian National Joint Replacement Registry (NJRR) database to find instances of fracture and revision. End points were periprosthetic fracture and revision for any reason. Follow-up was 1.2-13.8 years with a mean of 6.58 years. Of the 500 hips, 17 (3.4%) had undergone a revision. Of these, 13 were due to periprosthetic fracture. Four further fractures occurred that were not revised. Eight of these periprosthetic fractures occurred within 1 year post-operatively. There were four revisions for recurrent dislocations. Kaplan-Meier survival curve demonstrates a 93.7% survivorship at 6.58 years for revision for any reason. Multivariate analysis showed the only statistically significant factor for increased risk of revision was smaller stem size. Our results were consistent with the literature in that the ABG II system has good medium-term results but is prone to periprosthetic fractures, especially in the early post-operative period. When used as a primary total hip arthroplasty, the ABG II system has an 8-year revision rate of 5.6% compared with the 4.9% of all primary total hip arthroplasties. © 2014 Royal Australasian College of Surgeons.

Undisplaced Intraoperative Fracture Presenting as Early Dislocation with Tapered Wedge Stems in Total Hip Arthroplasty - Case Series and Review of Literature

PubMed Central

Reddy, A V Gurava; Eachempati, Krishna Kiran; Mugalur, Aakash; Suchinder, A; Rao, V B N Prasad; Kamurukuru, Nalanda

2017-01-01

Introduction: Periprosthetic fractures and dislocation in the early post-operative period can be disastrous both for the surgeon and the patient. However, undisplaced periprosthetic fractures presenting with dislocation is uncommon. We describe successful management of two cases (one bilateral dislocation and one unilateral dislocation) of undisplaced iatrogenic fractures in total hip arthroplasty (THA) presenting as early dislocation. Case Report: Case 1 was a 45-year-old female with osteoarthritis of hip secondary to developmental dysplasia of the hip with bilateral early nontraumatic dislocation with bilateral identical periprosthetic fracture. It was managed by revision to long stem and encirclage wiring. Case 2 presented with early dislocation in the 2nd week post THA. We found an intertrochanteric fracture intra-operatively with unstable implant. Acetabular component and femoral component revision were done with reconstruction of the greater trochanter. Discussion: These fractures could be occult iatrogenic fractures characteristic of taper wedge stems which presented as early nontraumatic dislocation in the post-operative period. The prosthesis subsidence, loss of muscle tension and change of version might be the factors leading to dislocation. Conclusion: Unrecognized incomplete intraoperative fracture can occur with tapered wedge uncemented stems which can present as a dislocation in the immediate post-operative period. This will require early revision of the femoral component. PMID:29051875

Novel implant for peri-prosthetic proximal tibia fractures.

PubMed

Tran, Ton; Chen, Bernard K; Wu, Xinhua; Pun, Chung Lun

2018-03-01

Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has been designed with an extended flange over the anterior of tibial condyle to provide additional points of fixation, overcoming limitations of existing generic locking plates used for proximal tibia fractures. Furthermore, the screws fixed through the extended flange provide additional support to prevent the problem of subsidence of tibial component of knee implant. The design methodology involved extraction of bone data from CT scans into a flexible CAD format, implant design and structural evaluation and optimisation using FEM as well as prototype development and manufacture by selective laser melting 3D printing technology with Ti6Al4 V powder. A prototype tibia implant was developed based on a patient-specific bone structure, which was regenerated from the CT images of patient's tibia. The design is described in detail and being applied to fit up to 80% of patients, for both left and right sides based on the average dimensions and shape of the bone structure from a wide range of CT images. A novel tibial implant has been developed to repair peri-prosthetic proximal tibia fractures which overcomes significant constraints from the tibial component of existing knee implant. Copyright © 2018 Elsevier Ltd. All rights reserved.

Short uncemented stems allow greater femoral flexibility and may reduce peri-prosthetic fracture risk: a dry bone and cadaveric study.

PubMed

Jones, Christopher; Aqil, Adeel; Clarke, Susannah; Cobb, Justin P

2015-09-01

Short femoral stems for uncemented total hip arthroplasty have been introduced as a safe alternative to traditional longer stem designs. However, there has been little biomechanical examination of the effects of stem length on complications of surgery. This study aims to examine the effect of femoral stem length on torsional resistance to peri-prosthetic fracture. We tested 16 synthetic and two paired cadaveric femora. Specimens were implanted and then rapidly rotated until fracture to simulate internal rotation on a planted foot, as might occur during stumbling. 3D planning software and custom-printed 3D cutting guides were used to enhance the accuracy and consistency of our stem insertion technique. Synthetic femora implanted with short stems fractured at a significantly higher torque (27.1 vs. 24.2 Nm, p = 0.03) and angle (30.3° vs. 22.3°, p = 0.002) than those implanted with long stems. Fracture patterns of the two groups were different, but showed remarkable consistency within each group. These characteristic fracture patterns were closely replicated in the pair of cadaveric femora. This new short-stemmed press-fit femoral component allows more femoral flexibility and confers a higher resistance to peri-prosthetic fracture from torsional forces than long stems.

Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

PubMed Central

Thukral, Rajiv; Marya, SKS; Singh, Chandeep

2015-01-01

Background: Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF) with anatomic distal femoral (DF) locking plate permits early mobilization. However, this usually necessitates bone grafting (BG). Biological fixation using minimally invasive techniques minimizes periosteal stripping and morbidity. Materials and Methods: 31 patients with comminuted periprosthetic DF fractures were reviewed retrospectively from October 2006 to September 2012. All patients underwent fixation using a DF locking compression plate (Synthes). 17 patients underwent ORIF with primary BG, whereas 14 were treated by closed reduction (CR) and internal fixation using biological minimally invasive techniques. Clinical and radiological followup were recorded for an average 36 months. Results: Mean time to union for the entire group was 5.6 months (range 3-9 months). Patients of ORIF group took longer (Mean 6.4 months, range 4.5-9 months) than the CR group (mean 4.6 months, range 3-7 months). Three patients of ORIF and one in CR group had poor results. Mean knee society scores were higher for CR group at 6 months, but nearly identical at 12 months, with similar eventual range of motion. Discussion: Locked plating of comminuted periprosthetic DF fractures permits stable rigid fixation and early mobilization. Fixation using minimally invasive biological techniques minimizes morbidity and may obviate the need for primary BG. PMID:26015610

Periprosthetic fractures around the femoral stem: overcoming challenges and avoiding pitfalls

PubMed Central

Chen, Antonia F.

2015-01-01

Management of periprosthetic fractures around the femoral stem after total hip arthroplasty (THA) represents a significant challenge and optimal treatment remains controversial. The most common treatment paradigm involves treating fractures around a well-fixed stem with osteosynthesis, whereas fractures around a loose stem require revision arthroplasty and those with poor bone require augmentation with bone graft. Paradoxically, the literature reports a higher rate of failure for osteosynthesis around prostheses considered to be well-fixed. Such a high rate of poor outcomes may result not only from difficult fracture fixation and compromised biologic healing, but also from unrecognized peri-implant pathology. Therefore, proper preoperative and intraoperative evaluation is key, and a subset of patients may benefit from alternative management. We review the appropriate methods for evaluation and treatment of Vancouver type B fractures with particular emphasis on avoiding missteps that can lead to failure. PMID:26539451

Bilateral Distal Femoral Nailing in a Rare Symmetrical Periprosthetic Knee Fracture

PubMed Central

Carvalho, Marcos; Fonseca, Ruben; Simões, Pedro; Bahute, André; Mendonça, António; Fonseca, Fernando

2014-01-01

The authors report a case of a 78-year-old polytrauma patient, with severe thoracic trauma and bilateral symmetrical periprosthetic femoral fractures after a violent car accident. After the primary survey, with the thoracic trauma stabilized, neurovascular lesions excluded, and provisional immobilization applied, both fractures were classified as OTA: 33-A3, Rorabeck Type II, and closed reduction and internal fixation with distal femoral nails were performed. At 5 months of follow-up, the patient was able to walk with crutches and clear radiologic signs of fracture consolidation could be seen. At 24 months, the patient walked without any walking aid and had recovered her previous functional status. This surgical option allowed the authors to achieve relative stability using an intramedullary technique, preserving fracture hematoma in an osteopenic patient, and was found to be successful in recovering the patient's previous functional status and satisfaction after major trauma. PMID:25580332

A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff.

PubMed

Vanhegan, I S; Malik, A K; Jayakumar, P; Ul Islam, S; Haddad, F S

2012-05-01

Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p < 0.001). Financial costs vary significantly by indication, which is not reflected in current National Health Service tariffs.

Mortality and Financial Burden of Periprosthetic Fractures of the Femur.

PubMed

Shields, Edward; Behrend, Caleb; Bair, Jeff; Cram, Peter; Kates, Stephen

2014-12-01

This study examines patient factors to identify risks of 12-month mortality following periprosthetic femur fractures. Hospital charges were analyzed to quantify the financial burden for treatment modalities. Data were retrospectively analyzed from a prospective database at a university hospital setting. One-hundred and thirteen patients with a periprosthetic fracture of the proximal or distal femur were identified. Risk factors for 12-month mortality were analyzed, and financial data were compared between the various treatment modalities. In all, 14% of patients died (16 of 113) within 3 months and the 1-year mortality was 17.7% (20 of 113). Patients who died within 1 year had higher hospital charges (US$33 880 ± 25 051 vs US$22 886 ± 16 841; P = .01) and were older (87.6 ± 8.5 vs 81.5 ± 8.6; P = .004). Logistic regression analysis revealed age was the only significant predictor of 1-year mortality (P = .029, odds ratio 1.1). Analysis of financial data revealed 4 distinct groups (P < .05 between groups). Distal femoral revision arthroplasty (RA-DF) generated the highest hospital charges of US$91 035 ± 25 579 (n = 3). The second most highly charged group included proximal femoral fractures treated with revision arthroplasty (US$34 078 ± 17 832; n = 20) and hemi/total hip arthroplasty (THA; US$41 556 ± 23 651; n = 8). The third most charged group underwent open reduction internal fixation of the proximal (US$18 706 ± 6829; n = 35) and distal (US$22 381 ± 10 835; n = 35) femur. Nonoperative treatment generated the lowest charges (US$6426 ± 2899; n = 11). On average, the hospital lost money treating patients with RA-DF (US$-19 080 ± 2022 per patient) and hemi/THA (US$-6594 ± 9305 per patient), while all other treatment groups were profitable. One-year mortality after periprosthetic femur fractures was 17.7%, is mostly influenced by age, and 80% of deaths occur within 3 months. Patients treated with primary/revision arthroplasty generate more hospital charges than internal fixation. The average patient treated with revision arthroplasty of the distal femur or hemi/THA for a periprosthetic femur fractures resulted in net financial losses for the hospital.

[Treatment of periprosthetic femoral fractures after total hip arthroplasty with specially constructed retrograde hollow nails].

PubMed

Szalay, G; Meyer, C; Mika, J; Schnettler, R; Thormann, U

2014-12-01

Treatment of periprosthetic fractures by implantation of a specially constructed, retrograde hollow nail which fits over the tip of the prosthesis and becomes locked on it. Periprosthetic femoral fractures with firmly anchored prosthesis shaft after total hip arthroplasty of types B1 and C according to the Vancouver classification. Loosened prosthesis (type B2/B3) and trochanteric fractures (type A). Broken or damaged prosthesis, florid inflammation and soft tissue injuries in the operation field, contracted knee joint, advanced deformation in the knee joint and distal femur, enclosed prosthesis and general contraindications. In a supine position the periprosthetic fracture is exposed via a lateral access. For cemented prostheses the cement is removed around the tip of the prosthesis (at least 2-3 cm) and medullary cavity. Arthrotomy with flexion of the knee joint and marking of the nail entry point. Drill the medullary cavity, retrograde introduction of the nail, visually fit the nail over the tip of the prosthesis and lock the nail with the prosthesis. If necessary use additional spongiosaplasty or also placement of additional cerclages depending on fracture type and size of the defect zone. Lock the nail distally. Use intraoperative radiological imaging to control correct positioning and length of the nail. Close the wound layer by layer with placement of suction drainage devices and dressing. Partial loading for 6 weeks with a subsequent pain-adapted loading gradient until full loading is possible. If selective partial loading is not possible, a decision must be made in individual cases as to whether the intraoperative findings allow immediate full loading. From 2004 to 2011 a total of 25 periprosthetic femoral fractures in 25 patients were treated in 2 locations using specially constructed slotted hollow nails. Within the framework of a retrospective study 20 of these patients (16 female and 4 male; average age 77.2 [72-84] years) were clinically and radiologically re-examined on average 19.3 (7-31) months postoperatively. No postoperative bleeding, wound healing disorders and infections. In all patients there was a loading stable consolidation of the fracture in the correct femoral axis, length and rotation with no evidence for radiological signs of loosening of the prosthesis or dislocation of the nails. In one case there was loosening of the prosthesis which had obviously occurred during the operative procedure. After consolidation of the fracture it was necessary to exchange the prosthesis for a long shafted prosthesis. A comparable situation to the preoperative degree of mobility was found in 12 out of the 20 patients, a moderate deterioration in 5 patients, a substantial residual impairment in 2 patients and an improvement of the situation in 1 patient.

Treatment of periprosthetic femoral fractures of the knee.

PubMed

Ehlinger, Matthieu; Adam, Philippe; Abane, Lamine; Rahme, Michel; Moor, Beat Kaspar; Arlettaz, Yvan; Bonnomet, François

2011-09-01

We report a continuous series of periprosthetic femoral fractures after knee arthroplasty treated with a locking plate. We hypothesize that minimally invasive surgery and immediate weight-bearing improve functional recovery. From June 2002 to December 2008, 15 patients with 16 fractures were treated. Median age was 81 years. The autonomy level according to the mobility score of Parker and Palmer showed a median of 5 (0-9). Osteosynthesis was performed mainly through a minimally invasive approach using a locking compression plate. The rehabilitation protocol consisted of immediate mobilization and, whenever possible, immediate unrestricted weight-bearing. Five patients died during follow-up, more than 1 year after osteosynthesis. Their results were included. Autonomy and mobility were preserved with a median postoperative score of 4 (0-9) according to Parker and Palmer. The consolidation rate was 93.8%, which was obtained within 10 weeks. There were no mechanical or infectious complications. Fourteen cases were treated with minimally invasive surgery without fracture exposition; the remaining 2 required a slightly more extended approach. Full weight-bearing occurred 10 times; 20-kg partial weight-bearing was advised twice; and on 4 occasions, no weight-bearing was allowed for 6 weeks. Osteosynthesis with a minimally invasive bridge-plating technique is effective in the treatment of periprosthetic, distal femoral fractures without component loosening. Immediate full weight-bearing is possible if certain rules are respected. The surgical management presented herein is beneficial for these challenging fractures, and it may help reduce the complication rate and improve functional outcome.

Impact of intraprosthetic drilling on the strength of the femoral stem in periprosthetic fractures: A finite element investigation.

PubMed

Brand, Stephan; Bauer, Michael; Petri, Maximilian; Schrader, Julian; Maier, Hans J; Krettek, Christian; Hassel, Thomas

2016-07-01

Treatment of periprosthetic femur fractures after total hip arthroplasty remains a major challenge in orthopedic surgery. Recently, a novel surgical technique using intraprosthetic screw fixation has been suggested. The purpose of this study was to evaluate the influence of drilling the femoral hip stem on integrity and strength of the implant. The hypothesis was that intraprosthetic drilling and screw fixation would not cause the load limit of the prosthesis to be exceeded and that deformation would remain within the elastic limit. A sawbone model with a conventional straight hip stem was used and a Vancouver C periprosthetic fracture was created. The fracture was fixed with a nine-hole less invasive stabilization system plate with two screws drilled and inserted through the femoral hip stem. Three different finite element models were created using ANSYS software. The models increased in complexity including joint forces and stress risers from three different dimensions. A variation of drilling positions was analyzed. Due to the complexity of the physiological conditions in the human femur, the most complex finite element model provided the most realistic results. Overall, significant changes in the stresses to the prosthesis caused by the drilling procedure were observed. While the stresses at the site of the bore hole decreased, the load increased in the surrounding stem material. This effect is more pronounced and further the holes were apart, and it was found that increasing the number of holes could counteract this. The maximum load was still found to be in the area of the prosthesis neck. No stresses above the load limit of titanium alloy were detected. All deformations of the prosthesis stem remained in the elastic range. These results may indicate a potential role for intraprosthetic screw fixation in the future treatment of periprosthetic femur fractures. © IMechE 2016.

PERIPROSTHETIC FRACTURES IN TOTAL KNEE ARTHROPLASTY

PubMed Central

de Alencar, Paulo Gilberto Cimbalista; De Bortoli, Giovani; Ventura Vieira, Inácio Facó; Uliana, Christiano Saliba

2015-01-01

The increasing number of total knee arthroplasties, in combination with the population's longer life expectancy, has led to a greater number of long-term complications. These add to the poor bone quality of elderly patients and often culminate in periprosthetic fractures. This complex orthopedic problem has a great diversity of clinical presentation. It may affect any of the bones in the knee and, because of the difficulty in finding solutions, may lead to disastrous outcomes. Its treatment requires that orthopedists should have broad knowledge both of arthroplasty techniques and of osteosynthesis, as well as an elaborate therapeutic arsenal including, for example, access to a bone bank. PMID:27022546

The economic impact of surgically treated peri-prosthetic hip fractures on a university teaching hospital in Wales 7.5-year study.

PubMed

Jones, Andrew R; Williams, Tim; Paringe, Vishal; White, Simon P

2016-02-01

The number of total hip replacements taking place across the UK continues to grow. In an ageing population, with people placing greater demands on their prostheses, the number of peri-prosthetic fractures is increasing. We studied the economic impact this has on a large teaching hospital. All patients with peri-prosthetic femoral fracture in a 7.5 year period were identified. Radiographic and case note analysis was performed. Costings from the finance departments were obtained. 90 cases were identified, 58 female and 32 male, with a mean age of 76 (range: 38-91). 89 of the cases were managed surgically, 66% undergoing revision and 33% receiving open reduction and internal fixation. According to the Vancouver Classification, 3% were Type A, 79% Type B and 18% Type C. The mean length of stay was 43 days. The mean cost of management was £31,370 (range: £6885-£112,327). Patients with type C fractures had the highest mean length of stay at 53 days and mean cost of £33,417. Including rehabilitation costs, our study illustrated a mean cost of £31,370, roughly four times the current basic NHS tariff of £8552. Although implant costs are greater, treatment with revision where appropriate allows earlier weight bearing, reduced length of stay and lower overall cost. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Joint endoprosthesis pathology. Histopathological diagnostics and classification].

PubMed

Krenn, V; Morawietz, L; Jakobs, M; Kienapfel, H; Ascherl, R; Bause, L; Kuhn, H; Matziolis, G; Skutek, M; Gehrke, T

2011-05-01

Prosthesis durability has steadily increased with high 10-year rates of 88-95%. However, four pathogenetic groups of diseases can decrease prosthesis durability: (1) periprosthetic wear particle disease (aseptic loosening) (2) bacterial infection (septic loosening) (3) periprosthetic ossification, and (4) arthrofibrosis. The histopathological "extended consensus classification of periprosthetic membranes" includes four types of membranes, arthrofibrosis, and osseous diseases of endoprosthetics: The four types of neosynovia are: wear particle-induced type (type I), mean prosthesis durability (MPD) in years 12.0; infectious type (type II), MPD 2.5; combined type (type III) MPD 4.2; and indeterminate type (type IV), MPD 5.5. Arthrofibrosis can be determined in three grades: grade 1 needs clinical information to be differentiated from a type IV membrane, and grades 2 & 3 can be diagnosed histopathologically. Periprosthetic ossification, osteopenia-induced fractures, and aseptic osteonecrosis can be histopathologically diagnosed safely with clinical information. The extended consensus classification of periprosthetic membranes may be a diagnostic groundwork for a future national endoprosthesis register.

A double-plating approach to distal femur fracture: A clinical study.

PubMed

Steinberg, Ely L; Elis, Jacov; Steinberg, Yohai; Salai, Moshe; Ben-Tov, Tomer

2017-10-01

Locked plating is one of the latest innovative options for treating supracondylar femur fractures with relatively low failure rates. Single lateral plating was often found to have a relative higher failure rate. No clinical studies of double-plating distal femur fixation have thus far been reported. The aim of this study is to present our clinical experience with this surgical approach. Thirty-two patients (26 females and 6 males, mean age 76 years, range 44-101) were included in the study. Eight of them patients had a periprosthetic stable implant fracture and two patients were treated for a nonunion. All fractures, excluding one that needed bone grafting and one refracture, healed within 12 weeks. One patient needed bone grafting for delayed union and one patient needed fixation exchange due to femur re-fracture at the site of the most proximal screw. Two patients developed superficial wound infection and one patient required medial plate removal after union due to deep infection. Based on these promising results, we propose that the double-plating technique should be considered in the surgeon's armamentarium for the treatment of supracondylar femur fractures, particularly in patients with poor bone quality, comminuted fractures and very low periprosthetic fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

The influence of implant design on periprosthetic bone remodelling of two types of uncemented HA-coated hip stems. A two-year follow-up study using DEXA.

PubMed

Van der Wal, B C H; Rahmy, A I A; Grimm, B; Blake, G M; Heyligers, I C; Tonino, A J

2006-01-01

Proximal bone resorption and an increased fracture rate in the ABG-I stem has been shown. For these reasons the ABG-I stem design was changed to the ABG-II. In this study periprosthetic bone loss around the ABG-I vs ABG-II is compared to verify if the design changes resulted in improved proximal bone preservation. 51 patients were randomised to either the ABG-I or ABG-II hip prosthesis. Periprosthetic BMD change at various time points was measured using DEXA. Between the two groups (age, gender, weight etc.) no statistical difference was encountered. Compared to the baseline at two years the ABG-II preserved bone better proximally (e.g. zone 7: ABG-II: -3.7%, ABG-I: -11.9%, p=0.05) than the ABG-I. Distally, the trend was opposite and less bone loss was measured for the ABG-I than the ABG-II in zones 3, 4 and 5 (n.s.). this study confirms the philosophy behind the design changes from the ABG-I to ABG-II stem where increased elasticity, more proximal HA-coating, a shorter and distally polished stem, were meant to reduce proximal bone resorption. In future this may lead to fewer periprosthetic fractures and to less complicated revision surgery.

Recent Advances and Developments in Knee Surgery: Principles of Periprosthetic Knee Fracture Management

PubMed Central

Chimutengwende-Gordon, Mukai; Khan, Wasim; Johnstone, David

2012-01-01

The management of distal femoral, tibial and patellar fractures after total knee arthroplasty can be complex. The incidence of these fractures is increasing as the number of total knee arthroplasties being performed and patient longevity is increasing. There is a wide range of treatment options including revision arthroplasty for loose implants. This review article discusses the epidemiology, risk factors, classification and treatment of these fractures. PMID:22888380

Stabilization of an acetabular fracture with cables for acute total hip arthroplasty.

PubMed

Mears, D C; Shirahama, M

1998-01-01

A critical stage of total hip arthroplasty for an acute acetabular fracture where extensive comminution, impaction, and osteopenia thwart the application of conventional open or closed methods, especially in the elderly, is stable fixation of the acetabulum. The use of 2-mm braided cables permits effective immobilization of the fracture for use in conjunction with a hybrid arthroplasty. The method is consistent with the use of a conventional arthroplastic incision and is suitable for other applications including the fixation of periprosthetic fractures, bulk allografts, and conventional acetabular fractures.

Alteration of the RANKL/RANK/OPG System in Periprosthetic Osteolysis with Septic Loosening.

PubMed

Wang, Long; Dai, Zixun; Xie, Jie; Liao, Hao; Lv, Cheng; Hu, Yihe

2016-02-01

The pathogenesis of periprosthetic osteolysis with septic loosening remains incompletely understood. The purpose of this study was to investigate whether expression of the RANKL/RANK/OPG system is altered in septic interface membranes (SIMs). Seventeen cases with a SIM, 26 cases with an aseptic interface membrane (AIM), and 12 cases with a normal synovium (NS) were assessed. Scanning and transmission electron microscopy (SEM and TEM, respectively) were used to observe the microscopic morphology of three tissue conditions. Differences in RANKL, RANK, and OPG expression at the mRNA level were assessed by real-time quantitative PCR, and differences at the protein level were assessed by immunohistochemical staining and Western blotting. SEM showed wear debris widely distributed on the AIM surface, and TEM showed Bacillus activity in the SIM. RANKL expression and the RANKL/OPG ratio were significantly increased in SIMs. Imbalance in the RANKL/RANK/OPG system is related to periprosthetic osteolysis with septic loosening but is not the only possible pathogenic mechanism.

Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience.

PubMed

Klatte, T O; Kendoff, D; Kamath, A F; Jonen, V; Rueger, J M; Frommelt, L; Gebauer, M; Gehrke, T

2014-04-01

Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p < 0.02) in those undergoing revision replacement of the hip, and the mean Hospital for Special Surgery knee score increased to 75 points (70 to 80; p < 0.01) in those undergoing revision replacement of the knee. A single-stage revision following fungal peri-prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.

Survivorship and complications of total hip arthroplasty in patients with dwarfism.

PubMed

Modi, Ronuk M; Kheir, Michael M; Tan, Timothy L; Penny, Gregory S; Chen, Chi-Lung; Shao, Hongyi; Chen, Antonia F

2017-09-19

Total hip arthroplasty (THA) is a common procedure used to treat bony hip deformities and skeletal dysplasia in dwarfism. These surgeries are often more difficult than conventional THA as they may involve malformed joints and poor bone quality, and may require smaller prostheses. This study aims to investigate whether implant survivorship and revision rates vary among patients with and without dwarfism undergoing THA. A retrospective case-control study was performed for 102 THAs completed between 1997 and 2014 in patients under the height threshold of 147.32 cm. This cohort was matched 1:1.5 with patients of normal height with respect to age, gender, year of surgery, and Charlson comorbidities. All cases had a minimum follow-up of 1 year. A chart review was performed to identify patient and surgical characteristics, including outcomes. Radiographs were assessed for deformity, loosening, and periprosthetic fractures among other factors. The 2-, 5-, and 10-year survivorship of THA in patients with dwarfism was 92.9%, 92.9%, and 80.7%, respectively; and 94.4%, 86.4%, and 86.4% for controls, respectively (p = 0.95). The dwarfism cohort demonstrated an OR of 3.81 and 3.02 for revision for periprosthetic fractures (p = 0.11) and mechanical wear (p = 0.21), respectively. THA in patients with dwarfism achieves comparable results to a non-dwarfism population with regards to implant survivorship; however, there is a trend toward increased periprosthetic fractures and wear-related failures. Surgeons should be aware of this potentially higher risk in this population and take morphological differences into account during surgical planning and technique.

Principles of management and results of treating the fractured femur during and after total hip arthroplasty.

PubMed

Greidanus, Nelson V; Mitchell, Philip A; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

2003-01-01

The management of fractures of the femur during and after total hip arthroplasty can be difficult, and treatment can be fraught with complications. The ideal scenario would be one in which these fractures are prevented. It is important that the surgeon has a through understanding of the principles of managing these fractures and has access to a variety of fixation and prosthetic devices and allograft bone when necessary in order to provide the best treatment. Because periprosthetic fractures range from the very simple (requiring no surgical intervention) to the complex (requiring major revision), a classification system of these fractures aids in understanding both the principles of management and results of treatment.

MR Imaging of Knee Arthroplasty Implants

PubMed Central

Fritz, Jan; Lurie, Brett

2015-01-01

Primary total knee arthroplasty is a highly effective treatment that relieves pain and improves joint function in a large percentage of patients. Despite an initially satisfactory surgical outcome, pain, dysfunction, and implant failure can occur over time. Identifying the etiology of complications is vital for appropriate management and proper timing of revision. Due to the increasing number of knee arthroplasties performed and decreasing patient age at implantation, there is a demand for accurate diagnosis to determine appropriate treatment of symptomatic joints following knee arthroplasty, and for monitoring of patients at risk. Magnetic resonance (MR) imaging allows for comprehensive imaging evaluation of the tissues surrounding knee arthroplasty implants with metallic components, including the polyethylene components. Optimized conventional and advanced pulse sequences can result in substantial metallic artifact reduction and afford improved visualization of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. In this review article, we discuss strategies for MR imaging around knee arthroplasty implants and illustrate the imaging appearances of common modes of failure, including aseptic loosening, polyethylene wear–induced synovitis and osteolysis, periprosthetic joint infections, fracture, patellar clunk syndrome, recurrent hemarthrosis, arthrofibrosis, component malalignment, extensor mechanism injury, and instability. A systematic approach is provided for evaluation of MR imaging of knee implants. MR imaging with optimized conventional pulse sequences and advanced metal artifact reduction techniques can contribute important information for diagnosis, prognosis, risk stratification, and surgical planning. ©RSNA, 2015 PMID:26295591

Is total hip arthroplasty safely performed in lung transplant patients? Current experience from a retrospective study of the Zurich lung transplant cohort.

PubMed

Schmitt, Jürgen W; Benden, Christian; Dora, Claudio; Werner, Clément M L

2016-01-01

In recent years, the number of lung transplants has increased rapidly, with higher quality of life and improved survival rates in transplant recipients, including patients with advanced age. This, in turn, means that more transplant recipients will seek musculoskeletal care to treat degenerative joint disease and also trauma incidents. Safety concerns regarding elective and posttraumatic hip arthroplasty in transplant patients include an increased risk of infection, wound healing problems, periprosthetic fractures and loosening of the implants. Clinical outcomes and safety aspects were retrospectively reviewed for five primary total hip arthroplasties (THA) in lung transplant recipients with minimal follow-up of two years at average of 2.6 (2-11) years. Patients were recruited from the Zurich Lung Transplant Center comprising of a cohort of 253 patients between January 1st, 2004 and December 31st, 2013. All five patients subjectively reported excellent outcomes after THA with a final average Harris Hip Score of 97 (86-100). One 71-year-old patient died 26 months after THA unrelated to arthroplasty. One superficial wound healing disturbance was documented. No periprosthetic fractures, no dislocations, no periprosthetic infections, no further revision surgery, no implant loosening was observed. In conclusion, THA can be safely and successfully performed even in lung transplant patients under long-term immunosuppressive therapy and polymedication, provided a multidisciplinary approach can be granted.

Endoglin (CD105) expression differentiates between aseptic loosening and periprosthetic joint infection after total joint arthroplasty.

PubMed

Jansen, Philipp; Mumme, Torsten; Randau, Thomas; Gravius, Sascha; Hermanns-Sachweh, Benita

2014-01-01

The differentiation between aseptic loosening and periprosthetic joint infection (PJI) after total joint arthroplasty is essential for successful therapy. A better understanding of pathogenesis of aseptic loosening and PJI may help to prevent or treat these complications. Previous investigations revealed an increased vascularization in the periprosthetic membrane in cases of PJI via PET signals. Based on these findings our hypothesis was that PJI is associated with an increased neovascularization in the periprosthetic membrane. Tissue samples from periprosthetic membranes of the bone-implant interface were investigated histologically for inflammation, wear particles, vascularization and fibrosis. To identify vascular structures antibodies against CD 31, CD 34, factor VIII and CD 105 (endoglin) were applied for immunohistochemical investigations. According to a consensus classification of Morawietz the tissue samples were divided into four types: type I (wear particle induced type, n = 11), type II (infectious type, n = 7), type III (combined type, n = 7) and type IV (indeterminate type, n = 7). Patients with PJI (type II) showed a pronounced infiltration of neutrophil granulocytes in the periprosthetic membrane and an enhanced neovascularization indicated by positive immunoreaction with antibodies against CD 105 (endoglin). Tissue samples classified as type I, type III and type IV showed significantly less immune reaction for CD 105. In cases of aseptic loosening and PJI vascularization is found in different expression in periprosthetic membranes. However, in aseptic loosening, there is nearly no neovascularization with CD 105-positive immune reaction. Therefore, endoglin (CD 105) expression allows for differentiation between aseptic loosening and PJI.

Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses.

PubMed

Tomaszewski, P K; Verdonschot, N; Bulstra, S K; Rietman, J S; Verkerke, G J

2012-11-01

Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditions, namely immediate post-amputation implantation and the conventional implantation after considerable time of socket prosthesis use. We questioned the difference in bone modeling response the implants provoked and if it could lead to premature bone fracture. Generic CT-based finite element models of an intact femoral bone and amputated bone implanted with models of two existing direct-fixation implants, the OPRA system (Integrum AB) and the ISP Endo/Exo prosthesis (ESKA Implants AG) were created for this study. Adaptive bone-remodeling simulations used the heel-strike and toe-off loads from a normal walking cycle. The bone loss caused by prolonged use of socket prosthesis had more severe effects on the ultimate bone quality than adaptation induced by the direct-fixation implants. Both implants showed considerable bone remodeling; the titanium screw implant (OPRA system) provoked more bone loss than the porous coated CoCrMo stem (ISP implant). The chance of the peri-prosthetic bone fracture remained higher for the post-socket case as compared to the direct amputation cases. In conclusion, both direct-fixation implants lead to considerable bone loss and bone loss is more severe after a prolonged period of post-socket use. Hence, from a biomechanical perspective it is better to limit the post-socket time and to re-design direct fixation devices to reduce bone loss and the probability of peri-prosthetic bone fractures. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Endoprosthesis failure in the ankle joint : Histopathological diagnostics and classification].

PubMed

Müller, S; Walther, M; Röser, A; Krenn, V

2017-03-01

Endoprostheses of the ankle joint show higher revision rates of 3.29 revisions per 100 component years. The aims of this study were the application and modification of the consensus classification of the synovia-like interface membrane (SLIM) for periprosthetic failure of the ankle joint, the etiological clarification of periprosthetic pseudocysts and a detailed measurement of proliferative activity (Ki67) in the region of osteolysis. Tissue samples from 159 patients were examined according to the criteria of the standardized consensus classification. Of these, 117 cases were derived from periprosthetic membranes of the ankle. The control group included 42 tissue specimens from the hip and knee joints. Particle identification and characterization were carried out using the particle algorithm. An immunohistochemical examination with Ki67 proliferation was performed in all cases of ankle pseudocysts and 19 control cases. The consensus classification of SLIM is transferrable to endoprosthetic failure of the ankle joint. Periprosthetic pseudocysts with the histopathological characteristics of the appropriate SLIM subtype were detectable in 39 cases of ankle joint endoprostheses (33.3%). The mean value of the Ki67 index was 14% and showed an increased proliferation rate in periprosthetic pseudocysts of the ankle (p-value 0.02037). In periprosthetic pseudocysts an above average higher detection rate of type 1 SLIM induced by abrasion (51.3%) with an increased Ki67 proliferation fraction (p-value 0.02037) was found, which can be interpreted as local destructive intraosseus synovialitis. This can be the reason for formation of pseudocystic osteolysis caused by high mechanical stress in ankle endoprostheses. A simplified diagnostic classification scoring system of dysfunctional endoprostheses of the ankle is proposed for collation of periprosthetic pseudocysts, ossifications and the Ki67 proliferation fraction.

[Patella fractures in knee arthroplasty].

PubMed

Roth, A; Ghanem, M; Fakler, J

2016-05-01

Periprosthetic patella fractures occur both with and without retropatellar joint replacement. A non-operative treatment yields satisfactory results with low morbidity. It can be applied in minimally displaced fractures that have an intact retropatellar component and an intact extensor mechanism, combined with an initial immobilization. The surgical treatment is associated with relatively poor results and with high complication rates. There was only minor improvement of functional results, no matter which surgical technique was used. Surgical intervention is still required in fractures with a loosening of the patellar component, considerable dislocations of fragments, and damage to or rupture of the extensor mechanism. In particular, type II fractures require repair of the extensor mechanism and the fracture or patellectomy. Type III fractures require a revision or resection of the patella, a patelloplasty or total patellectomy. In addition, early or late reconstruction using allograft to restore the extensor mechanism can be taken in consideration.

Bearing Change to Metal-On-Polyethylene for Ceramic Bearing Fracture in Total Hip Arthroplasty; Does It Work?

PubMed

Lee, Soong Joon; Kwak, Hong Suk; Yoo, Jeong Joon; Kim, Hee Joong

2016-01-01

We evaluated the short-term to midterm results of reoperation with bearing change to metal-on-polyethylene (MoP) after ceramic bearing fracture in ceramic-on-ceramic total hip arthroplasty. Nine third-generation ceramic bearing fractures (6 heads and 3 liners) were treated with bearing change to MoP. Mean age at reoperation was 52.7 years. Mean follow-up was 4.3 years. During follow-up, 2 of 3 liner-fractured hips and 1 of 6 head-fractured hips showed radiologic signs of metallosis and elevated serum chromium levels. Re-reoperation with bearing rechange to a ceramic head was performed for the hips with metallosis. One liner-fractured hip had periprosthetic joint infection. Dislocation occurred in 3 hips. From our experience, bearing change to MoP is not a recommended treatment option for ceramic bearing fracture in total hip arthroplasty. Copyright © 2016 Elsevier Inc. All rights reserved.

A comparative study of the therapeutic effect between long and short intramedullary nails in the treatment of intertrochanteric femur fractures in the elderly.

PubMed

Guo, Xue-Feng; Zhang, Ke-Ming; Fu, Hong-Bo; Cao, Wen; Dong, Qiang

2015-01-01

To compare the clinical effects of long vs. short intramedullary nails in the treatment of intertrochanteric fractures in old patients more than 65 years old. A retrospective analysis of 178 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted from January 2008 to December 2013. There were 85 males (47.8%) and 93 females (52.2%) with the age of 65e89 (70.2±10.8) years. The patients were treated by closed reduction and long or short intramedullary nail (Gamma 3) fixation. The length of short nail was 180 mm and that for long nail was 320e360 mm. The general data of patients, operation time, intraoperative blood loss, length of hospital stay, preoperative hemoglobin level, blood transfusion rate, postoperative periprosthetic fractures, infections, complications, etc were carefully recorded. There were 76 cases (42.7%) in the long intramedullary nail group and 102 cases (57.3%) in the short nail group. All the cases were followed up for 12e48 (21.3±6.8) months, during which there were 21 deaths (11.8%), mean (13.8±6.9) months after operation. The intraoperative blood loss was (90.7±50.6) ml in short nail group, greatly less than that in long nail group (127.8±85.9) ml (p=0.004). The short nail group also had a significantly shorter operation time (43.5 min±12.3 min vs. 58.5 min±20.3 min, p=0.002) and lower rate of postoperative transfusion (42.3% vs. 56.7%, p=0.041). But the length of hospital stay showed no big differences. After operation, in each group there was 1 case of periprosthetic fracture with a total incidence of 1.1%, 1.3% in long nail group and 0.9% in short nail group. At the end of the follow-up, all patients achieved bony union. The average healing time of the long nail group was (6.5±3.1) months, and the short nail group was (6.8±3.7) months, revealing no significant differences (p=0.09). Postoperative complications showed no great differences either. Both the intramedullary long and short nail fixation has a good clinical effect in treating intertrochanteric femur fractures in the elderly. They showed no significant difference in terms of therapeutic effect, hospital stay and postoperative complications. The incidence of periprosthetic fractures treated by either length of nails was low. But short intramedullary nailing can obviously decrease the intraoperative blood loss, operation time and postoperative blood transfusion.

Proximal femoral bone loss and increased rate of fracture with a proximally hydroxyapatite-coated femoral component.

PubMed

Radl, R; Aigner, C; Hungerford, M; Pascher, A; Windhager, R

2000-11-01

We performed a retrospective analysis of the clinical and radiological outcomes of total hip replacement using an uncemented femoral component proximally coated with hydroxyapatite. Of 136 patients, 118 who had undergone 124 primary total hip replacements were available for study. Their mean age was 66.5 years (19 to 90) and the mean follow-up was 5.6 years (4.25 to 7.25). At the final follow-up the mean Harris hip score was 92 (47.7 to 100). Periprosthetic femoral fractures, which occurred in seven patients (5.6%), were treated by osteosynthesis in six and conservatively in one. We had to revise five femoral components, one because of aseptic loosening, one because of septic loosening and three because of periprosthetic fracture. At the final follow-up there were definite signs of aseptic loosening in two patients. Radiologically, proximal femoral bone loss in Gruen zones I and VI was evident in 96.8% of hips, while bone hypertrophy in zones III and V was seen in 64.7%. In 24 hips (20.2%) the mean subsidence of the stem was 3.7 mm which occurred within the first 12 postoperative weeks. This indicated poor initial stability, which might have been aggravated by early weight-bearing. The high rate of failure in our study suggests that proximal femoral bone loss affects the long-term survival of the replacement.

Biomechanical Concepts for Fracture Fixation

PubMed Central

Bottlang, Michael; Schemitsch, Christine E.; Nauth, Aaron; Routt, Milton; Egol, Kenneth; Cook, Gillian E.; Schemitsch, Emil H.

2015-01-01

Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types, and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability. For unstable sacral fractures, “standard” iliosacral screw fixation is not sufficient for fractures with vertical or multiplanar instabilities. Periprosthetic femur fractures, in particular Vancouver B1 fractures, have increased stability when using 90/90 fixation versus a single locking plate. Far Cortical Locking combines the concept of dynamization with locked plating in order to achieve superior healing of a distal femur fracture. Finally, there is no ideal construct for syndesmotic fracture stabilization; however, these fractures should be fixed using a device that allows for sufficient motion in the syndesmosis. In general, orthopaedic surgeons should select a fracture fixation construct that restores stability and promotes healing at the fracture site, while reducing the potential for fixation failure. PMID:26584263

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

PubMed

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

Revision total hip arthroplasty: the femoral side using cemented implants.

PubMed

Holt, Graeme; Hook, Samantha; Hubble, Matthew

2011-02-01

Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures.

A systematic review of endoprosthetic replacement for non-tumour indications around the knee joint.

PubMed

Korim, Muhammad T; Esler, Colin N A; Reddy, Venuthurla R M; Ashford, Robert U

2013-12-01

Endoprosthetic replacement (EPR) for limb salvage is an established treatment modality for orthopaedic malignancies around the knee. Increasingly, they are being used for non-tumour indications such as fractures, bone loss associated with aseptic loosening, septic loosening and ligament insufficiencies. We reviewed the evolution and biomechanics of knee EPRs. MEDLINE was searched using the PubMed interface to identify relevant studies pertaining to the use of knee EPRs in non-tumour conditions. Failures, mortality and knee scores were the main outcome measures. Subgroup analysis in the non-tumour conditions was also performed. There were nine studies with an average follow-up of 3.3years (Range 1-5years) describing 241 EPRs used in non-tumour conditions. Re-operation for any reason occurred in 17% (41/241) of cases. The most common complication was infection (15%) followed by aseptic loosening (5%) and periprosthetic fractures (5%). The mortality rate averaged 22%. Infected knee arthroplasties were less likely to have a successful outcome when salvaged with an EPR with failure rates up to 33%. Endoprosthetic replacement is a limb salvage option when other surgical options are unfeasible, especially in low demand elderly patients with limited life expectancy. They have low rates of failure in the medium term. Level 1. Copyright © 2013 Elsevier B.V. All rights reserved.

Humeral windows in revision total elbow arthroplasty.

PubMed

Peach, Chris A; Salama, Amir; Stanley, David

2016-04-01

The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.

Novel biological strategies for treatment of wear particle-induced periprosthetic osteolysis of orthopaedic implants for joint replacement

PubMed Central

Goodman, S. B.; Gibon, E.; Pajarinen, J.; Lin, T.-H.; Keeney, M.; Ren, P.-G.; Nich, C.; Yao, Z.; Egashira, K.; Yang, F.; Konttinen, Y. T.

2014-01-01

Wear particles and by-products from joint replacements and other orthopaedic implants may result in a local chronic inflammatory and foreign body reaction. This may lead to persistent synovitis resulting in joint pain and swelling, periprosthetic osteolysis, implant loosening and pathologic fracture. Strategies to modulate the adverse effects of wear debris may improve the function and longevity of joint replacements and other orthopaedic implants, potentially delaying or avoiding complex revision surgical procedures. Three novel biological strategies to mitigate the chronic inflammatory reaction to orthopaedic wear particles are reported. These include (i) interference with systemic macrophage trafficking to the local implant site, (ii) modulation of macrophages from an M1 (pro-inflammatory) to an M2 (anti-inflammatory, pro-tissue healing) phenotype in the periprosthetic tissues, and (iii) local inhibition of the transcription factor nuclear factor kappa B (NF-κB) by delivery of an NF-κB decoy oligodeoxynucleotide, thereby interfering with the production of pro-inflammatory mediators. These three approaches have been shown to be viable strategies for mitigating the undesirable effects of wear particles in preclinical studies. Targeted local delivery of specific biologics may potentially extend the lifetime of orthopaedic implants. PMID:24478281

Unplanned hip arthroplasty imposes clinical and cost burdens on treating institutions.

PubMed

Kamath, Atul F; Austin, Daniel C; Derman, Peter B; Israelite, Craig L

2013-12-01

Emergent surgery has been shown to be a risk factor for perioperative complications. Studies suggest that patient morbidity is greater with an unplanned hip arthroplasty, although it is controversial whether unplanned procedures also result in higher patient mortality. The financial impact of these procedures is not fully understood, as the costs of unplanned primary hip arthroplasties have not been studied previously. We asked: (1) What are the institutional costs associated with unplanned hip arthroplasties (primary THA, hemiarthroplasty, revision arthroplasty, including treatment of periprosthetic fractures, dislocations, and infections)? (2) Does timing of surgery (urgent/unplanned versus elective) influence perioperative outcomes such as mortality, length of stay, or need for advanced care? (3) What diagnoses are associated with unplanned surgery and are treated urgently most often? (4) Do demographics and insurance status differ between admission types (unplanned versus elective hip arthroplasty)? We prospectively followed all 419 patients who were admitted to our Level I trauma center in 2011 for procedures including primary THA, hemiarthroplasty, and revision arthroplasty, including the treatment of periprosthetic fractures, dislocations, and infections. Fifty-seven patients who were treated urgently on an unplanned basis were compared with 362 patients who were treated electively. Demographics, admission diagnoses, complications, and costs were recorded and analyzed statistically. Median total costs were 24% greater for patients admitted for unplanned hip arthroplasties (USD 18,206 [USD 15,261-27,491] versus USD 14,644 [USD 13,511-16,309]; p < 0.0001) for patients admitted for elective arthroplasties. Patients with unplanned admissions had a 67% longer median hospital stay (5 days [range, 4-9 days] versus 3 days [range, 3-4 days]; p < 0.0001) for patients with elective admissions. Mortality rates were equivalent between groups (p = 1.0). Femoral fracture (p < 0.0001), periprosthetic fracture (p = 0.01), prosthetic infection (p = 0.005), and prosthetic dislocation (p < 0.0001) were observed at higher rates in the patients with unplanned admissions. These patients were older (p = 0.04), less likely to have commercial insurance (p < 0.0001), more likely to be transferred from another institution (p < 0.0001), and more likely to undergo a revision procedure (p < 0.0001). Unplanned arthroplasty and urgent surgery are associated with increased financial and clinical burdens, which must be accounted for when considering bundled quality and reimbursement measures for these procedures.

The biomechanics of plate fixation of periprosthetic femoral fractures near the tip of a total hip implant: cables, screws, or both?

PubMed

Shah, S; Kim, S Y R; Dubov, A; Schemitsch, E H; Bougherara, H; Zdero, R

2011-09-01

Femoral shaft fractures after total hip arthroplasty (THA) remain a serious problem, since there is no optimal surgical repair method. Virtually all studies that examined surgical repair methods have done so clinically or experimentally. The present study assessed injury patterns computationally by developing three-dimensional (3D) finite element (FE) models that were validated experimentally. The investigation evaluated three different constructs for the fixation of Vancouver B1 periprosthetic femoral shaft fractures following THA. Experimentally, three bone plate repair methods were applied to a synthetic femur with a 5 mm fracture gap near the tip of a total hip implant. Repair methods were identical distal to the fracture gap, but used cables only (construct A), screws only (construct B), or cables plus screws (construct C) proximal to the fracture gap. Specimens were oriented in 15 degrees adduction to simulate the single-legged stance phase of walking, subjected to 1000 N of axial force, and instrumented with strain gauges. Computationally, a linearly elastic and isotropic 3D FE model was developed to mimic experiments. Results showed excellent agreement between experimental and FE strains, yielding a Pearson linearity coefficient, R2, of 0.92 and a slope for the line of best data fit of 1.06. FE-computed axial stiffnesses were 768 N/mm (construct A), 1023 N/mm (construct B), and 1102 N/mm (construct C). FE surfaces stress maps for cortical bone showed Von Mises stresses, excluding peaks, of 0-8 MPa (construct A), 0-15 MPa (construct B), and 0-20 MPa (construct C). Cables absorbed the majority of load, followed by the plates and then the screws. Construct A yielded peak stress at one of the empty holes in the plate. Constructs B and C had similar bone stress patterns, and can achieve optimal fixation.

Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty.

PubMed

Lee, Y K; Ha, Y C; Yoo, J-I; Jo, W L; Kim, K-C; Koo, K H

2017-06-01

We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

Proposal for a histopathological consensus classification of the periprosthetic interface membrane

PubMed Central

Morawietz, L; Classen, R‐A; Schröder, J H; Dynybil, C; Perka, C; Skwara, A; Neidel, J; Gehrke, T; Frommelt, L; Hansen, T; Otto, M; Barden, B; Aigner, T; Stiehl, P; Schubert, T; Meyer‐Scholten, C; König, A; Ströbel, P; Rader, C P; Kirschner, S; Lintner, F; Rüther, W; Bos, I; Hendrich, C; Kriegsmann, J; Krenn, V

2006-01-01

Aims The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery. Methods Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria. Results Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter‐observer reproducibility sufficient (85%). Conclusion The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non‐infectious, non‐particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients. PMID:16731601

Proposal for a histopathological consensus classification of the periprosthetic interface membrane.

PubMed

Morawietz, L; Classen, R-A; Schröder, J H; Dynybil, C; Perka, C; Skwara, A; Neidel, J; Gehrke, T; Frommelt, L; Hansen, T; Otto, M; Barden, B; Aigner, T; Stiehl, P; Schubert, T; Meyer-Scholten, C; König, A; Ströbel, P; Rader, C P; Kirschner, S; Lintner, F; Rüther, W; Bos, I; Hendrich, C; Kriegsmann, J; Krenn, V

2006-06-01

The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery. Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria. Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter-observer reproducibility sufficient (85%). The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non-infectious, non-particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients.

Removal torque of nail interlocking screws is related to screw proximity to the fracture and screw breakage.

PubMed

White, Alexander A; Kubacki, Meghan R; Samona, Jason; Telehowski, Paul; Atkinson, Patrick J

2016-06-01

Studies have shown that titanium implants can be challenging to explant due to the material's excellent biocompatibility and resulting osseointegration. Clinically, titanium alloy nail interlocking screws may require removal to dynamize a construct or revise the nail due to nonunion, infection, pain, or periprosthetic fracture. This study was designed to determine what variables influence the removal torque for titanium alloy interlocking screws. An intramedullary nail with four interlocking screws was used to stabilize a 1-cm segmental femoral defect in a canine model for 16 weeks. The animals were observed to be active following a several-day recovery after surgery. In six animals, the femora and implanted nail/screws were first tested to failure in torsion to simulate periprosthetic fracture of an implant after which the screws were then removed. In four additional animals, the screws were removed without mechanical testing. Both intraoperative insertional and extraction torques were recorded for all screws. Mechanical testing to failure broke 10/24 screws. On average, the intact screws required 70% of the insertional torque during removal while broken screws only required 16% of the insertional torque (p < 0.001). In addition, intact screws closer to the fracture required 2.8 times more removal torque than the outboard distal screw (p < 0.005). On average, the angle of rotation to peak torque was ∼80°. The peak axial load did not significantly correlate with the torque required to remove the screws. On average, the removal torque was lower than at the time of insertion, and less torque was required to remove broken screws and screws remote to the fracture. However, broken screws will require additional time to retrieve the remaining screw fragment. This study suggests that broken screws and screws in prematurely active patients will require less torque to remove. © IMechE 2016.

Periprosthetic supracondylar femoral fractures following total knee arthroplasty: clinical comparison and related complications of the femur plate system and retrograde-inserted supracondylar nail.

PubMed

Gondalia, Viral; Choi, Duck Hyun; Lee, Su Chan; Nam, Chang Hyun; Hwang, Bo Hyun; Ahn, Hye Sun; Ong, Alvin C; Park, Ha Young; Jung, Kwang Am

2014-09-01

The purpose of this study is to analyze the clinical results and related complications of the femur plate system (FP) and the retrograde-inserted supracondylar nail (RISN). The study included 42 cases of periprosthetic supracondylar femoral fractures (PSF) proximal to posterior stabilized total knee arthroplasty between 2005 and 2009. Twenty-four cases of PSF were treated with the FP, and the other 18 cases were treated with the RISN. This study cohort was divided into subgroups according to the AO classification. We retrospectively compared the clinical results between the FP and RISN group. There were no significant differences between the two groups in terms of time of clinical union (p = 0.649). In the subgroup analysis, the mean operation time was significantly different only in subgroup A1 (p = 0.03). Complications were seen in 29.2 % (7/24) of patients in the FP group and 27.8 % (5/18) in the RISN group. The age during the index TKA and fracture fixation was a significant risk (p = 0.008) factor for complications between the two groups. No significant differences were found in the other factors between the two groups. The p value for operative time (p = 0.223), immobilization period (p = 0.129), ROM (p = 0.573), KSS (p = 0.379), KSS functional scores (p = 0.310) and time to union (p = 0.649). Clinical results did not differ according to the treatment methods used. Fixation method and fracture type did not cause an increase in the complication rate, but there was a trend toward higher non-union rates with the FP method and higher re-fracture rate with the RISN method. Noting the fact that only increasing age correlated with an increased complication rate, more careful attention should be paid to elderly patients in terms of both prevention and surgical care. Level III, therapeutic study.

Different thermal conductivity in drilling of cemented compared with cementless hip prostheses in the treatment of periprosthetic fractures of the proximal femur: an experimental biomechanical analysis.

PubMed

Brand, Stephan; Klotz, Johannes; Hassel, Thomas; Petri, Maximilian; Ettinger, Max; Krettek, Christian; Goesling, Thomas; Bach, Friedrich-Wilhelm

2013-10-01

The purpose of this study was to evaluate the different temperature levels whilst drilling cemented and cementless hip prostheses implanted in bovine femora, and to evaluate the insulating function of the cement layer. Standard hip prostheses were implanted in bovine donor diaphyses, with or without a cement layer. Drilling was then performed using high-performance-cutting drills with a reinforced core, a drilling diameter of 5.5 mm and cooling channels through the tip of the drill for constantly applied internal cooling solution. An open type cooling model was used in this setup. Temperature was continuously measured by seven thermocouples placed around the borehole. Thermographic scans were also performed during drilling. At the cemented implant surface, the temperature never surpassed 24.7 °C when constantly applied internal cooling was used. Without the insulating cement layer (i.e. during drilling of the cementless bone-prosthesis construct), the temperature increased to 47 °C. Constantly applied internal cooling can avoid structural bone and soft tissue damage during drilling procedures. With a cement layer, the temperatures only increased to non-damaging levels. The results could be useful in the treatment of periprosthetic fractures with intraprosthetic implant fixation.

Failed Reverse Total Shoulder Arthroplasty Caused by Recurrent Candida glabrata Infection with Prior Serratia marcescens Coinfection

PubMed Central

Skedros, John G.; Keenan, Kendra E.; Updike, Wanda S.; Oliver, Marquam R.

2014-01-01

This report describes a 58-year-old insulin-dependent diabetic male patient who initially sustained a proximal humerus fracture from a fall. The fracture fixation failed and then was converted to a humeral hemiarthroplasty, which became infected with Candida glabrata and Serratia marcescens. After these infections were believed to be cured with antibacterial and antifungal treatments and two-stage irrigation and debridement, he underwent conversion to a reverse total shoulder arthroplasty. Unfortunately, the C. glabrata infection recurred and, nearly 1.5 years after implantation of the reverse total shoulder, he had a resection arthroplasty (removal of all implants and cement). His surgical and pharmacologic treatment concluded with (1) placement of a tobramycin-impregnated cement spacer also loaded with amphotericin B, with no plan for revision arthroplasty (i.e., the spacer was chronically retained), and (2) chronic use of daily oral fluconazole. We located only three reported cases of Candida species causing infection in shoulder arthroplasties (two C. albicans, one C. parapsilosis). To our knowledge, a total shoulder arthroplasty infected with C. glabrata has not been reported, nor has a case of a C. glabrata and S. marcescens periprosthetic coinfection in any joint. In addition, it is well known that S. marcescens infections are uncommon in periprosthetic joint infections. PMID:25431708

Toll-like receptors and aseptic loosening of hip endoprosthesis-a potential to respond against danger signals?

PubMed

Lähdeoja, Tuomas; Pajarinen, Jukka; Kouri, Vesa-Petteri; Sillat, Tarvo; Salo, Jari; Konttinen, Yrjö T

2010-02-01

Bacterial remnants and subclinical biofilms residing on prosthesis surfaces have been speculated to play a role in hip implant loosening by opsonizing otherwise relatively inert wear particles. The innate immune system recognizes these microbial pathogen-associated molecular patterns (PAMPs) using Toll-like receptors (TLRs). Our objective was to evaluate the possible presence of TLRs in aseptic synovial membrane-like interface tissue. Bacterial culture-negative, aseptic (n = 4) periprosthetic synovial membrane-like tissue was compared to osteoarthritis synovial membrane (n = 5) for the presence of cells positive for all known human functional TLRs, stained using specific antibodies by immunohistochemistry, and evaluated using morphometry. In comparison to osteoarthtritic synovium, the number of TLR-positive cells was found to be increased in the aseptic setting, reflecting the considerable macrophage infiltration to the tissues investigated. Thus aseptic periprosthetic tissue seems to be very reactive to PAMPs. It has been recently recognized that TLR do not only respond to traditional PAMPs, but also to endogenous alarmings or danger signals released from necrotic and activated cells. Alarming-TLR interaction in the periprosthetic tissue might be a novel mechanism of aseptic loosening of endoprosthesis. (c) 2009 Orthopaedic Research Society.

Arthroscopic management of the painful total elbow arthroplasty.

PubMed

Phadnis, Joideep; Bain, Gregory I

2016-01-01

Failure of total elbow arthroplasty is more common than after other major joint arthroplasties and is often a result of aseptic loosening, peri-prosthetic infection, fracture and instability. Infection can be a devastating complication, yet there are no established guidelines for the pre-operative diagnosis of total elbow peri-prosthetic infection. This is because pre-operative clinical, radiographic and biochemical tests are often unreliable. Using three case examples, a standardized protocol for the clinical and arthroscopic assessment of the painful total elbow arthroplasty is described. This is used to provide a mechanical and microbiological diagnosis of the patient's pain. There have been no complications resulting from the use of this technique in the three patients described, nor in any other patient to date. The staged protocol described in the present study, utilizing arthroscopic assessment, has refined the approach to the painful total elbow arthroplasty because it directly influences the definitive surgical management of the patient. It is recommended that other surgeons follow the principles outlined in the present study when faced with this challenging problem.

Tangential Bicortical Locked Fixation Improves Stability in Vancouver B1 Periprosthetic Femur Fractures: A Biomechanical Study.

PubMed

Lewis, Gregory S; Caroom, Cyrus T; Wee, Hwabok; Jurgensmeier, Darin; Rothermel, Shane D; Bramer, Michelle A; Reid, John Spence

2015-10-01

The biomechanical difficulty in fixation of a Vancouver B1 periprosthetic fracture is purchase of the proximal femoral segment in the presence of the hip stem. Several newer technologies provide the ability to place bicortical locking screws tangential to the hip stem with much longer lengths of screw purchase compared with unicortical screws. This biomechanical study compares the stability of 2 of these newer constructs to previous methods. Thirty composite synthetic femurs were prepared with cemented hip stems. The distal femur segment was osteotomized, and plates were fixed proximally with either (1) cerclage cables, (2) locked unicortical screws, (3) a composite of locked screws and cables, or tangentially directed bicortical locking screws using either (4) a stainless steel locking compression plate system with a Locking Attachment Plate (Synthes) or (5) a titanium alloy Non-Contact Bridging system (Zimmer). Specimens were tested to failure in either axial or torsional quasistatic loading modes (n = 3) after 20 moderate load preconditioning cycles. Stiffness, maximum force, and failure mechanism were determined. Bicortical constructs resisted higher (by an average of at least 27%) maximum forces than the other 3 constructs in torsional loading (P < 0.05). Cables constructs exhibited lower maximum force than all other constructs, in both axial and torsional loading. The bicortical titanium construct was stiffer than the bicortical stainless steel construct in axial loading. Proximal fixation stability is likely improved with the use of bicortical locking screws as compared with traditional unicortical screws and cable techniques. In this study with a limited sample size, we found the addition of cerclage cables to unicortical screws may not offer much improvement in biomechanical stability of unstable B1 fractures.

Tangential Bicortical Locked Fixation Improves Stability in Vancouver B1 Periprosthetic Femur Fractures: A Biomechanical Study

PubMed Central

Lewis, Gregory S.; Caroom, Cyrus T.; Wee, Hwabok; Jurgensmeier, Darin; Rothermel, Shane D.; Bramer, Michelle A.; Reid, J. Spence

2015-01-01

Objectives The biomechanical difficulty in fixation of a Vancouver B1 periprosthetic fracture is purchase of the proximal femoral segment in the presence of the hip stem. Several newer technologies provide the ability to place bicortical locking screws tangential to the hip stem with much longer lengths of screw purchase compared to unicortical screws. This biomechanical study compares the stability of two of these newer constructs to previous methods. Methods Thirty composite synthetic femurs were prepared with cemented hip stems. The distal femur segment was osteotomized, and plates were fixed proximally with either: (1) cerclage cables; (2) locked unicortical screws; (3) a composite of locked screws and cables; or tangentially directed bicortical locking screws using either (4) a stainless steel LCP system with a Locking Attachment Plate (Synthes), or (5) a titanium alloy NCB system (Zimmer). Specimens were tested to failure in either axial or torsional quasi-static loading modes (n = 3) after 20 moderate load pre-conditioning cycles. Stiffness, maximum force, and failure mechanism were determined. Results Bicortical constructs resisted higher (by an average of at least 27%) maximum forces than the other three constructs in torsional loading (p<0.05). Cables constructs exhibited lower maximum force than all other constructs, in both axial and torsional loading. The bicortical titanium construct was stiffer than the bicortical stainless steel construct in axial loading. Conclusions Proximal fixation stability is likely improved with the use of bicortical locking screws as compared to traditional unicortical screws and cable techniques. In this study with a limited sample size, we found the addition of cerclage cables to unicortical screws may not offer much improvement in biomechanical stability of unstable B1 fractures. PMID:26053467

Better Axial Stiffness of a Bicortical Screw Construct Compared to a Cable Construct for Comminuted Vancouver B1 Proximal Femoral Fractures.

PubMed

Griffiths, Jamie T; Taheri, Arash; Day, Robert E; Yates, Piers J

2015-12-01

The aim of this study was to biomechanically evaluate the Locking attachment plate (LAP) construct in comparison to a Cable plate construct, for the fixation of periprosthetic femoral fractures after cemented total hip arthroplasty. Each construct incorporated a locking compression plate with bi-cortical locking screws for distal fixation. In the Cable construct, 2 cables and 2 uni-cortical locking screws were used for proximal fixation. In the LAP construct, the cables were replaced by a LAP with 4 bi-cortical locking screws. The LAP construct was significantly stiffer than the cable construct under axial load with a bone gap (P=0.01). The LAP construct offers better axial stiffness compared to the cable construct in the fixation of comminuted Vancouver B1 proximal femoral fractures. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Ceramic femoral component fracture in total knee arthroplasty: an analysis using fractography, fourier-transform infrared microscopy, contact radiography and histology.

PubMed

Krueger, Alexander P; Singh, Gurpal; Beil, Frank Timo; Feuerstein, Bernd; Ruether, Wolfgang; Lohmann, Christoph H

2014-05-01

Ceramic components in total knee arthroplasty (TKA) are evolving. We analyze the first case of BIOLOX delta ceramic femoral component fracture. A longitudinal midline fracture in the patellar groove was present, with an intact cement mantle and no bony defects. Fractographic analysis with laser scanning microscopy and white light interferometry showed no evidence of arrest lines, hackles, wake hackles, material flaws, fatigue or crack propagation. Analysis of periprosthetic tissues with Fourier-transform infrared (FT-IR) microscopy, contact radiography, histology, and subsequent digestion and high-speed centrifugation did not show ceramic debris. A macrophage-dominated response was present around polyethylene debris. We conclude that ceramic femoral component failure in this case was related to a traumatic event. Further research is needed to determine the suitability of ceramic components in TKA. Copyright © 2014 Elsevier Inc. All rights reserved.

[Proposal for the classification of the periprosthetic membrane from loosened hip and knee endoprostheses].

PubMed

Morawietz, L; Gehrke, Th; Classen, R-A; Barden, B; Otto, M; Hansen, T; Aigner, Th; Stiehl, P; Neidel, J; Schröder, J H; Frommelt, L; Schubert, Th; Meyer-Scholten, C; König, A; Ströbel, Ph; Rader, Ch P; Kirschner, S; Lintner, F; Rüther, W; Skwara, A; Bos, I; Kriegsmann, J; Krenn, V

2004-09-01

After 10 years, loosening of total joint endoprostheses occurs in about 3 to 10 percent of all patients, requiring elaborate revision surgery. A periprosthetic membrane is routinely found between bone and loosened prosthesis. Further histomorphological examination allows determination of the etiology of the loosening process. Aim of this study is the introduction of clearly defined histopathological criteria for a standardized evaluation of the periprosthetic membrane. Based on histomorphological criteria and polarized light microscopy, four types of the periprosthetic membrane were defined: periprosthetic membrane of wear particle type (type I), periprosthetic membrane of infectious type (type II), periprosthetic membrane of combined type (type III), periprosthetic membrane of indifferent type (type IV). Periprosthetic membranes of 268 patients were analyzed according to the defined criteria. The correlation between histopathological and microbiological diagnosis was high (89%, p<0,001), the inter-observer reproducibility was sufficient (95%). This classification system enables a standardized diagnostic procedure and therefore is a basis for further studies concerning the etiology of and pathogenesis of prosthesis loosening.

The efficiency of risedronate in reducing bone resorption after total hip arthroplasty: a meta-analysis of randomized control trials at a minimum of 6 months' follow-up.

PubMed

Yang, Liqing

2018-04-17

Recently risedronate is suggested to be effective for the prevention and treatment of for osteoporosis in total hip arthroplasty. This meta-analysis aimes to evaluate the efficacy of risedronate in reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty. A systematic search was performed in Medline (1966-31 October 2017), PubMed (1966-31 October 2017), Embase (1980-31 October 2017), ScienceDirect (1985-31 October 2017) and the Cochrane Library. Only randomized controlled trial (RCT) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata 11.0 software. The outcome measures included periprosthetic bone mineral density, length of stay and adverse effects. Four RCTs including 198 patients met the inclusion criteria. The present meta-analysis showed that there were significant differences between treatment groups in terms of periprosthetic bone mineral density in Gruen zones 1 (standard mean difference (SMD) = 0.758, 95% CI 0.469 to 1.047, P = 0.000), 2 (SMD = 0.814, 95% CI 0.523 to 1.106, P = 0.000), 3 (SMD = 0.340, 95% CI 0.059 to 0.622, P = 0.018), 6 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000), and 7 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000). Oral risedronate could significantly reduce periprosthetic bone resorption around an uncemented femoral stem (Gruen zones 1, 2, 3, 6, and 7) up to 6 months after THA. In addition, no severe adverse events were identified. Future trials of risedronate treatment after THA should focus on clinically relevant end points such as the risks of fracture and revision arthroplasty.

Preparation of the femoral bone cavity in cementless stems: broaching versus compaction

PubMed Central

Hjorth, Mette H; Stilling, Maiken; Søballe, Kjeld; Nielsen, Poul Torben; Christensen, Poul H; Kold, Søren

2016-01-01

Background and purpose — Short-term experimental studies have confirmed that there is superior fixation of cementless implants inserted with compaction compared to broaching of the cancellous bone. Patients and methods — 1-stage, bilateral primary THA was performed in 28 patients between May 2001 and September 2007. The patients were randomized to femoral bone preparation with broaching on 1 side and compaction on the other side. 8 patients declined to attend the postoperative follow-up, leaving 20 patients (13 male) with a mean age of 58 (36–70) years for evaluation. The patients were followed with radiostereometric analysis (RSA) at baseline, at 6 and 12 weeks, and at 1, 2, and 5 years, and measurements of periprosthetic bone mineral density (BMD) at baseline and at 1, 2, and 5 years. The subjective part of the Harris hip score (HHS) and details of complications throughout the observation period were obtained at a mean interval of 6.3 (3.0–9.5) years after surgery. Results — Femoral stems in the compaction group had a higher degree of medio-lateral migration (0.21 mm, 95% CI: 0.03–0.40) than femoral stems in the broaching group at 5 years (p = 0.02). No other significant differences in translations or rotations were found between the 2 surgical techniques at 2 years (p > 0.4) and 5 years (p > 0.7) postoperatively. There were no individual stems with continuous migration. Periprosthetic BMD in the 7 Gruen zones was similar at 2 years and at 5 years. Intraoperative femoral fractures occurred in 2 of 20 compacted hips, but there were none in the 20 broached hips. The HHS and dislocations were similar in the 2 groups at 6.3 (3.0–9.5) years after surgery. Interpretation — Bone compaction as a surgical technique with the Bi-Metric stem did not show the superior outcomes expected compared to conventional broaching. Furthermore, 2 periprosthetic fractures occurred using the compaction technique, so we cannot recommend compaction for insertion of the cementless Bi-Metric stem. PMID:27759486

Arthroscopic management of the painful total elbow arthroplasty

PubMed Central

Bain, Gregory I

2015-01-01

Background Failure of total elbow arthroplasty is more common than after other major joint arthroplasties and is often a result of aseptic loosening, peri-prosthetic infection, fracture and instability. Infection can be a devastating complication, yet there are no established guidelines for the pre-operative diagnosis of total elbow peri-prosthetic infection. This is because pre-operative clinical, radiographic and biochemical tests are often unreliable. Methods Using three case examples, a standardized protocol for the clinical and arthroscopic assessment of the painful total elbow arthroplasty is described. This is used to provide a mechanical and microbiological diagnosis of the patient’s pain. Results There have been no complications resulting from the use of this technique in the three patients described, nor in any other patient to date. Conclusions The staged protocol described in the present study, utilizing arthroscopic assessment, has refined the approach to the painful total elbow arthroplasty because it directly influences the definitive surgical management of the patient. It is recommended that other surgeons follow the principles outlined in the present study when faced with this challenging problem. PMID:27583000

An investigation of the inelastic behaviour of trabecular bone during the press-fit implantation of a tibial component in total knee arthroplasty.

PubMed

Kelly, N; Cawley, D T; Shannon, F J; McGarry, J P

2013-11-01

The stress distribution and plastic deformation of peri-prosthetic trabecular bone during press-fit tibial component implantation in total knee arthroplasty is investigated using experimental and finite element techniques. It is revealed that the computed stress distribution, implantation force and plastic deformation in the trabecular bone is highly dependent on the plasticity formulation implemented. By incorporating pressure dependent yielding using a crushable foam plasticity formulation to simulate the trabecular bone during implantation, highly localised stress concentrations and plastic deformation are computed at the bone-implant interface. If the pressure dependent yield is neglected using a traditional von Mises plasticity formulation, a significantly different stress distribution and implantation force is computed in the peri-prosthetic trabecular bone. The results of the study highlight the importance of: (i) simulating the insertion process of press-fit stem implantation; (ii) implementing a pressure dependent plasticity formulation, such as the crushable foam plasticity formulation, for the trabecular bone; (iii) incorporating friction at the implant-bone interface during stem insertion. Simulation of the press-fit implantation process with an appropriate pressure dependent plasticity formulation should be implemented in the design and assessment of arthroplasty prostheses. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.

Bone density and anisotropy affect periprosthetic cement and bone stresses after anatomical glenoid replacement: A micro finite element analysis.

PubMed

Chevalier, Yan; Santos, Inês; Müller, Peter E; Pietschmann, Matthias F

2016-06-14

Glenoid loosening is still a main complication for shoulder arthroplasty. We hypothesize that cement and bone stresses potentially leading to fixation failure are related not only to glenohumeral conformity, fixation design or eccentric loading, but also to bone volume fraction, cortical thickness and degree of anisotropy in the glenoid. In this study, periprosthetic bone and cement stresses were computed with micro finite element models of the replaced glenoid depicting realistic bone microstructure. These models were used to quantify potential effects of bone microstructural parameters under loading conditions simulating different levels of glenohumeral conformity and eccentric loading simulating glenohumeral instability. Results show that peak cement stresses were achieved near the cement-bone interface in all loading schemes. Higher stresses within trabecular bone tissue and cement mantle were obtained within specimens of lower bone volume fraction and in regions of low anisotropy, increasing with decreasing glenohumeral conformity and reaching their maxima below the keeled design when the load is shifted superiorly. Our analyses confirm the combined influences of eccentric load shifts with reduced bone volume fraction and anisotropy on increasing periprosthetic stresses. They finally suggest that improving fixation of glenoid replacements must reduce internal cement and bone tissue stresses, in particular in glenoids of low bone density and heterogeneity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Osteolysis of the femur: principles of management.

PubMed

Dunbar, M J; Blackley, H R; Bourne, R B

2001-01-01

Femoral osteolysis is and will remain an important cause of THA failures. The presentation is initially radiographic and patients may or may not become symptomatic. If so, pain is the most common symptom. Infection is the most common differential diagnosis and must be excluded. Osteolysis is usually progressive and may eventually lead to loss of implant fixation, implant fracture, or periprosthetic fracture. Multiple factors influence the decision to revise a femoral component, including the degree and type of bone loss, the rate at which it is progressing, the potential for fracture, the degree of symptoms, especially pain, and the activity level and general health of the patient. There are many options for revising failed femoral stems, each with varying degrees of success. The choice of technique and prosthesis used in the revision can be guided by a simple bone defect classification presented in this chapter. Revision of femoral components in these patients can be fraught with complications and poor results; hence, the importance of preoperative planning cannot be overemphasized.

Periprosthetic Artifact Reduction Using Virtual Monochromatic Imaging Derived From Gemstone Dual-Energy Computed Tomography and Dedicated Software.

PubMed

Reynoso, Exequiel; Capunay, Carlos; Rasumoff, Alejandro; Vallejos, Javier; Carpio, Jimena; Lago, Karen; Carrascosa, Patricia

2016-01-01

The aim of this study was to explore the usefulness of combined virtual monochromatic imaging and metal artifact reduction software (MARS) for the evaluation of musculoskeletal periprosthetic tissue. Measurements were performed in periprosthetic and remote regions in 80 patients using a high-definition scanner. Polychromatic images with and without MARS and virtual monochromatic images were obtained. Periprosthetic polychromatic imaging (PI) showed significant differences compared with remote areas among the 3 tissues explored (P < 0.0001). No significant differences were observed between periprosthetic and remote tissues using monochromatic imaging with MARS (P = 0.053 bone, P = 0.32 soft tissue, and P = 0.13 fat). However, such differences were significant using PI with MARS among bone (P = 0.005) and fat (P = 0.02) tissues. All periprosthetic areas were noninterpretable using PI, compared with 11 (9%) using monochromatic imaging. The combined use of virtual monochromatic imaging and MARS reduced periprosthetic artifacts, achieving attenuation levels comparable to implant-free tissue.

Fracture toughness of dentin/resin-composite adhesive interfaces.

PubMed

Tam, L E; Pilliar, R M

1993-05-01

The reliability and validity of tensile and shear bond strength determinations of dentin-bonded interfaces have been questioned. The fracture toughness value (KIC) reflects the ability of a material to resist crack initiation and unstable propagation. When applied to an adhesive interface, it should account for both interfacial bond strength and inherent defects at or near the interface, and should therefore be more appropriate for characterization of interface fracture resistance. This study introduced a fracture toughness test for the assessment of dentin/resin-composite bonded interfaces. The miniature short-rod specimen geometry was used for fracture toughness testing. Each specimen contained a tooth slice, sectioned from a bovine incisor, to form the bonded interface. The fracture toughness of an enamel-bonded interface was assessed in addition to the dentin-bonded interfaces. Tensile bond strength specimens were also prepared from the dentin surfaces of the cut bovine incisors. A minimum of ten specimens was fabricated for each group of materials tested. After the specimens were aged for 24 h in distilled water at 37 degrees C, the specimens were loaded to failure in an Instron universal testing machine. There were significant differences (p < 0.05) between the dental adhesives tested. Generally, both the fracture toughness and tensile bond strength measurements were highest for AllBond 2, intermediate for 3M MultiPurpose, and lowest for Scotchbond 2. Scanning electron microscopy of the fractured specimen halves confirmed that crack propagation occurred along the bond interface during the fracture toughness test. It was therefore concluded that the mini-short-rod fracture toughness test provided a valid method for characterization of the fracture resistance of the dentin-resin composite interface.

Periprosthetic osteolysis after AES total ankle replacement: Conventional radiography versus CT-scan.

PubMed

Viste, Anthony; Al Zahrani, Nader; Brito, Nuno; Lienhart, Christophe; Fessy, Michel Henri; Besse, Jean-Luc

2015-09-01

The aim of this study was to compare conventional X-rays and CT-scan in detecting peri-prosthetic osteolytic lesions, a major concern after total ankle replacement (TAR). We prospectively assessed 50 patients (mean age 56 years), consecutively operated on by the same senior surgeon, between 2003 and 2006 and with a mean follow-up period of 4 years (range, 2-6.2). The component used was AES total ankle replacement. The etiologies for total ankle arthroplasty were: posttraumatic in 50%, osteoarthritis secondary to instability in 36%. Plain radiographs were analyzed by 4 independent observers, using a 10-zone protocol (location) and 5 size categories. At 4-year follow-up, all patients had been CT-scan assessed with the same protocol by 2 independent observers. Plain radiographs showed dramatic progression of severe periprosthetic lyses (>10mm): from 14% to 36% of interface cysts for the tibial component respectively at 2 and 4-year follow-up and from 4% to 30% for the talar implant. The talar component was more accurately assessed by CT-scan (mean frontal and sagittal talar lesion: from 270 mm2 to 288 mm2 for CT-scan versus 133 mm2 to 174 mm2 for X-rays). For tibial cysts, axial views showed larger lesions (313 mm2 than frontal (194 mm2) or sagittal (213.5 mm2) views. At 4-year follow-up, 24% of patients had revision with curetage or arthrodesis, and at 7 years follow-up 38% were revised. These results are similar to recent AES series, justifying withdrawal of this device. CT-scan was more accurate than X-rays for detecting and quantifying periprosthetic osteolysis. We recommend a yearly radiological control and CT-scan in case of lesion on X-rays. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Radiographic Measurement of Displacement in Acetabular Fractures: A Systematic Review of the Literature.

PubMed

Dodd, Andrew; Osterhoff, Georg; Guy, Pierre; Lefaivre, Kelly A

2016-06-01

To report methods of measurement of radiographic displacement and radiographic outcomes in acetabular fractures described in the literature. A systematic review of the English literature was performed using EMBASE and Medline in August 2014. Inclusion criteria were studies of operatively treated acetabular fractures in adults with acute (<6 weeks) open reduction and internal fixation that reported radiographic outcomes. Exclusion criteria included case series with <10 patients, fractures managed >6 weeks from injury, acute total hip arthroplasty, periprosthetic fractures, time frame of radiographic outcomes not stated, missing radiographic outcome data, and non-English language articles. Basic information collected included journal, author, year published, number of fractures, and fracture types. Specific data collected included radiographic outcome data, method of measuring radiographic displacement, and methods of interpreting or categorizing radiographic outcomes. The number of reproducible radiographic measurement techniques (2/64) and previously described radiographic interpretation methods (4) were recorded. One radiographic reduction grading criterion (Matta) was used nearly universally in articles that used previously described criteria. Overall, 70% of articles using this criteria documented anatomic reductions. The current standard of measuring radiographic displacement in publications dealing with acetabulum fractures almost universally lacks basic description, making further scientific rigor, such as testing reproducibility, impossible. Further work is necessary to standardize radiographic measurement techniques, test their reproducibility, and qualify their validity or determine which measurements are important to clinical outcomes. Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Effect of lubricant composition on the fatigue properties of ultra-high molecular weight polyethylene for total knee replacement.

PubMed

Aurora, A; DesJardins, J D; Joseph, P F; LaBerge, M

2006-05-01

Ultrahigh molecular weight polyethylene (UHMWPE) fatigue is a critical factor affecting the longevity of total knee replacement (TKR) bearings. With the increased need for laboratory studies to mimic near in vivo conditions for accurate characterization of material performance, the present study investigated the role of hyaluronic acid (HA) in testing lubricant on the crack growth response of UHMWPE. It was hypothesized that the change in lubricant viscosity as a result of HA would affect the fatigue life of the polymer. A fracture mechanics approach as per ASTM E 647 was adopted for this study. Surface micrograph and surface chemistry analyses were employed to study the micromechanisms of fatigue failure and protein adsorption of the specimen surfaces. Rheological analysis indicated that the addition of HA to diluted bovine serum increased testing lubricant viscosity. HA concentrations of 2.22, 0.55, and 1.5 g/l closely matched the viscosity ranges reported for osteoarthritis, rheumatoid arthritic diseased joint fluid, and periprosthetic fluids respectively. Results showed that the addition of HA to standard diluted bovine serum lubricants, in concentrations similar to that of periprosthetic fluid, delayed crack initiation and crack growth during fatigue testing.

Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties

PubMed Central

2009-01-01

Background Necrosis and inflammation in peri-implant soft tissues have been described in failed second-generation metal-on-metal (MoM) resurfacing hip arthroplasties and in the pseudotumors associated with these implants. The precise frequency and significance of these tissue changes is unknown. Method We analyzed morphological and immunophenotypic changes in the periprosthetic soft tissues and femoral heads of 52 revised MoM arthroplasties (fracture in 21, pseudotumor in 13, component loosening in 9, and other causes in 9 cases). Results Substantial necrosis was observed in the periprosthetic connective tissue in 28 of the cases, including all pseudotumors, and 5 cases of component loosening. A heavy, diffuse inflammatory cell infiltrate composed mainly of HLA-DR+/CD14+/CD68+ macrophages and CD3+ T cells was seen in 45 of the cases. Perivascular lymphoid aggregates composed of CD3+ cells and CD20+ B cells were noted in 27 of the cases, but they were not seen in all cases of component loosening or pseudotumors. Plasma cells were noted in 30 cases. Macrophage granulomas were noted in 6 cases of component loosening. In the bone marrow of the femoral head, a macrophage and T cell response was seen in 31 of the cases; lymphoid aggregates were noted in 19 of the cases and discrete granulomas in 1 case. Interpretation Our findings indicate that there is a spectrum of necrotic and inflammatory changes in response to the deposition of cobalt-chrome (Co-Cr) wear particles in periprosthetic tissues. Areas of extensive coagulative necrosis and a macrophage and T lymphocyte response occur in implant failure and pseudotumors, in which there is also granuloma formation. The pathogenesis of these changes is uncertain but it may involve both a cytotoxic response and a delayed hypersensitivity (type IV) response to Co-Cr particles. PMID:19995315

Reverse total shoulder arthroplasty

PubMed Central

Familiari, Filippo; Rojas, Jorge; Nedim Doral, Mahmut; Huri, Gazi; McFarland, Edward G.

2018-01-01

Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased. Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff. RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching. Current controversies in RTSA include optimal baseplate positioning, humeral neck-shaft angle (135° versus 155°), glenosphere placement (medial, lateral or bony increased offset RTSA) and subscapularis repair. Improvements in prosthesis design, surgeon experience and clinical results will need to occur to optimize this treatment for many shoulder conditions. Cite this article: EFORT Open Rev 2018;3:58–69 DOI: 10.1302/2058-5241.3.170044 PMID:29657846

What are the causes of revision total knee arthroplasty in Japan?

PubMed

Kasahara, Yasuhiko; Majima, Tokifumi; Kimura, Shoichi; Nishiike, Osamu; Uchida, Jun

2013-05-01

There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries. We therefore determined (1) causes of revision TKA in a cohort of Japanese patients with revision TKA and (2) whether patient demographic features and underlying diagnosis of primary TKA are associated with the causes of revision TKA. We assessed all revision TKA procedures performed at five major centers in Hokkaido from 2006 to 2011 for the causes of failures. Demographic data and underlying diagnosis for index primary TKA of the revision cases were compared to those of randomly selected primary TKAs during the same period. One hundred forty revision TKAs and 4047 primary TKAs were performed at the five centers, indicating a revision burden of 3.3%. The most common cause of revision TKA was mechanical loosening (40%) followed by infection (24%), wear/osteolysis (9%), instability (9%), implant failure (6%), periprosthetic fracture (4%), and other reasons (8%). The mean age of patients with periprosthetic fracture was older (77 versus 72 years) and the male proportion in patients with infection was higher (33% versus 19%) than those of patients in the primary TKA group. There was no difference in BMI between primary TKAs and any type of revision TKA except other causes. The revision burden at the five referral centers in Hokkaido was 3.3%, and the most common cause of revision TKA was mechanical loosening followed by infection. Demographic data such as age and sex might be associated with particular causes of revision TKA.

Surgical anatomy of the radial nerve in the deltopectoral approach for revision shoulder arthroplasty and periprosthetic fracture fixation: a cadaveric study.

PubMed

Fu, Michael C; Hendel, Michael D; Chen, Xiang; Warren, Russell F; Dines, David M; Gulotta, Lawrence V

2017-12-01

Radial nerve injury is a rare but clinically significant complication of revision shoulder arthroplasty and fixation of native and periprosthetic proximal humeral fractures. Understanding of the anatomic relationship between the radial nerve as it enters the humeral spiral groove and anterior shoulder landmarks in a deltopectoral approach is necessary to avoid iatrogenic radial nerve injury. Eight forequarter cadaveric specimens were dissected through a deltopectoral approach. Distances between the radial nerve entry into the proximal spiral groove and the coracoid process, distal lesser tuberosity/inferior subscapularis insertion, superior latissimus insertion, and inferior latissimus insertion were measured. Means, standard deviations, and ranges were determined for each distance. The radial nerve entry into the proximal spiral groove averaged 133.1 mm (range, 110.3-153.0 mm) from the coracoid process, 101.9 mm (range, 76.5-124.3 mm) from the distal lesser tuberosity/inferior subscapularis insertion, 81.0 mm (range, 63.4-101.5 mm) from the superior latissimus insertion, and 39.6 mm (range, 25.5-55.4 mm) from the inferior latissimus insertion. The proximal spiral groove was distal to the inferior latissimus insertion in all specimens. The risk of iatrogenic injury to the radial nerve at the spiral groove may be minimized through proper identification and protection or avoidance of circumferential fixation. However, if encircling fixation with cerclage cables is necessary, instrumentation proximal to the inferior edge of the latissimus dorsi insertion may reduce the risk of radial nerve injury. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Multiple Periprosthetic Joint Infections: Evidence for Decreasing Prevalence.

PubMed

Haverstock, John P; Somerville, Lyndsa E; Naudie, Douglas D; Howard, James L

2016-12-01

Multiple periprosthetic joint infections (MPJIs) are uncommon. We determine the prevalence of developing a second-site periprosthetic joint infection. Our institutional arthroplasty database was reviewed. Those who developed a second-site infection had a retrospective chart review to determine the pathogen, timing of infection, comorbidities, and results of treatment. Thirteen of 206 (6.3%) patients at-risk for MPJI experienced a second periprosthetic joint infection. Mode of the second infection was hematogenous in 6, all of whom were being treated for the index periprosthetic joint infection. Seven secondary infections did not relate to the index infection. Two patients were lost to follow-up, 5 continued on suppressive antibiotics, and 6 successfully cleared infection. The prevalence of MPJI has decreased compared with previous reports. Copyright © 2016 Elsevier Inc. All rights reserved.

The operative outcomes of displaced medial-end clavicle fractures.

PubMed

Sidhu, Verinder S; Hermans, Deborah; Duckworth, David G

2015-11-01

Nonoperative treatment of displaced medial clavicle fractures often leads to poor functional outcomes and painful nonunions. This study investigates the functional outcomes of patients undergoing operative fixation of these fractures. We investigated 27 patients undergoing operative fixation of a medial clavicle fracture; 24 had an acute, displaced fracture and 3 had fixation for nonunions. Preoperative radiographs or computed tomography scans were obtained, and data collected included age, sex, mechanism of injury, and fixation method. Follow-up included physical examination and radiographs for assessment of union; Disabilities of the Arm, Shoulder, and Hand scores at 12 months; and the recording of complications. The median age was 37 years (interquartile range, 17-47 years). There were 26 male patients and one female patient included, with 7 physeal injuries and 20 adult injuries. The most common mechanism of fracture was vehicular accident (n = 15). Three patients had operations for nonunions and 2 for a periprosthetic fracture medial to an existing plate. The fracture was fixed with plate and screws in 19 cases and with transosseous sutures in 8 cases. The median Disabilities of the Arm, Shoulder, and Hand score at 12 months was 0.4 (interquartile range, 0-5.0), with a union rate of 100% at 12 months. All patients had full shoulder range of motion at final follow-up and were able to return to preinjury occupational activities. There were no significant complications. Operative fixation of displaced medial clavicle fractures results in anatomic reconstruction and excellent functional outcomes, even in the setting of fixation performed for symptomatic nonunion. Early intervention can minimize the risk of painful nonunion. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Fracture mechanics analyses of ceramic/veneer interface under mixed-mode loading.

PubMed

Wang, Gaoqi; Zhang, Song; Bian, Cuirong; Kong, Hui

2014-11-01

Few studies have focused on the interface fracture performance of zirconia/veneer bilayered structure, which plays an important role in dental all-ceramic restorations. The purpose of this study was to evaluate the fracture mechanics performance of zirconia/veneer interface in a wide range of mode-mixities (at phase angles ranging from 0° to 90°), and to examine the effect of mechanical properties of the materials and the interface on the fracture initiation and crack path of an interfacial crack. A modified sandwich test configuration with an oblique interfacial crack was proposed and calibrated to choose the appropriate geometry dimensions by means of finite element analysis. The specimens with different interface inclination angles were tested to failure under three-point bending configuration. Interface fracture parameters were obtained with finite element analyses. Based on the interfacial fracture mechanics, three fracture criteria for crack kinking were used to predict crack initiation and propagation. In addition, the effects of residual stresses due to coefficient of thermal expansion mismatch between zirconia and veneer on the crack behavior were evaluated. The crack initiation and propagation were well predicted by the three fracture criteria. For specimens at phase angle of 0, the cracks propagated in the interface; whereas for all the other specimens the cracks kinked into the veneer. Compressive residual stresses in the veneer can improve the toughness of the interface structure. The results suggest that, in zirconia/veneer bilayered structure the veneer is weaker than the interface, which can be used to explain the clinical phenomenon that veneer chipping rate is larger than interface delamination rate. Consequently, a veneer material with larger fracture toughness is needed to decrease the failure rate of all-ceramic restorations. And the coefficient of thermal expansion mismatch of the substrates can be larger to produce larger compressive stresses in the veneer. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implant salvage in breast reconstruction with severe peri-prosthetic infection.

PubMed

Meybodi, Farid; Sedaghat, Negin; French, James; Keighley, Caitlin; Mitchell, David; Elder, Elisabeth

2017-12-01

Although treatment of mild peri-prosthetic infection in implant-based breast reconstruction results in high rates of resolution, successful management of severe peri-prosthetic infection remains a significant challenge. In this case series, a protocol utilizing a novel dressing - negative pressure wound therapy with instillation (NPWTi) - for the management of severe peri-prosthetic infection in breast reconstruction patients is described. This is an operative technique involving: (i) explantation of the breast prosthesis and application of the NPWTi dressing to the implant pocket; (ii) change of the NPWTi dressing; (iii) intraoperative fluid/tissue cultures; and (iv) reimplantation of the breast prosthesis when cultures yield no growth. This protocol was utilized in six cases of severe peri-prosthetic infection in five patients with immediate breast reconstruction for breast cancer or risk-reducing surgery. Cultures of fluid/tissue grew typical and/or unusual organisms. Only one case did not yield an organism. The hospital length of stay upon completion of the protocol ranged from 7-16 days (mean, 12 days). Successful implant salvage was achieved in five of six cases. The protocol was aborted in one case to allow for completion of adjuvant chemotherapy. Early findings from this case series suggest that in cases of severe peri-prosthetic infection this novel operative protocol may result in successful implant salvage for breast reconstruction patients. Further studies are needed to more fully elaborate the role of NPWTi to achieve implant salvage in challenging cases of peri-prosthetic infection. © 2015 Royal Australasian College of Surgeons.

Combined measurement of synovial fluid α-Defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection.

PubMed

Deirmengian, Carl; Kardos, Keith; Kilmartin, Patrick; Cameron, Alexander; Schiller, Kevin; Parvizi, Javad

2014-09-03

The diagnosis of periprosthetic joint infection remains a challenge. The purpose of this study was to evaluate the combined measurement of the levels of two synovial fluid biomarkers, α-defensin and C-reactive protein (CRP), for the diagnosis of periprosthetic joint infection. One hundred and forty-nine synovial fluid aspirates, including 112 from patients with an aseptic diagnosis and thirty-seven from patients with periprosthetic joint infection, met the inclusion criteria for this prospective study. Synovial fluid aspirates were tested for α-defensin and CRP levels with use of enzyme-linked immunosorbent assay (ELISA). The Musculoskeletal Infection Society (MSIS) definition of periprosthetic joint infection was utilized for the classification of cases as aseptic or infected. Comorbidities, such as inflammatory conditions, that could confound a test for periprosthetic joint infection were documented, but the patients with such comorbidities were included in the study. The combination of synovial fluid α-defensin and CRP tests demonstrated a sensitivity of 97% and a specificity of 100% for the diagnosis of periprosthetic joint infection. Synovial fluid α-defensin tests alone demonstrated a sensitivity of 97% and a specificity of 96% for the diagnosis of periprosthetic joint infection. Synovial fluid CRP tests, with a low threshold of 3 mg/L, reversed all-false positive α-defensin results without affecting the sensitivity of the test. The diagnostic characteristics of these assays were achieved in a population of patients demonstrating a 23% rate of systemic inflammatory diseases (in the series as a whole) and a 27% rate of concurrent antibiotic treatment (in the infection group). The synovial fluid levels of α-defensin in the setting of periprosthetic joint infection were unchanged during concurrent antibiotic treatment. The combined measurement of synovial fluid α-defensin and CRP levels correctly diagnosed 99% of the cases in this study as aseptic or infected. This was achieved despite the inclusion of patients with systemic inflammatory disease and those receiving treatment with antibiotics. Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

PubMed

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

Inflammation, Fracture and Bone Repair

PubMed Central

Loi, Florence; Córdova, Luis A.; Pajarinen, Jukka; Lin, Tzu-hua; Yao, Zhenyu; Goodman, Stuart B.

2016-01-01

The reconstitution of lost bone is a subject that is germane to many orthopaedic conditions including fractures and non-unions, infection, inflammatory arthritis, osteoporosis, osteonecrosis, metabolic bone disease, tumors, and periprosthetic particle-associated osteolysis. In this regard, the processes of acute and chronic inflammation play an integral role. Acute inflammation is initiated by endogenous or exogenous adverse stimuli, and can become chronic in nature if not resolved by normal homeostatic mechanisms. Dysregulated inflammation leads to increased bone resorption and suppressed bone formation. Crosstalk amongst inflammatory cells (polymorphonuclear leukocytes and cells of the monocyte-macrophage-osteoclast lineage) and cells related to bone healing (cells of the mesenchymal stem cell-osteoblast lineage and vascular lineage) is essential to the formation, repair and remodeling of bone. In this review, the authors provide a comprehensive summary of the literature related to inflammation and bone repair. Special emphasis is placed on the underlying cellular and molecular mechanisms, and potential interventions that can favorably modulate the outcome of clinical conditions that involve bone repair. PMID:26946132

Field and numerical descriptions of fracture geometries and terminations in chalk containing chert layers and inclusions; implications for groundwater flow in Danish chalk aquifers

NASA Astrophysics Data System (ADS)

Seyum, S.

2017-12-01

This study is a description of the fracture distribution in laterally discontinuous chalk and chert layers, with an investigation on how fracture lengths and apertures vary as a function of applied stresses, material properties, and interface properties. Natural fractures intersect laterally extensive, discontinuous, chalk-chert material interfaces in 62 million-year old to 72 million-year old Chalk Group formations exposed at Stevns Klint, Denmark. Approximately one-third of Denmark's fresh water use is from chalk and limestone regional aquifers of the Chalk Group formations, where rock permeability is dominantly a function of open fracture connectivities. Fractured, centimeter- to decimeter-thick chert layers and inclusions (101 GPa elastic stiffness) are interlayered with fractured, meter-thick chalk layers (100 GPa elastic stiffness). Fractures are observed to terminate against and cross chalk-chert interfaces, affecting the vertical flow of water and pollutants between aquifers. The discontinuous and variably thin nature of chert layers at Stevns Klint effectively merges adjacent fracture-confining layers of chalk along discrete position intervals, resulting in lateral variability of fracture spacing. Finite element numerical models are designed to describe fracture interactions with stiff, chert inclusions of various shapes, thicknesses, widths, orientations, and interface friction and fracture toughness values. The models are two-dimensional with isotropic, continuous material in plane strain and uniformly applied remote principal stresses. These characteristics are chosen based on interpretations of the petrophysics of chalk and chert, the burial history of the rock, and the scale of investigation near fracture tips relative to grain sizes. The result are value ranges for relative stiffness contrasts, applied stresses, and material interface conditions that would cause fractures to cross, terminate at, or form along chalk-chert interfaces, with emphasis on conditions that reproduce measured fracture geometries. The results of this study provide predictive, field-supported fracture geometries for flow models and, with appropriate changes to the parameters, the methodology is applicable to describing fracture geometries in chalk hydrocarbon systems.

Treatment of Periprosthetic Infections: An Economic Analysis

PubMed Central

Hernández-Vaquero, Daniel; Fernández-Fairen, Mariano; Torres, Ana; Menzie, Ann M.; Fernández-Carreira, José Manuel; Murcia-Mazon, Antonio; Merzthal, Luis

2013-01-01

This review summarizes the existing economic literature, assesses the value of current data, and presents procedures that are the less costly and more effective options for the treatment of periprosthetic infections of knee and hip. Optimizing antibiotic use in the prevention and treatment of periprosthetic infection, combined with systemic and behavioral changes in the operating room, the detection and treatment of high-risk patient groups, as well as the rational management of the existing infection by using the different procedures according to each particular case, could allow for improved outcomes and lead to the highest quality of life for patients and the lowest economic impact. Nevertheless, the costeffectiveness of different interventions to treat periprosthetic infections remains unclear. PMID:23781163

Osseointegration into a Novel Titanium Foam Implant in the Distal Femur of a Rabbit

PubMed Central

Willie, Bettina M.; Yang, Xu; Kelly, Natalie H.; Merkow, Justin; Gagne, Shawn; Ware, Robin; Wright, Timothy M.; Bostrom, Mathias P.G.

2010-01-01

A novel porous titanium foam implant has recently been developed to enhance biological fixation of orthopaedic implants to bone. The aim of this study was to examine the mechanical and histological characteristics of bone apposition into two different pore sizes of this titanium foam (565 and 464 micron mean void intercept length) and to compare these characteristics to those obtained with a fully porous conventionally sintered titanium bead implant. Cylindrical implants were studied in a rabbit distal femoral intramedullary osseointegration model at time zero and at 3, 6, and 12 weeks. The amount of bone ingrowth, amount of periprosthetic bone, and mineral apposition rate of periprosthetic bone measured did not differ among the three implant designs at 3, 6, or 12 weeks. By 12 weeks, the interface stiffness and maximum load of the beaded implant was significantly greater than either foam implant. No significant difference was found in the interface stiffness or maximum load between the two foam implant designs at 3, 6, or 12 weeks. The lower compressive modulus of the foam compared to the more dense sintered beaded implants likely contributed to the difference in failure mode. However, the foam implants have a similar compressive modulus to other clinically successful coatings, suggesting they are nonetheless clinically adequate. Additional studies are required to confirm this in weight-bearing models. Histological data suggest that these novel titanium foam implants are a promising alternative to current porous coatings and should be further investigated for clinical application in cementless joint replacement. PMID:20024964

Wear Debris Characterization and Corresponding Biological Response: Artificial Hip and Knee Joints

PubMed Central

Nine, Md J.; Choudhury, Dipankar; Hee, Ay Ching; Mootanah, Rajshree; Osman, Noor Azuan Abu

2014-01-01

Wear debris, of deferent sizes, shapes and quantities, generated in artificial hip and knees is largely confined to the bone and joint interface. This debris interacts with periprosthetic tissue and may cause aseptic loosening. The purpose of this review is to summarize and collate findings of the recent demonstrations on debris characterization and their biological response that influences the occurrence in implant migration. A systematic review of peer-reviewed literature is performed, based on inclusion and exclusion criteria addressing mainly debris isolation, characterization, and biologic responses. Results show that debris characterization largely depends on their appropriate and accurate isolation protocol. The particles are found to be non-uniform in size and non-homogeneously distributed into the periprosthetic tissues. In addition, the sizes, shapes, and volumes of the particles are influenced by the types of joints, bearing geometry, material combination, and lubricant. Phagocytosis of wear debris is size dependent; high doses of submicron-sized particles induce significant level of secretion of bone resorbing factors. However, articles on wear debris from engineered surfaces (patterned and coated) are lacking. The findings suggest considering debris morphology as an important parameter to evaluate joint simulator and newly developed implant materials. PMID:28788496

Lower periprosthetic bone loss and good fixation of an ultra-short stem compared to a conventional stem in uncemented total hip arthroplasty.

PubMed

Salemyr, Mats; Muren, Olle; Ahl, Torbjörn; Bodén, Henrik; Eisler, Thomas; Stark, André; Sköldenberg, Olof

2015-01-01

We hypothesized that an ultra-short stem would load the proximal femur in a more physiological way and could therefore reduce the adaptive periprosthetic bone loss known as stress shielding. 51 patients with primary hip osteoarthritis were randomized to total hip arthroplasty (THA) with either an ultra-short stem or a conventional tapered stem. The primary endpoint was change in periprosthetic bone mineral density (BMD), measured with dual-energy x-ray absorptiometry (DXA), in Gruen zones 1 and 7, two years after surgery. Secondary endpoints were change in periprosthetic BMD in the entire periprosthetic region, i.e. Gruen zones 1 through 7, stem migration measured with radiostereometric analysis (RSA), and function measured with self-administered functional scores. The periprosthetic decrease in BMD was statistically significantly lower with the ultra-short stem. In Gruen zone 1, the mean difference was 18% (95% CI: -27% to -10%). In zone 7, the difference was 5% (CI: -12% to -3%) and for Gruen zones 1-7 the difference was also 5% (CI: -9% to -2%). During the first 6 weeks postoperatively, the ultra-short stems migrated 0.77 mm more on average than the conventional stems. 3 months after surgery, no further migration was seen. The functional scores improved during the study and were similar in the 2 groups. Up to 2 years after total hip arthroplasty, compared to the conventional tapered stem the ultra-short uncemented anatomical stem induced lower periprosthetic bone loss and had equally excellent stem fixation and clinical outcome.

[Influence of preoperative bone mass density in periprosthetic bone remodeling after implantation of ABG-II prosthesis: A 10-year follow-up].

PubMed

Aguilar Ezquerra, A; Panisello Sebastiá, J J; Mateo Agudo, J

2016-01-01

Preoperative bone mass index has shown to be an important factor in peri-prosthetic bone remodelling in short follow-up studies. Bone density scans (DXA) were used to perform a 10-year follow-up study of 39 patients with a unilateral, uncemented hip replacement. Bone mass index measurements were made at 6 months, one year, 3 years, 5 years, and 10 years after surgery. Pearson coefficient was used to quantify correlations between preoperative bone mass density (BMD) and peri-prosthetic BMD in the 7 Gruen zones at 6 months, one year, 3 years, 5 years, and 10 years. Pre-operative BMD was a good predictor of peri-prosthetic BMD one year after surgery in zones 1, 2, 4, 5 and 6 (Pearson index from 0.61 to 0.75). Three years after surgery it has good predictive power in zones 1, 4 and 5 (0.71-0.61), although in zones 3 and 7 low correlation was observed one year after surgery (0.51 and 0.57, respectively). At the end of the follow-up low correlation was observed in the 7 Gruen zones. Sex and BMI were found to not have a statistically significant influence on peri-prosthetic bone remodelling. Although preoperative BMD seems to be an important factor in peri-prosthetic remodelling one year after hip replacement, it loses its predictive power progressively, until not being a major factor in peri-prosthetic remodelling ten years after surgery. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

Plesiomonas shigelloides Periprosthetic Knee Infection After Consumption of Raw Oysters.

PubMed

Hustedt, Joshua W; Ahmed, Sarim

Periprosthetic infections are a leading cause of morbidity after total joint arthroplasty. Common pathogens include Staphylococcus aureus, streptococcus, enterococcus, Escherichia coli, and Pseudomonas aeruginosa. However, there are many cases in which rare bacteria are isolated. This case report describes a periprosthetic knee infection caused by Plesiomonas shigelloides. In the United States, P shigelloides and 2 other Vibrionaceae family members, Vibrio vulnificus and Vibrio parahaemolyticus, are most often contracted from eating raw oysters and shellfish. P shigelloides usually causes a self-limiting watery diarrhea, but in immunosuppressed people it can cause septicemia. In this case report, a chemically and biologically immunosuppressed man consumed raw oysters and developed P shigelloides septicemia and acute periprosthetic knee infection that required surgical intervention.

Candida glabrata prosthetic joint infection, successfully treated with anidulafungin: A case report and review of the literature.

PubMed

Koutserimpas, Christos; Samonis, George; Velivassakis, Emmanouil; Iliopoulou-Kosmadaki, Stylliani; Kontakis, Georgios; Kofteridis, Diamantis P

2018-04-01

Non-albicans Candida prosthetic joint infection (PJI) is extremely rare. A case of a Candida glabrata knee PJI is a 68-year-old splenectomised female smoker, suffering from chronic obstructive pulmonary disease (COPD) and alcoholism is reported. The patient presented with a peri-prosthetic fracture, 15 years after total knee replacement surgery. Cultures of the intraoperative peri-prosthetic tissue and materials yielded C. glabrata, as well as a methicillin-resistant S. epidermitis. The patient was treated with anidulafungin and vancomycin. The knee prosthetic joint was removed and cement-spacer with vancomycin and gentamycin was placed. Additionally, an external fixation was performed. A second stage revision surgery was planned, after completion of the antimicrobial and antifungal treatment. The patient is followed up for 4 months without signs, symptoms or findings of infection. PJI Candida infections require a high clinical suspicion index. It is of utmost importance to report these cases, since there is no consensus yet of the proper antifungal treatment. Furthermore, a literature review regarding treatment of those cases is provided. First-line treatment with an echinocandin seems most proper, due to their fungicidal properties, their effectiveness against biofilm, as well as their minimal toxicity, making them ideal for long-term use. Further experience is needed, for better understanding the disease's pathogenesis and optimal treatment. © 2017 Blackwell Verlag GmbH.

Lower periprosthetic bone loss and good fixation of an ultra-short stem compared to a conventional stem in uncemented total hip arthroplasty

PubMed Central

Salemyr, Mats; Muren, Olle; Ahl, Torbjörn; Bodén, Henrik; Eisler, Thomas; Stark, André; Sköldenberg, Olof

2015-01-01

Background and purpose — We hypothesized that an ultra-short stem would load the proximal femur in a more physiological way and could therefore reduce the adaptive periprosthetic bone loss known as stress shielding. Patients and methods — 51 patients with primary hip osteoarthritis were randomized to total hip arthroplasty (THA) with either an ultra-short stem or a conventional tapered stem. The primary endpoint was change in periprosthetic bone mineral density (BMD), measured with dual-energy x-ray absorptiometry (DXA), in Gruen zones 1 and 7, two years after surgery. Secondary endpoints were change in periprosthetic BMD in the entire periprosthetic region, i.e. Gruen zones 1 through 7, stem migration measured with radiostereometric analysis (RSA), and function measured with self-administered functional scores. Results — The periprosthetic decrease in BMD was statistically significantly lower with the ultra-short stem. In Gruen zone 1, the mean difference was 18% (95% CI: −27% to −10%). In zone 7, the difference was 5% (CI: −12% to −3%) and for Gruen zones 1–7 the difference was also 5% (CI: −9% to −2%). During the first 6 weeks postoperatively, the ultra-short stems migrated 0.77 mm more on average than the conventional stems. 3 months after surgery, no further migration was seen. The functional scores improved during the study and were similar in the 2 groups. Interpretation — Up to 2 years after total hip arthroplasty, compared to the conventional tapered stem the ultra-short uncemented anatomical stem induced lower periprosthetic bone loss and had equally excellent stem fixation and clinical outcome. PMID:26134386

Experimental Study and Fractal Analysis on the Anisotropic Performance of Explosively Welded Interfaces of 304 Stainless Steel/245 Carbon Steel

NASA Astrophysics Data System (ADS)

Fu, Yanshu; Qiu, Yaohui; Li, Yulong

2018-03-01

The mechanical anisotropy of an explosive welding composite plate made of 304 stainless steel/245 steel was studied through shear experiments performed on explosively welded wavy interfaces along several orientation angles. The results indicated that the strength and the fracture energy of samples significantly varied with the orientation angles. The fracture surfaces of all samples were observed using a scanning electron microscope and through three-dimensional structure microscopy. The periodic features of all the fracture surfaces were clearly shown in different fracture modes. The fractal dimension of the fracture surfaces was calculated based on the fractal geometry by the box-counting method in MATLAB. The cohesive element model was used to analyze the fracture energy according to the physical dependence of the fractal dimension on thermodynamic entropy and interface separation energy. The fracture energy was an exponential function of the fractal dimension value, which was in good agreement with the experimental results. All results were validated for effective use in the application of anisotropy analysis to the welded interface and structural optimization of explosively welded composite plates.

Experimental Study and Fractal Analysis on the Anisotropic Performance of Explosively Welded Interfaces of 304 Stainless Steel/245 Carbon Steel

NASA Astrophysics Data System (ADS)

Fu, Yanshu; Qiu, Yaohui; Li, Yulong

2018-05-01

The mechanical anisotropy of an explosive welding composite plate made of 304 stainless steel/245 steel was studied through shear experiments performed on explosively welded wavy interfaces along several orientation angles. The results indicated that the strength and the fracture energy of samples significantly varied with the orientation angles. The fracture surfaces of all samples were observed using a scanning electron microscope and through three-dimensional structure microscopy. The periodic features of all the fracture surfaces were clearly shown in different fracture modes. The fractal dimension of the fracture surfaces was calculated based on the fractal geometry by the box-counting method in MATLAB. The cohesive element model was used to analyze the fracture energy according to the physical dependence of the fractal dimension on thermodynamic entropy and interface separation energy. The fracture energy was an exponential function of the fractal dimension value, which was in good agreement with the experimental results. All results were validated for effective use in the application of anisotropy analysis to the welded interface and structural optimization of explosively welded composite plates.

Batman-cracks. Observations and numerical simulations

NASA Astrophysics Data System (ADS)

Selvadurai, A. P. S.; Busschen, A. Ten; Ernst, L. J.

1991-05-01

To ensure mechanical strength of fiber reinforced plastics (FRP), good adhesion between fibers and the matrix is considered to be an essential requirement. An efficient test of fiber-matrix interface characterization is the fragmentation test which provides information about the interface slip mechanism. This test consists of the longitudinal loading of a single fiber which is embedded in a matrix specimen. At critical loads the fiber experiences fragmentation. This fragmentation will terminate depending upon the shear-slip strength of the fiber-matrix adhesion, which is inversely proportional to average fragment lengths. Depending upon interface strength characteristics either bond or slip matrix fracture can occur at the onset of fiber fracture. Certain particular features of matrix fracture are observed at the locations of fiber fracture in situations where there is sufficient interface bond strength. These refer to the development of fractures with a complex surface topography. The experimental procedure involved in the fragmentation tests is discussed and the boundary element technique to examine the development of multiple matrix fractures at the fiber fracture locations is examined. The mechanics of matrix fracture is examined. When bond integrity is maintained, a fiber fracture results in a matrix fracture. The matrix fracture topography in a fragmentation test is complex; however, simplified conoidal fracture patterns can be used to investigate the crack extension phenomena. Via a mixed-mode fracture criterion, the generation of a conoidal fracture pattern in the matrix is investigated. The numerical results compare favorably with observed experimental data derived from tests conducted on fragmentation test specimens consisting of a single glass fiber which is embedded in a polyester matrix.

Acetabular fractures in the elderly treated with a primary Burch-Schneider reinforcement ring, autologous bone graft, and a total hip arthroplasty: a prospective study with a 4-year follow-up.

PubMed

Enocson, Anders; Blomfeldt, Richard

2014-06-01

To investigate the clinical and radiologic outcomes in elderly patients suffering from an acetabular fracture operated with an acute primary acetabular reinforcement ring, autologous bone graft, and a total hip arthroplasty (THA). Prospective cohort study. Tertiary care university hospital. Fifteen elderly patients (7 women) with a mean age of 76 years and a displaced acetabular fracture after a low-energy trauma were included. The fractures involved the anterior column, but no patients with associated both column fractures were included. All the patients were able to walk independently before the fracture occurred. Primary operation with a Burch-Schneider reinforcement ring, autologous bone graft, and a THA. The patients were reviewed at 4, 12, 24, and 48 months after the fracture occurred. The outcome assessments included complications, reoperations, activity of daily living function, functional scores (Harris hip score and short musculoskeletal function assessment), health-related quality of life [EuroQol (EQ-5D) index score], and radiologic evaluation. There were no prosthetic dislocations, periprosthetic fractures, deep infections, or other adverse events. There were no radiologic signs of loosening of the reinforcement ring or the prosthesis components at any of the follow up sessions, and the autologous bone graft was well incorporated in all the patients at the final follow-up. At 48 months, the mean Harris hip score was 88, the mean short musculoskeletal function assessment dysfunction score was 30, the bother score was 25, and the mean EQ-5D index score was 0.65. All the patients were able to walk independently at the final follow-up. Treatment of displaced anterior column, anterior column posterior hemitransverse and transverse acetabular fractures in elderly patients using a primary reinforcement ring, autologous bone graft, and a THA seems to be a safe option with good functional and radiologic outcomes. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Effect of Microstructure on the Strength and Fracture Energy of Bimaterial Interfaces.

DTIC Science & Technology

1992-12-31

Bimaterials Interfaces includes three sections: Mechanics of Interfaces, Coating Design for Composite Systems, and Mechanics of Brittle Matrix... Composites . For more details see Executive Summary. 14. SUBJECT TERM 15. NUMBER OF PAGES Effect, Microstructure, Strength, Fracture Energy, Bimatenal...The Role of Interfaces in Fiber-Reinforced Brittle A.G. Evans Matrix Composites F.W. Zok J.B. Davis Article 2. Effects of Fiber Roughness on Interface

The Role of Interface on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model.

PubMed

Deland, Trevor S; Niespodziewanski, Emily; Fenton, Todd W; Haut, Roger C

2016-01-01

The role of impact interface characteristics on the biomechanics and patterns of cranial fracture has not been investigated in detail, and especially for the pediatric head. In this study, infant porcine skulls aged 2-19 days were dropped with an energy to cause fracturing onto four surfaces varying in stiffness from a rigid plate to one covered with plush carpeting. Results showed that heads dropped onto the rigid surface produced more extensive cranial fracturing than onto carpeted surfaces. Contact forces generated at fracture initiation and the overall maximum contact forces were generally lower for the rigid than carpeted impacts. While the degree of cranial fracturing from impacts onto the heavy carpeted surface was comparable to that of lower-energy rigid surface impacts, there were fewer diastatic fractures. This suggests that characteristics of the cranial fracture patterns may be used to differentiate energy level from impact interface in pediatric forensic cases. © 2015 American Academy of Forensic Sciences.

The Effect of High Concentration and Small Size of Nanodiamonds on the Strength of Interface and Fracture Properties in Epoxy Nanocomposite

PubMed Central

Haleem, Yasir A.; Song, Pin; Liu, Daobin; Wang, Changda; Gan, Wei; Saleem, Muhammad Farooq; Song, Li

2016-01-01

The concentration and small size of nanodiamonds (NDs) plays a crucial role in the mechanical performance of epoxy-based nanocomposites by modifying the interface strength. Herein, we systemically analyzed the relation between the high concentration and small size of ND and the fracture properties of its epoxy-based nanocomposites. It was observed that there is a two-fold increase in fracture toughness and a three-fold increase in fracture energy. Rationally, functionalized-NDs (F-NDs) showed a much better performance for the nanocomposite than pristine NDs (P-NDs) because of additional functional groups on its surface. The F-ND/epoxy nanocomposites exhibited rougher surface in contrast with the P-ND/epoxy, indicating the presence of a strong interface. We found that the interfaces in F-ND/epoxy nanocomposites at high concentrations of NDs overlap by making a web, which can efficiently hinder further crack propagation. In addition, the de-bonding in P-ND/epoxy nanocomposites occurred at the interface with the appearance of plastic voids or semi-naked particles, whereas the de-bonding for F-ND/epoxy nanocomposites happened within the epoxy molecular network instead of the interface. Because of the strong interface in F-ND/epoxy nanocomposites, at high concentrations the de-bonding within the epoxy molecular network may lead to subsequent cracks, parallel to the parent crack, via crack splitting which results in a fiber-like structure on the fracture surface. The plastic void growth, crack deflection and subsequent crack growth were correlated to higher values of fracture toughness and fracture energy in F-ND/epoxy nanocomposites. PMID:28773628

The Effect of High Concentration and Small Size of Nanodiamonds on the Strength of Interface and Fracture Properties in Epoxy Nanocomposite.

PubMed

Haleem, Yasir A; Song, Pin; Liu, Daobin; Wang, Changda; Gan, Wei; Saleem, Muhammad Farooq; Song, Li

2016-06-23

The concentration and small size of nanodiamonds (NDs) plays a crucial role in the mechanical performance of epoxy-based nanocomposites by modifying the interface strength. Herein, we systemically analyzed the relation between the high concentration and small size of ND and the fracture properties of its epoxy-based nanocomposites. It was observed that there is a two-fold increase in fracture toughness and a three-fold increase in fracture energy. Rationally, functionalized-NDs (F-NDs) showed a much better performance for the nanocomposite than pristine NDs (P-NDs) because of additional functional groups on its surface. The F-ND/epoxy nanocomposites exhibited rougher surface in contrast with the P-ND/epoxy, indicating the presence of a strong interface. We found that the interfaces in F-ND/epoxy nanocomposites at high concentrations of NDs overlap by making a web, which can efficiently hinder further crack propagation. In addition, the de-bonding in P-ND/epoxy nanocomposites occurred at the interface with the appearance of plastic voids or semi-naked particles, whereas the de-bonding for F-ND/epoxy nanocomposites happened within the epoxy molecular network instead of the interface. Because of the strong interface in F-ND/epoxy nanocomposites, at high concentrations the de-bonding within the epoxy molecular network may lead to subsequent cracks, parallel to the parent crack, via crack splitting which results in a fiber-like structure on the fracture surface. The plastic void growth, crack deflection and subsequent crack growth were correlated to higher values of fracture toughness and fracture energy in F-ND/epoxy nanocomposites.

Redistribution Mechanisms and Quantification of Homogeneity in Friction Stir Welding and Processing of an Aluminum Silicon Alloy

DTIC Science & Technology

2012-09-01

have been extensively studied in regard to the mechanical effects of the Si particle distribution. Micro- mechanisms of fracture are significantly...ratio particles, and that global fracture occurs by linkage of these locally fractured areas. Their overall conclusion was that the mechanical ...interface, which is undergoing deformation in either tension or compression. Particle fracture was found to occur by two mechanisms : interface

Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty.

PubMed

Resch, H; Krappinger, D; Moroder, P; Auffarth, A; Blauth, M; Becker, J

2017-04-01

Fractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required. Between August 2009 and 2014, 30 cases were reported in which all patients underwent total hip arthroplasty additionally to a customized implant designed as an antiprotrusion cage. Inclusion criteria were an acetabular fracture with or without a previous hemiarthroplasty, age above 65 years, and pre-injury mobility dependent on a walking frame at the most. The median age was 79.9 years (65-92), and of 30 fractures, 25 were primary acetabular fractures (83%), four periprosthetic acetabular fractures (14%), and one non-union after a failed ORIF (3%). The average time from injury to surgery was 9.4 days (3-23) and 295 days for the non-union case. Mean time of surgery was 154.4 min (range 100 to 303). In 21 cases (70%), mobilization with full weight bearing was possible within the first 10 days. Six patients died before the follow-up examination 3 and 6 months after surgery, while 24 patients underwent radiologic examination showing consolidated fractures in bi-plane radiographs. In 9 patients, additional CT scan was performed which confirmed the radiographical results. 13 had regained their pre-injury level of mobility including the non-union case. Only one patient did not regain independent mobility. Four complications were recognized with necessary surgical revision (one prosthetic head dislocation, one pelvic cement leakage, one femoral shaft fracture, and one infected hematoma). The presented cage provides the possibility of early mobilization with full weight bearing which represents a valuable addition to the treatment spectrum in this challenging patient group.

Operative treatment of distal femoral fractures above total knee arthroplasty with the indirect reduction technique: a long-term follow-up study.

PubMed

Kolb, Klaus; Koller, Heiko; Lorenz, Ingo; Holz, Ulrich; Marx, Frank; Grützner, Paul; Kolb, Werner

2009-04-01

The complication rate of conventional plate osteosynthesis (CPO) of periprosthetic femoral fractures above total knee arthroplasties (TKA) is high. Indirect reduction techniques were introduced to reduce surgical dissection at the fracture site. Twenty-one patients (4 men and 17 women) with femoral fractures above well-fixed total knee arthroplasties were consecutively treated with the indirect reduction technique. AO/ASIF (Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of the Problems of Internal Fixation) Type 33A fractures were included. The mean age was 78 years (range, 67-94 years). Four fractures were stabilised with bone grafts, three in combination with bone cement. Nineteen of the patients were seen at a 1-year follow-up, 15 were seen after a long-term follow-up of 9 years (range, 7-12 years). There was only one implant failure in a comminuted fracture with severe osteoporosis, no infection, and no non-union. At the 1-year follow-up malalignment of 5 degrees varus occurred in one patient. The mean range of motion of the eighteen patients was 98 degrees (range, 65-110 degrees). The mean knee society score was 74 (range, 62-84), the mean function score was 52 (range, 39-72). At the long-term follow-up, the mean range of motion of the patients was 101 degrees (range, 65-115 degrees). The mean knee society score was 77 (range, 65-88), the mean function score was 55 (range, 40-75). Our results suggest the 95 degrees condylar blade plate in the indirect reduction technique is still a good implant with good long-term results. It works best in proximal fractures when there is minimal comminution of the distal fragment in the hands of an experienced trauma surgeon. Knee function and range of motion increased less over time.

The potential role of the osteoblast in the development of periprosthetic osteolysis: review of in vitro osteoblast responses to wear debris, corrosion products, and cytokines and growth factors.

PubMed

Vermes, C; Glant, T T; Hallab, N J; Fritz, E A; Roebuck, K A; Jacobs, J J

2001-12-01

Limited information is available on the responses of osteoblasts to wear debris, corrosion products, and cytokines and on the roles of altered osteoblast functions in the development of periprosthetic bone loss. Wear debris-challenged osteoblasts exhibit altered functions resulting in the loss of their capacity to produce bone matrix and to replace the resorbed bone. Also, osteoblasts may secrete cytokines, which act in a paracrine fashion to recruit inflammatory cells into the periprosthetic space and to stimulate osteoclastic bone resorption. These effects may be mediated in part by ionic metal dissolution products. We review the mechanisms by which altered osteoblast functions, in response to particulate wear debris, corrosion products, and cytokines and growth factors, may contribute to the development and the progression of periprosthetic osteolysis.

Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?

PubMed

Jafari, S Mehdi; Casper, David S; Restrepo, Camilo; Zmistowski, Benjamin; Parvizi, Javad; Sharkey, Peter F

2012-06-01

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years). Copyright © 2012 Elsevier Inc. All rights reserved.

First-principles study of the structure properties of Al(111)/6H-SiC(0001) interfaces

NASA Astrophysics Data System (ADS)

Wu, Qingjie; Xie, Jingpei; Wang, Changqing; Li, Liben; Wang, Aiqin; Mao, Aixia

2018-04-01

This paper presents a systematic study on the energetic and electronic structure of the Al(111)/6H-SiC(0001) interfaces by using first-principles calculation with density functional theory (DFT). There are all three situations for no-vacuum layer of Al/SiC superlattics, and two cases of C-terminated and Si-terminated interfaces are compared and analyzed. Through the density of states analysis, the initial information of interface combination is obtained. Then the supercells are stretched vertically along the z-axis, and the fracture of the interface is obtained, and it is pointed out that C-terminated SiC and Al interfaces have a better binding property. And, the fracture positions of C-terminated and Si-terminated interfaces are different in the process of stretching. Then, the distance variation in the process of stretching, the charge density differences, and the distribution of the electrons near the interface are analyzed. Al these work makes the specific reasons for the interface fracture are obtained at last.

Perioperative alendronate, risedronate, calcitonin and indomethacin treatment alters femoral stem fixation and periprosthetic bone mineral density in ovariectomized rats.

PubMed

Cankaya, Deniz; Tabak, Yalcin; Ozturk, Akif Muhtar; Gunay, Muhammed Cuneyd

2015-07-01

Many factors affect implant stability and periprosthetic bone mineral density (BMD) following total joint arthroplasty. We asked whether perioperative alendronate, risedronate, calcitonin and indomethacine administration altered (1) femoral stem shear strength and periprosthetic bone mineral density BMD in ovariectomized rats and (2) whether there were differences in the effect of these drugs. Thirty overiectomized rats were divided into five groups and implanted with intramedullary mini-cortical screws in the femur. Four groups were treated with alendronate, risedronate, salmon calcitonin and indomethacin for 4 weeks preoperatively and 8 weeks postoperatively. Although alendronate and risedronate increased the periprosthetic BMD more than calcitonin, they did not alter implant fixation compared to calcitonin. Indomethacin significantly decreased the BMD around the stem and implant stability compared to all other groups. This study showed that perioperative treatment with bisphosphonates and calcitonin improved the BMD around the stems and implant stability. Although bisphosphonates increased the BMD more than calcitonin, there was no difference in implant stability. Indomethacin markedly decreased the periprosthetic BMD and implant stability. The main clinical significance of our study was the finding about the need to strictly avoid long-term use of high-dose nonsteroidal antiinflammatory drugs for patients who have major joint arthritis and a previous history of arthroplasty.

A numerical investigation into the influence of the properties of cobalt chrome cellular structures on the load transfer to the periprosthetic femur following total hip arthroplasty.

PubMed

Hazlehurst, Kevin Brian; Wang, Chang Jiang; Stanford, Mark

2014-04-01

Stress shielding of the periprosthetic femur following total hip arthroplasty is a problem that can promote the premature loosening of femoral stems. In order to reduce the need for revision surgery it is thought that more flexible implant designs need to be considered. In this work, the mechanical properties of laser melted square pore cobalt chrome molybdenum cellular structures have been incorporated into the design of a traditional monoblock femoral stem. The influence of incorporating the properties of cellular structures on the load transfer to the periprosthetic femur was investigated using a three dimensional finite element model. Eleven different stiffness configurations were investigated by using fully porous and functionally graded approaches. This investigation confirms that the periprosthetic stress values depend on the stiffness configuration of the stem. The numerical results showed that stress shielding is reduced in the periprosthetic Gruen zones when the mechanical properties of cobalt chrome molybdenum cellular structures are used. This work identifies that monoblock femoral stems manufactured using a laser melting process, which are designed for reduced stiffness, have the potential to contribute towards reducing stress shielding. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

Economical Analysis on Prophylaxis, Diagnosis, and Treatment of Periprosthetic Infections

PubMed Central

Fernandez-Fairen, Mariano; Torres, Ana; Menzie, Ann; Hernandez-Vaquero, Daniel; Fernandez-Carreira, José Manuel; Murcia-Mazon, Antonio; Guerado, Enrique; Merzthal, Luis

2013-01-01

The economic burden of periprosthetic infections is enormous, but the number of economic studies dealing with this issue is very scarce. This review tries to know the economic literature existing, assess the value of current data, and recognize the less costly and more effective procedures for prevention, diagnosis and treatment of periprosthetic infections. Forty five studies meeting the inclusion criteria and adhering to the quality criteria used were carefully analyzed to extract the economic data of relevance in evaluating the magnitude of problem and the more cost-effective solutions. However, because the heterogeneity and the low-quality of most of these studies meta-analytical technique has not been possible. Instead, the studies have been reviewed descriptively. Optimizing the antibiotic use in the prevention and treatment of periprosthetic infection, combined with systemic and behavioral changes in the operating room; detecting and treating the high-risk groups; a quick, simple, reliable, safe, and cost-effective diagnosis, and the rationale management of the instituted infection, specifically using the different procedures according to each particular case, could allow to improve outcomes and produce the highest quality of life for patients and the lowest economic impact. Nevertheless, the cost effectiveness of different interventions to prevent and to treat the periprosthetic infection remains unclear. PMID:24082966

Fracture of Polymers and Interfaces: A Universal Molecular Approach

NASA Astrophysics Data System (ADS)

Wool, Richard

2003-03-01

Fracture of polymers, linear or crosslinked, can be viewed as a breaking of molecular connectivity via disentanglement or bond rupture. When treated as a vector percolation phenomenon, we find that it captures the essential physics of fracture and makes broad accurate predictions for strength S, and fracture energy G, of polymers and their interfaces. In the bulk, we find that G ˜ [p-pc], and S ˜ [p-pc]^1/2, where p is the local normalized entanglement density and pc is the percolation threshold. For interfaces, p = nL/w, where n is the areal density of chains of length L ˜M (mol wt) in an interface of width w. For incompatible interfaces of width w, G ˜ [w-wc]; when reinforced with n compatibilizers, G ˜ (n - nc]. For welding, p ˜ L, the welding time tw ˜ L. For adhesion with sticker group X on the polymer and receptor groups Y on the solid, the strength first increases with X, Y and X-Y strength and then decreases after a predictable maximum. For thermosets, the modulus E ˜ [p-pc]^3 and the strength S ˜ [p-pc]^2. Numerous experimental examples are given to support the above universal relations for fracture.

Fracture of coherent interfaces between an fcc metal matrix and the Cr23C6 carbide precipitate from first principles

NASA Astrophysics Data System (ADS)

Barbé, Elric; Fu, Chu-Chun; Sauzay, Maxime

2018-02-01

It is known that microcrack initiation in metallic alloys containing second-phase particles may be caused by either an interfacial or an intraprecipitate fracture. So far, the dependence of these features on properties of the precipitate and the interface is not clearly known. The present study aims to determine the key properties of carbide-metal interfaces controlling the energy and critical stress of fracture, based on density functional theory (DFT) calculations. We address coherent interfaces between a fcc iron or nickel matrix and a frequently observed carbide, the M23C6 , for which a simplified chemical composition Cr23C6 is assumed. The interfacial properties such as the formation and Griffith energies, and the effective Young's modulus are analyzed as functions of the magnetic state of the metal lattice, including the paramagnetic phase of iron. Interestingly, a simpler antiferromagnetic phase is found to exhibit similar interfacial mechanical behavior to the paramagnetic phase. A linear dependence is determined between the surface (and interface) energy and the variation of the number of chemical bonds weighted by the respective bond strength, which can be used to predict the relative formation energy for the surface and interface with various chemical terminations. Finally, the critical stresses of both intraprecipitate and interfacial fractures due to a tensile loading are estimated via the universal binding energy relation (UBER) model, parametrized on the DFT data. The validity of this model is verified in the case of intraprecipitate fracture, against results from DFT tensile test simulations. In agreement with experimental evidences, we predict a much stronger tendency for an interfacial fracture for this carbide. In addition, the calculated interfacial critical stresses are fully compatible with available experimental data in steels, where the interfacial carbide-matrix fracture is only observed at incoherent interfaces.

Tensile Fracture of Welded Polymer Interfaces: Miscibility, Entanglements, and Crazing

DOE PAGES

Ge, Ting; Grest, Gary S.; Robbins, Mark O.

2014-09-26

Large-scale molecular simulations are performed to investigate tensile failure of polymer interfaces as a function of welding time t. Changes in the tensile stress, mode of failure and interfacial fracture energy G I are correlated to changes in the interfacial entanglements as determined from Primitive Path Analysis. Bulk polymers fail through craze formation, followed by craze breakdown through chain scission. At small t welded interfaces are not strong enough to support craze formation and fail at small strains through chain pullout at the interface. Once chains have formed an average of about one entanglement across the interface, a stable crazemore » is formed throughout the sample. The failure stress of the craze rises with welding time and the mode of craze breakdown changes from chain pullout to chain scission as the interface approaches bulk strength. The interfacial fracture energy G I is calculated by coupling the simulation results to a continuum fracture mechanics model. As in experiment, G I increases as t 1/2 before saturating at the average bulk fracture energy G b. As in previous studies of shear strength, saturation coincides with the recovery of the bulk entanglement density. Before saturation, G I is proportional to the areal density of interfacial entanglements. Immiscibiltiy limits interdiffusion and thus suppresses entanglements at the interface. Even small degrees of immisciblity reduce interfacial entanglements enough that failure occurs by chain pullout and G I << G b.« less

Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

PubMed

Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

2017-04-01

Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Periprosthetic bleeding 18 years post-silicone reconstruction of the orbital floor.

PubMed

Ilie, Vlad Ionut; Ilie, Victor George; Quarmby, Craig; Lefter, Mihaela

2011-10-01

Periprosthetic orbital haemorrhage is an uncommon complication of the alloplastic implants used in post-traumatic orbital floor repair. The small case series or individual reports provide no definite causative explanation for this delayed bleeding around silicone implants. It is likely that it is related to the disruption of fine capillaries within the pseudocapsule surrounding the implant, since the material does cause low-grade irritation with evidence of chronic inflammation. We report the case of a patient who developed a spontaneous periprosthetic bleeding 18 years' post-silicone sheet reconstruction of the orbital floor. Urgent removal of the implant insured prompt resolution of all symptoms and no further problem during the 2-year follow-up. This report emphasizes that periprosthetic orbital haemorrhage can occur years after the initial repair. Awareness of this rare complication allows for prompt diagnosis, decreasing the possibility of permanent damage of the orbital content. The removal of implant is necessary to relieve the symptoms and prevent potential infective complications.

Fracture behavior of the Space Shuttle thermal protection system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Komine, A.; Kobayashi, A.S.

1983-09-01

Stable crack-growth and fracture-toughness experiments were conducted using precracked specimens machined from LI-900 reusable surface insulation (RSI) tiles of the Space Shuttle thermal protection system (TPS) at room temperature. Similar fracture experiments were conducted on fracture specimens with preexisting cracks at the interface of the tile and the strain isolation pad (SIP). Stable crack growth was not observed in the LI-900 tile fracture specimens which had a fracture toughness of 12.0 kPa sq rt of m. The intermittent subcritical crack growth at the tile-pad interface of the fracture specimens was attributed to successive local pull-outs due to tensile overload inmore » the LI-900 tile and cannot be characterized by linear elastic fracture mechanics. No subcritical interfacial crack growth was observed in the fracture specimens with densified LI-900 tiles where brittle fracture initiated at an interior point away from the densification. 11 references.« less

Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.

PubMed

Schmalzried, T P; Jasty, M; Harris, W H

1992-07-01

Thirty-four hips in which there had been prosthetic replacement were selected for study because of the presence of linear (diffuse) or lytic (localized) areas of periprosthetic bone loss. In all hips, there was careful documentation of the anatomical location of the material that had been obtained for histological analysis, and the specific purpose of the removal of the tissue was for examination to determine the cause of the resorption of bone. Specimens from twenty-three hips were retrieved during an operation and from eleven hips, at autopsy. The area of bone loss was linear only in sixteen hips, lytic only in thirteen, and both linear and lytic in five. In all thirty-four hips, intracellular particulate debris was found in the macrophages that were present in the area of bone resorption. All thirty-four had intracellular particles of polyethylene, many of which were less than one micrometer in size. Thirty-one hips had extracellular particles of polyethylene as well. Twenty-two of the thirty-four hips had intracellular metallic debris; in ten, metallic debris was found extracellularly as well. Ten of the sixteen cemented specimens had intracellular and extracellular polymethylmethacrylate debris. In the mechanically stable prostheses--cemented and uncemented--polyethylene wear debris was identified in areas of bone resorption far from the articular surfaces. The number of macrophages in a microscopic field was directly related to the amount of particulate polyethylene debris that was visible by light microscopy. Although the gross radiographic appearances of linear bone loss and lytic bone loss were different, the histological appearance of the regions in which there was active bone resorption was similar. Regardless of the radiographic appearance and anatomical origin of the specimen, bone resorption was found to occur in association with macrophages that were laden with polyethylene debris. In general, the number of macrophages present had a direct relationship to the degree of bone resorption that was seen. We believe that these findings indicate that joint fluid penetrates far more extensively than previously thought, even in a well fixed component, along the interface between the prosthesis and bone and in the periprosthetic tissues; it is often more extensive than is shown by arthrography. We therefore suggest the concept of the effective joint space to include all periprosthetic regions that are accessible to joint fluid and thus accessible to particulate debris.(ABSTRACT TRUNCATED AT 400 WORDS)

Ultrasound elastography assessment of bone/soft tissue interface

NASA Astrophysics Data System (ADS)

Parmar, Biren J.; Yang, Xu; Chaudhry, Anuj; Shafeeq Shajudeen, Peer; Nair, Sanjay P.; Weiner, Bradley K.; Tasciotti, Ennio; Krouskop, Thomas A.; Righetti, Raffaella

2016-01-01

We report on the use of elastographic imaging techniques to assess the bone/soft tissue interface, a region that has not been previously investigated but may provide important information about fracture and bone healing. The performance of axial strain elastograms and axial shear strain elastograms at the bone/soft tissue interface was studied ex vivo on intact and fractured canine and ovine tibias. Selected ex vivo results were corroborated on intact sheep tibias in vivo. The elastography results were statistically analyzed using elastographic image quality tools. The results of this study demonstrate distinct patterns in the distribution of the normalized local axial strains and axial shear strains at the bone/soft tissue interface with respect to the background soft tissue. They also show that the relative strength and distribution of the elastographic parameters change in the presence of a fracture and depend on the degree of misalignment between the fracture fragments. Thus, elastographic imaging modalities might be used in the future to obtain information regarding the integrity of bones and to assess the severity of fractures, alignment of bone fragments as well as to follow bone healing.

Evaluation of Shear Strength of RC Beams with Multiple Interfaces Formed before Initial Setting Using 3D Printing Technology

PubMed Central

Kim, Kyeongjin; Park, Sangmin; Jeong, Yoseok; Lee, Jaeha

2017-01-01

With the recent development of 3D printing technology, concrete materials are sometimes used in 3D printing. Concrete structures based on 3D printing have been characterized to have the form of multiple layer build-up. Unlike general concrete structures, therefore, the 3D-printed concrete can be regarded as an orthotropic material. The material property of the 3D-printed concrete’s interface between layers is expected to be far different from that of general concrete bodies since there are no aggregate interlocks and weak chemical bonding. Such a difference finally affects the structural performance of concrete structures even though the interfaces are formed before initial setting of the concrete. The current study mainly reviewed the changes in fracture energy (toughness) with respect to various environmental conditions of such interface. Changes in fracture energies of interfaces between concrete layers were measured using low-speed Crack Mouth Opening Displacement (CMOD) closed loop concrete fracture test. The experimental results indicated reduction in fracture energy as well as tensile strengths. To improve the tensile strength of interfaces, the use of bridging materials is suggested. Since it was assumed that reduction in fracture energy could be a cause of shear strength, to evaluate the reduced structural performance of concrete structure constructed with multiple interfaces by 3D printing technology, the shear strength of RC beam by 3D printing technology was predicted and compared with that of plain RC beam. Based on the fracture energy measured in this study, Modified Compression Field Theory (MCFT) theory-applied Vector 2 program was employed to predict the degree of reduction in shear strength without considering stirrups. Reduction factors were presented based on the obtained results to predict the reduction in shear strength due to interfaces before initial setting of the concrete.

Reverse hybrid total hip arthroplasty.

PubMed

Wangen, Helge; Havelin, Leif I; Fenstad, Anne M; Hallan, Geir; Furnes, Ove; Pedersen, Alma B; Overgaard, Søren; Kärrholm, Johan; Garellick, Göran; Mäkelä, Keijo; Eskelinen, Antti; Nordsletten, Lars

2017-06-01

Background and purpose - The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA, have been sparsely described. The Nordic Arthroplasty Register Association (NARA) has already published 2 papers describing results of reverse hybrid THAs in different age groups. Based on data collected over 2 additional years, we wanted to perform in depth analyses of not only the reverse hybrid concept but also of the different cup/stem combinations used. Patients and methods - From the NARA, we extracted data on reverse hybrid THAs from January 1, 2000 until December 31, 2013. 38,415 such hips were studied and compared with cemented THAs. The Kaplan-Meier method and Cox regression analyses were used to estimate the prosthesis survival and the relative risk of revision. The main endpoint was revision for any reason. We also performed specific analyses regarding the different reasons for revision and analyses regarding the cup/stem combinations used in more than 500 cases. Results - We found a higher rate of revision for reverse hybrids than for cemented THAs, with an adjusted relative risk of revision (RR) of 1.4 (95% CI: 1.3-1.5). At 10 years, the survival rate was 94% (CI: 94-95) for cemented THAs and 92% (95% CI: 92-93) for reverse hybrids. The results for the reverse hybrid THAs were inferior to those for cemented THAs in patients aged 55 years or more (RR =1.1, CI: 1.0-1.3; p < 0.05). We found a higher rate of early revision due to periprosthetic femoral fracture for reverse hybrids than for cemented THAs in patients aged 55 years or more (RR =3.1, CI: 2.2-4.5; p < 0.001). Interpretation - Reverse hybrid THAs had a slightly higher rate of revision than cemented THAs in patients aged 55 or more. The difference in survival was mainly caused by a higher incidence of early revision due to periprosthetic femoral fracture in the reversed hybrid THAs.

Interface test series: An in situ study of factors affecting the containment of hydraulic fractures

NASA Astrophysics Data System (ADS)

Warpinski, N. R.; Finley, S. J.; Vollendorf, W. C.; Obrien, M.; Eshom, E.

1982-02-01

In situ experiments, which are accessible for direct observation by mineback, were conducted to determine the effect that material-property interfaces and in situ stress differences have on hydraulic fracture propagation and the resultant overall geometry. These experiments show conclusively that a difference in elastic modulus at a geologic interface has little or no effect on crack growth and, therefore, is not a feature which would promote containment of fractures within a specified reservoir zone. However, differences in the in situ stress between adjacent layers is shown to have a considerable influence on fracture propagation. Experiments were conducted in a low modulus ash-fall tuff which contained two layers of high minimum principal in situ stress and which was overlain by a formation with at least a factor of 5 increase in elastic modulus. Fractures were observed to terminate in regions of high minimum principal in situ stress in nearly every case.

Shoulder Arthroplasty for Humeral Head Avascular Necrosis Is Associated With Increased Postoperative Complications.

PubMed

Burrus, M Tyrrell; Cancienne, Jourdan M; Boatright, Jeffrey D; Yang, Scott; Brockmeier, Stephen F; Werner, Brian C

2018-02-01

Humeral head avascular necrosis (AVN) of differing etiologies may lead to shoulder arthroplasty due to subchondral bone collapse and deformity of the articular surface. There have been no large studies evaluating the complications for these patients after they undergo total shoulder arthroplasty (TSA). The first objective of this study is to evaluate the complication rate after TSA in patients with humeral head AVN. The secondary objective is to compare the complication rates among the different etiologies of the AVN. Patients who underwent TSA were identified in the PearlDiver database using ICD-9 codes. Patients who underwent shoulder arthroplasty for humeral head AVN were identified using ICD-9 codes and were subclassified according to AVN etiology (posttraumatic, alcohol use, chronic steroid use, and idiopathic). Complications evaluated included postoperative infection within 6 months, dislocation within 1 year, revision shoulder arthroplasty up to 8 years postoperatively, shoulder stiffness within 1 year, and periprosthetic fracture within 1 year and systemic complications within 3 months. Postoperative complication rates were compared to controls. The study cohorts included 4129 TSA patients with AVN with 141,778 control TSA patients. Patients with posttraumatic AVN were significantly more likely to have a postoperative infection (OR 2.47, P  < 0.001), dislocation (OR 1.45, P  = 0.029), revision surgery (OR 1.53, P  = 0.001), stiffness (OR 1.24, P  = 0.042), and systemic complication (OR 1.49, P  < 0.001). Steroid-associated AVN was associated with a significantly increased risk for a postoperative infection (OR 1.72, P  = 0.004), revision surgery (OR 1.33, P  = 0.040), fracture (OR 2.76, P  = 0.002), and systemic complication (OR 1.59, P  < 0.001). Idiopathic and alcohol-associated AVN were not significantly associated with any of the postoperative evaluated complications. TSA in patients with humeral head AVN is associated with significantly increased rates of numerous postoperative complications compared to patients without a diagnosis of AVN, including infection, dislocation, revision arthroplasty, stiffness, periprosthetic fracture, and medical complications. Specifically, AVN due to steroid use or from a posttraumatic cause appears to be associated with the statistically highest rates of postoperative TSA complications. Given these findings, orthopedic surgeons should be increasingly aware of this association, which should influence the shared decision-making process of undergoing TSA in patients with humeral head AVN.

Biomechanical Studies on Patterns of Cranial Bone Fracture Using the Immature Porcine Model.

PubMed

Haut, Roger C; Wei, Feng

2017-02-01

This review was prepared for the American Society of Mechanical Engineers Lissner Medal. It specifically discusses research performed in the Orthopaedic Biomechanics Laboratories on pediatric cranial bone mechanics and patterns of fracture in collaboration with the Forensic Anthropology Laboratory at Michigan State University. Cranial fractures are often an important element seen by forensic anthropologists during the investigation of pediatric trauma cases litigated in courts. While forensic anthropologists and forensic biomechanists are often called on to testify in these cases, there is little basic science developed in support of their testimony. The following is a review of studies conducted in the above laboratories and supported by the National Institute of Justice to begin an understanding of the mechanics and patterns of pediatric cranial bone fracture. With the lack of human pediatric specimens, the studies utilize an immature porcine model. Because much case evidence involves cranial bone fracture, the studies described below focus on determining input loading based on the resultant bone fracture pattern. The studies involve impact to the parietal bone, the most often fractured cranial bone, and begin with experiments on entrapped heads, progressing to those involving free-falling heads. The studies involve head drops onto different types and shapes of interfaces with variations of impact energy. The studies show linear fractures initiating from sutural boundaries, away from the impact site, for flat surface impacts, in contrast to depressed fractures for more focal impacts. The results have been incorporated into a "Fracture Printing Interface (FPI)," using machine learning and pattern recognition algorithms. The interface has been used to help interpret mechanisms of injury in pediatric death cases collected from medical examiner offices. The ultimate aim of this program of study is to develop a "Human Fracture Printing Interface" that can be used by forensic investigators in determining mechanisms of pediatric cranial bone fracture.

Laser Engineered Net Shaping of Nickel-Based Superalloy Inconel 718 Powders onto AISI 4140 Alloy Steel Substrates: Interface Bond and Fracture Failure Mechanism

PubMed Central

Kim, Hoyeol; Cong, Weilong; Zhang, Hong-Chao; Liu, Zhichao

2017-01-01

As a prospective candidate material for surface coating and repair applications, nickel-based superalloy Inconel 718 (IN718) was deposited on American Iron and Steel Institute (AISI) 4140 alloy steel substrate by laser engineered net shaping (LENS) to investigate the compatibility between two dissimilar materials with a focus on interface bonding and fracture behavior of the hybrid specimens. The results show that the interface between the two dissimilar materials exhibits good metallurgical bonding. Through the tensile test, all the fractures occurred in the as-deposited IN718 section rather than the interface or the substrate, implying that the as-deposited interlayer bond strength is weaker than the interfacial bond strength. From the fractography using scanning electron microscopy (SEM) and energy disperse X-ray spectrometry (EDS), three major factors affecting the tensile fracture failure of the as-deposited part are (i) metallurgical defects such as incompletely melted powder particles, lack-of-fusion porosity, and micropores; (ii) elemental segregation and Laves phase, and (iii) oxide formation. The fracture failure mechanism is a combination of all these factors which are detrimental to the mechanical properties and structural integrity by causing premature fracture failure of the as-deposited IN718. PMID:28772702

Laser Engineered Net Shaping of Nickel-Based Superalloy Inconel 718 Powders onto AISI 4140 Alloy Steel Substrates: Interface Bond and Fracture Failure Mechanism.

PubMed

Kim, Hoyeol; Cong, Weilong; Zhang, Hong-Chao; Liu, Zhichao

2017-03-25

As a prospective candidate material for surface coating and repair applications, nickel-based superalloy Inconel 718 (IN718) was deposited on American Iron and Steel Institute (AISI) 4140 alloy steel substrate by laser engineered net shaping (LENS) to investigate the compatibility between two dissimilar materials with a focus on interface bonding and fracture behavior of the hybrid specimens. The results show that the interface between the two dissimilar materials exhibits good metallurgical bonding. Through the tensile test, all the fractures occurred in the as-deposited IN718 section rather than the interface or the substrate, implying that the as-deposited interlayer bond strength is weaker than the interfacial bond strength. From the fractography using scanning electron microscopy (SEM) and energy disperse X-ray spectrometry (EDS), three major factors affecting the tensile fracture failure of the as-deposited part are (i) metallurgical defects such as incompletely melted powder particles, lack-of-fusion porosity, and micropores; (ii) elemental segregation and Laves phase, and (iii) oxide formation. The fracture failure mechanism is a combination of all these factors which are detrimental to the mechanical properties and structural integrity by causing premature fracture failure of the as-deposited IN718.

Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration.

PubMed

Khan, Umar Daraz

2010-02-01

Infections after augmentation mammoplasty are not uncommon, and prophylactic antibiotics are routinely administered to minimize infection. However, there is paucity of information on the relationship between the length of prophylaxis cover and its benefits in primary augmentation mammoplasty. A retrospective analysis of different antibiotic cover regimens, their effectiveness in preventing infections, and the management of infection in established cases is reviewed. A retrospective chart analysis of periprosthetic infections in primary augmentation mammoplasties performed over the past 10 years was conducted. Periprosthetic infection was determined by the presence of pain, swelling, redness, and discharge. Each breast was taken as an individual unit in 1,628 patients, and data for 3,256 breasts were analyzed. The patients had their augmentation in the partial submuscular plane (214 breasts in 107 patients), the subglandular plane (1,548 breasts in 774 patients), and the muscle-splitting biplane (1,494 breasts in 747 patients). All the patients had soft round cohesive gel silicone implants. Of the 3,256 implants, 3,218 were textured, and 38 were smooth surfaced. The patients received antibiotics as a single intravenous dose of cephalosporin (474 breasts in 237 patients), a single intravenous dose plus an oral dose for 24 h (344 breasts in 172 patients), or a single intravenous dose plus an oral course for 5 days (2,438 breasts in 1,219 patients). Infection was recorded as superficial (e.g., wound breakdown, stitch extrusion, stitch abscess) or deep (periprosthetic). The patients with established periprosthetic infections, determined clinically by the presence of pain, discharge, swelling, and redness of the breasts, were managed either conservatively using antibiotics, passive wound drainage, and healing of the wound with secondary intention or by explantation and replacement after 3 to 4 months. In selected cases of periprosthetic infection, the implants were removed after a course of antibiotics and negative swab cultures. The cavity was washed thoroughly with betadine and saline, and new implants were simultaneously reimplanted. The incidence of infection was lowest with a single perioperative dose of intravenous antibiotic compared with a combination of intravenous and oral antibiotics. Superficial infection was seen in 38 breasts (all unilateral), with an incidence of 1.2%, and periprosthetic infection was observed in 17 breasts (13 unilateral and 2 bilateral), giving an infection incidence of 0.52% (p = 0.002). In patients with a single intravenous dose of antibiotic, superficial and periprosthetic infection was seen in four breasts (0.8%) and no breasts, respectively. The difference was not significant (p = 0.13). The patients receiving a single intravenous antibiotic and a 24-h oral antibiotic had superficial and periprosthetic infection rates of 2.3% (8 breasts) and 0.3% (1 breast), respectively, and the difference between the two sub-groups was significantly higher (p = 0.04). The patients receiving an intravenous antibiotic and 5 days of oral antibiotics had superficial and periprosthetic infection rates of 1.1% (26 breasts) and 0.65% (14 breasts), respectively. The difference between the two subgroups was not significant (p = 0.09). Of the 17 periprosthetic infections in 15 patients (13 unilateral and 2 bilateral), 11 breasts (1 bilateral and 9 unilateral) were treated conservatively using antibiotics, passive drainage, and wound healing with secondary intention. Capsular contracture developed in two of the conservatively treated breasts, requiring capsulotomies with change of implants. Of the six periprosthetic infections in six patients, requiring surgical intervention, two implants were treated using explantation with immediate replacement after a course of antibiotics and a negative culture, and two implants were explanted followed by reimplantation later. One patient had both implants removed after unilateral infection, and no reimplantation was performed. One patient had a bilateral infection. In this case, one implant was explanted and the other was treated conservatively. The patient had bilateral reimplantion 6 months later, and bilateral Baker 4 capsular contracture developed in both breasts within 6 months. No other complications were seen in the patients who underwent surgery. A single dose of intravenous antibiotic is adequate for prophylaxis in breast augmentation surgery, and the extra duration of antibiotic cover does not result in reduced superficial or periprosthetic infections. Infection can be managed in more than one way depending on the nature, degree, and extent of infection.

What Are the Risk Factors and Complications Associated With Intraoperative and Postoperative Fractures in Total Wrist Arthroplasty?

PubMed

Wagner, Eric R; Srnec, Jason J; Mehrotra, Kapil; Rizzo, Marco

2017-11-01

Total wrist arthroplasty (TWA) can relieve pain and preserve some wrist motion in patients with advanced wrist arthritis. However, few studies have evaluated the risks and outcomes associated with periprosthetic fractures around TWAs. (1) What is the risk of intraoperative and postoperative fractures after TWAs? (2) What factors are associated with increased risk of intraoperative and postoperative fracture after TWAs? (3) What is the fracture-free and revision-free survivorship of TWAs among patients who sustained an intraoperative fracture during the index TWA? At one institution during a 40-year period, 445 patients underwent primary TWAs. Of those, 15 patients died before 2 years and 5 were lost to followup, leaving 425 patients who underwent primary TWAs with a minimum of 2-year followup. The primary diagnosis for the TWA included osteoarthritis ([OA] 5%), inflammatory arthritis (90%), and posttraumatic arthritis (5%). Indications for TWA included pancarpal arthritis combined with marked pain and loss of wrist function. The mean age of the patients was 57 years, BMI was 26 kg/m 2 , and 73% were females. Six different implants were used during the 40-year period. Mean followup was 10 years (range, 2-18 years). Intraoperative fractures occurred in nine (2%) primary TWAs, while postoperative fractures occurred after eight (2%) TWAs. After analyzing demographics, comorbidities, and surgical factors, intraoperative fractures were found to be associated with only age at surgery (hazard ratio [HR], 1.10; 95% CI, 1.03-1.20; p = 0.006) and use of a bone graft (HR, 5.80; 95% CI, 1.18-23.08; p = 0.03). No factors were found to be associated with increased risk of postoperative fractures; specifically, intraoperative fracture was not associated with subsequent fracture development. The 5-, 10-, and 15-year Kaplan-Meier survival rates free of postoperative fracture were 99%, 98%, and 95%, respectively. The 5- and 10-year revision-free survival rates after intraoperative fracture were 88% and 88%, respectively, compared with 84% and 74% without an intraoperative fracture (p = 0.36). Furthermore, the survival-free of revision surgery rates for aseptic distal loosening at 5 and 10 years were 88% and 88%, respectively, compared with 93% and 87% without a fracture (p = 0.85). Intraoperative fractures occur in approximately 2% of TWAs. These fractures do not appear to affect long-term implant survival or risk of fracture. Patient age and the need for bone graft were the only factors in the risk of intraoperative fractures. Postoperative fractures also occur in 2% of TWAs, but often result in revision surgery. Level III, therapeutic study.

Econazole-releasing porous space maintainers for fungal periprosthetic joint infection.

PubMed

Tatara, Alexander M; Rozich, Allison J; Kontoyiannis, Panayiotis D; Watson, Emma; Albert, Nathaniel D; Bennett, George N; Mikos, Antonios G

2018-05-11

While antibiotic-eluting polymethylmethacrylate space maintainers have shown efficacy in the treatment of bacterial periprosthetic joint infection and osteomyelitis, antifungal-eluting space maintainers are associated with greater limitations for treatment of fungal musculoskeletal infections including limited elution concentration and duration. In this study, we have designed a porous econazole-eluting space maintainer capable of greater inhibition of fungal growth than traditional solid space maintainers. The eluted econazole demonstrated bioactivity in a concentration-dependent manner against the most common species responsible for fungal periprosthetic joint infection as well as staphylococci. Lastly, these porous space maintainers retain compressive mechanical properties appropriate to maintain space before definitive repair of the joint or bony defect.

Effects of isothermal and cyclic exposures on interface structure and mechanical properties of FPalpha-Al2O3/aluminum composites. [polycrystaline alumina fibers

NASA Technical Reports Server (NTRS)

Kim, W. M.; Koczak, M. J.; Lawley, A.

1979-01-01

The microstructural and interface stability of FPalpha-Al203/Al-Li composites are investigated as a function of isothermal exposure at 500 C or thermal cycling between 140 and 500 C with hold time at Tmax. Interfacial morphology, growth kinetics, crystal structure, and composition of interfacial reaction products are characterized. Strength is monitored in the transverse orientation, and fracture mechanics is analyzed in terms of interface reaction products. The interfacial reaction product in FP/Al is Li2O.5Al2O3. Significant fiber-matrix reaction occurs during fabrication. The number of thermal cycles rather than total time at Tmax is the determining factor in strength degradation, thermal cycling giving rise to voids at the fiber-matrix interface. Extensive interface failures occur at composite fracture stresses below about 128 MPa; above this stress level failure is attributed to ductile matrix fracture.

Functional outcome following tibio-talar-calcaneal nailing for unstable osteoporotic ankle fractures.

PubMed

Jonas, S C; Young, A F; Curwen, C H; McCann, P A

2013-07-01

Fragility fractures of the ankle are increasing in incidence. Such fractures typically occur from low-energy injuries but lead to disproportionately high levels of morbidity. Ankle fractures in this age group are managed conservatively in plaster or by open reduction and internal fixation. Both modalities have shown high rates of failure in terms of delayed union or mal-union together with perioperative complications such as implant failure and wound breakdown. The optimal treatment of these patients remains controversial. We aimed to review the functional outcome of patients with ankle fragility fractures primarily managed using a tibio-talar-calcaneal nail (TTC). We retrospectively reviewed 31 consecutive patients primarily managed with a TCC nail for osteoporotic fragility fractures about the ankle. Data were collected via case notes, radiographic reviews and by clinical reviews at the outpatient clinic or a telephone follow-up. Information regarding patient characteristics, indication for operation, Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture classification, operative and postoperative complications, time to radiographic union and current clinical state including Olerud and Molander scores were recorded (as a measure of ankle function). Nine of 31 patients had died by the time of follow-up. Mean preoperative and postoperative Olerud and Molander scores were 56 and 45, respectively. There were no postoperative wound complications. Twenty-nine of 31 patients returned to the same level of mobility as pre-injury. There were three peri-prosthetic fractures managed successfully with nail removal and replacement or plaster cast. There were two nail failures, both in patients who mobilised using only a stick, which were managed by nail removal. Ten of 31 patients were not followed up radiographically due to either infirmity or death. Thirteen of 21 followed up radiographically had evidence of union and 8/21 had none. None, however, had clinical evidence of fracture nonunion. The TTC nail can successfully be used to manage fragility fractures about the ankle in the elderly. Much like fractured neck of femur patients, who also have a high rate of mortality, this allows immediate mobilisation with minimal risk of wound complications. However, careful assessment must be made of each patient's mobility, as there is a significant incidence of device failure in the more active patient. Copyright © 2012 Elsevier Ltd. All rights reserved.

May one-stage exchange for Candida albicans peri-prosthetic infection be successful?

PubMed

Jenny, J-Y; Goukodadja, O; Boeri, C; Gaudias, J

2016-02-01

Fungal infection of a total joint arthroplasty has a low incidence but is generally considered as more difficult to cure than bacterial infection. As for bacterial infection, two-stage exchange is considered as the gold standard of treatment. We report two cases of one-stage total joint exchange for fungal peri-prosthetic infection with Candida albicans, where the responsible pathogens was only identified on intraoperative samples. This situation can be considered as a one-stage exchange for fungal peri-prosthetic infection without preoperative identification of the responsible organism, which is considered as having a poor prognosis. Both cases were free of infection after two years. One-stage revision has several potential advantages over two-stage revision, including shorter hospital stay and rehabilitation, no interim period with significant functional impairment, shorter antibiotic treatment, better functional outcome and probably lower costs. We suggest that one-stage revision for C. albicans peri-prosthetic infection may be successful even without preoperative fungal identification. Level IV-Historical cases. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Ultralow-Carbon Nanotube-Toughened Epoxy: The Critical Role of a Double-Layer Interface.

PubMed

Liu, Jingwei; Chen, Chao; Feng, Yuezhan; Liao, Yonggui; Ye, Yunsheng; Xie, Xiaolin; Mai, Yiu-Wing

2018-01-10

Understanding the chemistry and structure of interfaces within epoxy resins is important for studying the mechanical properties of nanofiller-filled nanocomposites as well as for developing high-performance polymer nanocomposites. Despite the intensive efforts to construct nanofiller/matrix interfaces, few studies have demonstrated an enhanced stress-transferring efficiency while avoiding unfavorable deformation due to undesirable interface fractures. Here, we report an optimized method to prepare epoxy-based nanocomposites whose interfaces are chemically modulated by poly(glycidyl methacrylate)-block-poly(hexyl methacrylate) (PGMA-b-PHMA)-functionalized multiwalled carbon nanotubes (bc@fMWNTs) and also offer a fundamental explanation of crack growth behavior and the toughening mechanism of the resulting nanocomposites. The presence of block copolymers on the surface of the MWNT results in a promising double-layered interface, in which (1) the outer-layered PGMA segment provides good dispersion in and strong interface bonding with the epoxy matrix, which enhances load transfer efficiency and debonding stress, and (2) the interlayered rubbery PHMA segment around the MWNT provides the maximum removable space for nanotubes as well as triggering cavitation while promoting local plastic matrix deformation, for example, shear banding to dissipate fracture energy. An outstanding toughening effect is achieved with only a 0.05 wt % carbon nanotube loading with the bc@fMWNT, that is, needing only a 20-times lower loading to obtain improvements in fracture toughness comparable to epoxy-based nanocomposites. The enhancements of their corresponding ultimate mode-I fracture toughnesses and fracture energies are 4 times higher than those of pristine MWNT-filled epoxy. These results demonstrate that a MWNT/epoxy interface could be optimized by changing the component structure of grafted modifiers, thereby facilitating the transfer of both mechanical load and energy dissipation across the nanofiller/matrix interface. This work provides a new route for the rational design and development of polymer nanocomposites with exceptional mechanical performance.

Waterjet cutting of periprosthetic interface tissue in loosened hip prostheses: an in vitro feasibility study.

PubMed

Kraaij, Gert; Tuijthof, Gabrielle J M; Dankelman, Jenny; Nelissen, Rob G H H; Valstar, Edward R

2015-02-01

Waterjet cutting technology is considered a promising technology to be used for minimally invasive removal of interface tissue surrounding aseptically loose hip prostheses. The goal of this study was to investigate the feasibility of waterjet cutting of interface tissue membrane. Waterjets with 0.2 mm and 0.6 mm diameter, a stand-off distance of 5 mm, and a traverse speed of 0.5 mm/s were used to cut interface tissue samples in half. The water flow through the nozzle was controlled by means of a valve. By changing the flow, the resulting waterjet pressure was regulated. Tissue sample thickness and the required waterjet pressures were measured. Mean thickness of the samples tested within the 0.2 mm nozzle group was 2.3 mm (SD 0.7 mm) and within the 0.6 mm nozzle group 2.6 mm (SD 0.9 mm). The required waterjet pressure to cut samples was between 10 and 12 MPa for the 0.2 mm nozzle and between 5 and 10 MPa for the 0.6 mm nozzle. Cutting bone or bone cement requires about 3 times higher waterjet pressure (30-50 MPa, depending on used nozzle diameter) and therefore we consider waterjet cutting as a safe technique to be used for minimally invasive interface tissue removal. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Fracture toughness of titanium-cement interfaces: effects of fibers and loading angles.

PubMed

Khandaker, Morshed; Utsaha, Khatri Chhetri; Morris, Tracy

2014-01-01

Ideal implant-cement or implant-bone interfaces are required for implant fixation and the filling of tissue defects created by disease. Micron- to nanosize osseointegrated features, such as surface roughness, fibers, porosity, and particles, have been fused with implants for improving the osseointegration of an implant with the host tissue in orthopedics and dentistry. The effects of fibers and loading angles on the interface fracture toughness of implant-cement specimens with and without fibers at the interface are not yet known. Such studies are important for the design of a long-lasting implant for orthopedic applications. The goal of this study was to improve the fracture toughness of an implant-cement interface by deposition of micron- to nanosize fibers on an implant surface. There were two objectives in the study: 1) to evaluate the influence of fibers on the fracture toughness of implant-cement interfaces with and without fibers at the interfaces, and 2) to evaluate the influence of loading angles on implant-cement interfaces with and without fibers at the interfaces. This study used titanium as the implant, poly(methyl methacrylate) (PMMA) as cement, and polycaprolactone (PCL) as fiber materials. An electrospinning unit was fabricated for the deposition of PCL unidirectional fibers on titanium (Ti) plates. The Evex tensile test stage was used to determine the interface fracture toughness (KC) of Ti-PMMA with and without PCL fibers at 0°, 45°, and 90° loading angles, referred to in this article as tension, mixed, and shear tests. The study did not find any significant interaction between fiber and loading angles (P>0.05), although there was a significant difference in the KC means of Ti-PMMA samples for the loading angles (P<0.05). The study also found a significant difference in the KC means of Ti-PMMA samples with and without fibers (P<0.05). The results showed that the addition of the micron- to nanosize PCL fibers on Ti improved the quality of the Ti-PMMA union. The results of the study are essential for fatigue testing and finite-element analysis of implant-cement interfaces to evaluate the performance of orthopedic and orthodontic implants.

Fracture toughness of titanium–cement interfaces: effects of fibers and loading angles

PubMed Central

Khandaker, Morshed; Utsaha, Khatri Chhetri; Morris, Tracy

2014-01-01

Ideal implant–cement or implant–bone interfaces are required for implant fixation and the filling of tissue defects created by disease. Micron- to nanosize osseointegrated features, such as surface roughness, fibers, porosity, and particles, have been fused with implants for improving the osseointegration of an implant with the host tissue in orthopedics and dentistry. The effects of fibers and loading angles on the interface fracture toughness of implant–cement specimens with and without fibers at the interface are not yet known. Such studies are important for the design of a long-lasting implant for orthopedic applications. The goal of this study was to improve the fracture toughness of an implant–cement interface by deposition of micron- to nanosize fibers on an implant surface. There were two objectives in the study: 1) to evaluate the influence of fibers on the fracture toughness of implant–cement interfaces with and without fibers at the interfaces, and 2) to evaluate the influence of loading angles on implant–cement interfaces with and without fibers at the interfaces. This study used titanium as the implant, poly(methyl methacrylate) (PMMA) as cement, and polycaprolactone (PCL) as fiber materials. An electrospinning unit was fabricated for the deposition of PCL unidirectional fibers on titanium (Ti) plates. The Evex tensile test stage was used to determine the interface fracture toughness (KC) of Ti–PMMA with and without PCL fibers at 0°, 45°, and 90° loading angles, referred to in this article as tension, mixed, and shear tests. The study did not find any significant interaction between fiber and loading angles (P>0.05), although there was a significant difference in the KC means of Ti–PMMA samples for the loading angles (P<0.05). The study also found a significant difference in the KC means of Ti–PMMA samples with and without fibers (P<0.05). The results showed that the addition of the micron- to nanosize PCL fibers on Ti improved the quality of the Ti–PMMA union. The results of the study are essential for fatigue testing and finite-element analysis of implant–cement interfaces to evaluate the performance of orthopedic and orthodontic implants. PMID:24729704

Bioelectric analyses of an osseointegrated intelligent implant design system for amputees.

PubMed

Isaacson, Brad M; Stinstra, Jeroen G; MacLeod, Rob S; Webster, Joseph B; Beck, James P; Bloebaum, Roy D

2009-07-15

The projected number of American amputees is expected to rise to 3.6 million by 2050. Many of these individuals depend on artificial limbs to perform routine activities, but prosthetic suspensions using traditional socket technology can prove to be cumbersome and uncomfortable for a person with limb loss. Moreover, for those with high proximal amputations, limited residual limb length may prevent exoprosthesis attachment all together. Osseointegrated implant technology is a novel operative procedure which allows firm skeletal attachment between the host bone and an implant. Preliminary results in European amputees with osseointegrated implants have shown improved clinical outcomes by allowing direct transfer of loads to the bone-implant interface. Despite the apparent advantages of osseointegration over socket technology, the current rehabilitation procedures require long periods of restrictive load bearing prior which may be reduced with expedited skeletal attachment via electrical stimulation. The goal of the osseointegrated intelligent implant design (OIID) system is to make the implant part of an electrical system to accelerate skeletal attachment and help prevent periprosthetic infection. To determine optimal electrode size and placement, we initiated proof of concept with computational modeling of the electric fields and current densities that arise during electrical stimulation of amputee residual limbs. In order to provide insure patient safety, subjects with retrospective computed tomography scans were selected and three dimensional reconstructions were created using customized software programs to ensure anatomical accuracy (Seg3D and SCIRun) in an IRB and HIPAA approved study. These software packages supported the development of patient specific models and allowed for interactive manipulation of electrode position and size. Preliminary results indicate that electric fields and current densities can be generated at the implant interface to achieve the homogenous electric field distributions required to induce osteoblast migration, enhance skeletal fixation and may help prevent periprosthetic infections. Based on the electrode configurations experimented with in the model, an external two band configuration will be advocated in the future.

Roles of interfacial reaction on mechanical properties of solder interfaces

NASA Astrophysics Data System (ADS)

Liu, Pilin

This study investigated roles of interfacial reaction in fracture and fatigue of solder interconnects. The interfacial reaction phases in the as-reflowed and after aging were examined by cross-sectional transmission electron microscopy (TEM) while interfacial mechanical properties were determined from a flexural peel fracture mechanics technique. Because of their widespread uses in microelectronic packaging, SnPb solder interfaces, and Bi-containing Pb-free solder interfaces were chosen as the subjects of this study. In the interfacial reaction study, we observed a complicated micro structural evolution during solid-state aging of electroless-Ni(P)/SnPb solder interconnects. In as-reflowed condition, the interfacial reaction produced Ni3Sn 4 and P-rich layers. Following overaging, the interfacial microstructure degenerated into a complex multilayer structure consisting of multiple layers of Ni-Sn compounds and transformed Ni-P phases. In SnPb solder interfacial system, fatigue study showed that the overaging of the high P electroless Ni-P/SnPb interconnects resulted in a sharp reduction in the fatigue resistance of the interface in the high crack growth rate regime. Fracture mechanism analysis indicated that the sharp drop in fatigue resistance was triggered by the brittle fracture of the Ni3Sn2 intermetallic phase developed at the overaged interface. The fatigue behavior was strongly dependent on P concentration in electroless Ni. Kirkendall voids were found in the interfacial region after aging, but they did not cause premature fracture of the solder interfaces. In Bi-containing solder interfacial system, we found that Bi segregated to the Cu-intermetallic interface during aging in SnBi/Cu interconnect. This caused serious embrittlement of Sn-Bi/Cu interface. Further aging induced numerous voids along the Cu3Sn/Cu interface. These interfacial voids were different from Kirkendall voids. Their formation was explained on basis of vacancy condensation at the interface as the Bi segregants reduced the number of effective Cu vacancy sink sites and enhanced void nucleation at the interface. The Bi segregation was avoided by replacing the Cu metallization with Ni. It was found that Bi developed a concentration gradient in the Ni 3Sn4 during interfacial reaction, with the Bi concentration falling off to zero as the Ni/IMC interface was approached. Therefore, the inhibition of Bi segregation by Ni was due to the inability of Bi to reach Ni/IMC interface.

Percolation Model of Adhesion at Polymer Interfaces

NASA Astrophysics Data System (ADS)

Wool, Richard P.

1998-03-01

Adhesion at polymer interfaces is treated as a percolation problem, where an areal density of chains Σ, of length L, contribute a number of entanglements to the interface of thickness X. The fracture energy G, is determined by the fraction of entanglements P, fractured or disentangled in the deformation zone preceding the crack tip, via G ~ P-P_c, where Pc is the percolation threshold, given by Pc = 1- M_e/Mc . For incompatible A/B interfaces reinforced with Σ diblocks or random A-B copolymers of effective length L'(L' ~ 0 for brushes and strongly adsorbed chains), we obtain P ~ ΣL/X, Pc ~ Σ _cL/X, such that G = K(Σ - Σ _c)+ G_o, where K and Go ~ 1 J/m^2 are constants. Note that Log G vs Log Σ will have an apparent slope of about 2, incorrectly suggesting that G ~ Σ ^2. For cohesive fracture, disentanglement dominates at M M*, G = G*[1-M_c/M]. For fatigue crack propagation da/dN, at welding interfaces, we obtain da/dN ~ M-5/2(t/Tr)-5/4, where t is the welding time and Tr is the reptation time. For polymer-solid interfaces, G ~ (X/R)^2. where X is the conformational width of the first layer of chains of random coil size R. The fractal nature of the percolation process is relevant to the fracture mechanism and fractography.

Hybrid-dimensional modelling of two-phase flow through fractured porous media with enhanced matrix fracture transmission conditions

NASA Astrophysics Data System (ADS)

Brenner, Konstantin; Hennicker, Julian; Masson, Roland; Samier, Pierre

2018-03-01

In this work, we extend, to two-phase flow, the single-phase Darcy flow model proposed in [26], [12] in which the (d - 1)-dimensional flow in the fractures is coupled with the d-dimensional flow in the matrix. Three types of so called hybrid-dimensional two-phase Darcy flow models are proposed. They all account for fractures acting either as drains or as barriers, since they allow pressure jumps at the matrix-fracture interfaces. The models also permit to treat gravity dominated flow as well as discontinuous capillary pressure at the material interfaces. The three models differ by their transmission conditions at matrix fracture interfaces: while the first model accounts for the nonlinear two-phase Darcy flux conservations, the second and third ones are based on the linear single phase Darcy flux conservations combined with different approximations of the mobilities. We adapt the Vertex Approximate Gradient (VAG) scheme to this problem, in order to account for anisotropy and heterogeneity aspects as well as for applicability on general meshes. Several test cases are presented to compare our hybrid-dimensional models to the generic equi-dimensional model, in which fractures have the same dimension as the matrix, leading to deep insight about the quality of the proposed reduced models.

The dentin-enamel junction and the fracture of human teeth.

PubMed

Imbeni, V; Kruzic, J J; Marshall, G W; Marshall, S J; Ritchie, R O

2005-03-01

The dentin-enamel junction (DEJ), which is the interfacial region between the dentin and outer enamel coating in teeth, is known for its unique biomechanical properties that provide a crack-arrest barrier for flaws formed in the brittle enamel1. In this work, we re-examine how cracks propagate in the proximity of the DEJ, and specifically quantify, using interfacial fracture mechanics, the fracture toughness of the DEJ region. Careful observation of crack penetration through the interface and the new estimate of the DEJ toughness ( approximately 5 to 10 times higher than enamel but approximately 75% lower than dentin) shed new light on the mechanism of crack arrest. We conclude that the critical role of this region, in preventing cracks formed in enamel from traversing the interface and causing catastrophic tooth fractures, is not associated with the crack-arrest capabilities of the interface itself; rather, cracks tend to penetrate the (optical) DEJ and arrest when they enter the tougher mantle dentin adjacent to the interface due to the development of crack-tip shielding from uncracked-ligament bridging.

The dentin-enamel junction and the fracture of human teeth

NASA Astrophysics Data System (ADS)

Imbeni, V.; Kruzic, J. J.; Marshall, G. W.; Marshall, S. J.; Ritchie, R. O.

2005-03-01

The dentin-enamel junction (DEJ), which is the interfacial region between the dentin and outer enamel coating in teeth, is known for its unique biomechanical properties that provide a crack-arrest barrier for flaws formed in the brittle enamel1. In this work, we re-examine how cracks propagate in the proximity of the DEJ, and specifically quantify, using interfacial fracture mechanics, the fracture toughness of the DEJ region. Careful observation of crack penetration through the interface and the new estimate of the DEJ toughness (~5 to 10 times higher than enamel but ~75% lower than dentin) shed new light on the mechanism of crack arrest. We conclude that the critical role of this region, in preventing cracks formed in enamel from traversing the interface and causing catastrophic tooth fractures, is not associated with the crack-arrest capabilities of the interface itself; rather, cracks tend to penetrate the (optical) DEJ and arrest when they enter the tougher mantle dentin adjacent to the interface due to the development of crack-tip shielding from uncracked-ligament bridging.

Breast reconstruction with tissue expanders: implementation of a standardized best-practices protocol to reduce infection rates.

PubMed

Khansa, Ibrahim; Hendrick, Russell G; Shore, Alison; Meyerson, Joseph; Yang, Maelee; Boehmler, James H

2014-07-01

Periprosthetic infection remains a frustrating and costly complication of breast reconstruction with tissue expanders. Although some specific steps have been previously shown to reduce periprosthetic infections, no comprehensive protocol addressing all aspects of preoperative, intraoperative, and postoperative patient management has been evaluated in the literature. The authors' goal was to evaluate the effectiveness of their protocol at reducing periprosthetic infections. A comprehensive, best-practices protocol was introduced and implemented in November of 2010. All patients undergoing breast reconstruction using tissue expanders at the authors' institution in the 5 years before the protocol, and in the 2 years after, were analyzed. Three hundred five patients underwent 456 tissue expander reconstructions in the 5 years before the protocol, and 198 patients underwent 313 reconstructions in the 2 years after. Significantly fewer patients developed periprosthetic infection after protocol (11.6 percent versus 18.4 percent; p=0.042), and the number of infected tissue expanders trended toward a decrease (9.3 percent versus 13.2 percent; p=0.097). On multivariate analysis, the protocol significantly reduced the odds of periprosthetic infection (OR, 0.45; p=0.022). Predictors of infection included obesity (OR, 2.01; p=0.045) and preoperative breast size larger than C cup (OR, 2.83; p=0.006). The authors' comprehensive, best-practices protocol allowed them to reduce the odds of tissue expander infections by 55 percent (OR, 0.45; p=0.022). The authors were able to identify several potential areas of improvement that may help them lower the rate of infection further in the future. Therapeutic, III.

Periprosthetic bone remodelling of short-stem total hip arthroplasty: a systematic review.

PubMed

Yan, Shuang G; Weber, Patrick; Steinbrück, Arnd; Hua, Xingyi; Jansson, Volkmar; Schmidutz, Florian

2017-11-27

Short-stem hip arthroplasty (SHA) was designed to preserve bone stock and provide an improved load transfer. To gain more evidence regarding the load transfer, this review analysed the periprosthetic bone remodelling of SHA in comparison to standard hip arthroplasty (THA). PubMed and ScienceDirect were screened to extract dual-energy X-ray absorptiometry (DXA) studies evaluating the periprosthetic bone remodelling of SHA and two proven THA designs. From the studies included, the postoperative change in periprosthetic bone mineral density (BMD) after one year and the trend over two years was determined. Fifteen studies with four SHAs (CFP, Metha, Nanos, Fitmore) and two THAs (CLS and Bicontact) designs were included. All SHA and THA stems revealed an initial decrease at the calcar and major trochanter (Gruen 1 and 7) with the Metha, Nanos and Fitmore showing a smaller and more balanced remodelling compared to THA. The pattern after one year and the trend over two years argue for a methaphyseal anchorage of the Metha and Nanos, whereas the Fitmore and CFP seem to anchor metha-diaphyseal. Clearly different pattern of bone remodelling were observed between all four SHAs. Periprosthetic bone remodelling is also present in SHA, with the main bone reduction observed proximally. However, certain SHA stems show a more balanced remodelling compared to THA, arguing for a favourable load transfer. Also, the femoral length where bone remodelling occurs is clearly shorter in SHA. As distinctively different pattern between the SHA designs were observed, they should not be judged as a single implant group.

30years of DXA technology innovations.

PubMed

Glüer, Claus-C

2017-11-01

As the successor of Dual Photon Absorptiometry (DPA), Dual X-ray Absorptiometry (DXA) has seen 30years of continuous technological innovations. Implementation of measures for standardization and quality assurance made DXA a reliable and clinically useful approach. Its use in clinical multicenter drug studies in osteoporosis lead to general acceptance as the standard technique of bone densitometry. The limitations of DXA are well established. As a measure of areal bone mineral density (aBMD) it depends on bone size and is biased by overlaying soft tissue and calcified structures. To some extent these errors can be reduced by estimation of bone depth and/or lateral imaging. DXA based aBMD can be supplemented by additional information obtainable from DXA scans: geometric indices such as hip axis length or complex models like 2-D finite element analysis have been developed and tested. Given the drastic improvement in image quality current DXA scans can be used for Vertebral Fracture Analysis (VFA) or grading of Abdominal Aortic Calcifications. A textural measure, Trabecular Bone Score (TBS) provides independent information on fracture risk. DXA devices can also be used for assessments beyond bone density. Periprosthetic aBMD changes can be monitored to study the mechanical fitting of bone implants. Total body composition measurements are increasingly being used in studies on nutrition, obesity, and sarcopenia. 30years after its inception DXA is the undisputed standard imaging technique for the assessment of osteoporotic fracture risk with new applications beyond bone densitometry adding to its value. Copyright © 2017 Elsevier Inc. All rights reserved.

Bactericidal micron-thin sol-gel films prevent pin tract and periprosthetic infection.

PubMed

Qu, Haibo; Knabe, Christine; Burke, Megan; Radin, Shula; Garino, Jonathan; Schaer, Thomas; Ducheyne, Paul

2014-08-01

Orthopedic injuries constitute the majority of wounds sustained by U.S. soldiers in recent conflicts. The risk of infection is considerable with fracture fixation devices. In this pilot study, we examined the use of unique bactericidal micron-thin sol-gel films on fracture fixation devices and their ability to prevent and eradicate infections. External fixation was studied with micron-thin sol-gel coated percutaneous pins releasing triclosan and inserted medially into rabbit tibiae. A total of 11 rabbits received percutaneous pins that were either uncoated or sol-gel/triclosan coated. Internal fracture fixation was also studied using sol-gel coated intramedullary (IM) nails releasing vancomycin in the intramedullary tibiae. Six sheep received IM nails that were coated with a sol-gel film that either contained vancomycin or did not contain vancomycin. All animals were challenged with Staphylococcus aureus around the implant. Animals were euthanized at 1 month postoperative. Rabbits receiving triclosan/sol-gel coated percutaneous pins did not show signs of infection. Uncoated percutaneous pins had a significantly higher infection rate. In the sheep study, there were no radiographic signs of osteomyelitis with vancomycin/sol-gel coated IM nails, in contrast to the observations in the control cohort. Hence, the nanostructured sol-gel controlled release technology offers the promise of a reliable and continuous delivery system of bactericidals from orthopedic devices to prevent and treat infection. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,^.

PubMed

Wei, Feng; Bucak, Serhat Selçuk; Vollner, Jennifer M; Fenton, Todd W; Jain, Anil K; Haut, Roger C

2017-01-01

Distinguishing between accidental and abusive head trauma in children can be difficult, as there is a lack of baseline data for pediatric cranial fracture patterns. A porcine head model has recently been developed and utilized in a series of studies to investigate the effects of impact energy level, surface type, and constraint condition on cranial fracture patterns. In the current study, an automated pattern recognition method, or a fracture printing interface (FPI), was developed to classify cranial fracture patterns that were associated with different impact scenarios documented in previous experiments. The FPI accurately predicted the energy level when the impact surface type was rigid. Additionally, the FPI was exceedingly successful in determining fractures caused by skulls being dropped with a high-level energy (97% accuracy). The FPI, currently developed on the porcine data, may in the future be transformed to the task of cranial fracture pattern classification for human infant skulls. © 2016 American Academy of Forensic Sciences.

Patients with intolerance reactions to total knee replacement: combined assessment of allergy diagnostics, periprosthetic histology, and peri-implant cytokine expression pattern.

PubMed

Thomas, Peter; von der Helm, Christine; Schopf, Christoph; Mazoochian, Farhad; Frommelt, Lars; Gollwitzer, Hans; Schneider, Josef; Flaig, Michael; Krenn, Veit; Thomas, Benjamin; Summer, Burkhard

2015-01-01

We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR): patch test (PT), lymphocyte transformation test (LTT), histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils), and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ). We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity). Control specimens were from 5 complicated TKR patients without metal sensitization, 12 OA patients before arthroplasty, and 8 PT patients without arthroplasty. Lymphocytic infiltrates were seen and fibrotic (Type IV membrane) tissue response was most frequent in the metal sensitive patients, for example, in 81% of the PT positive patients. The latter also had marked periprosthetic IFNγ expression. 8/9 patients with revision surgery using Ti-coated/oxinium based implants reported symptom relief. Our findings demonstrate that combining allergy diagnostics with histopathology and periprosthetic cytokine assessment could allow us to design better diagnostic strategies.

The Role of TLR and Chemokine in Wear Particle-Induced Aseptic Loosening

PubMed Central

Gu, Qiaoli; Shi, Qin; Yang, Huilin

2012-01-01

Wear particle-induced periprosthetic osteolysis remains the principal cause of aseptic loosening of orthopaedic implants. Monocytes/macrophages phagocytose wear particles and release cytokines that induce inflammatory response. This response promotes osteoclast differentiation and osteolysis. The precise mechanisms by which wear particles are recognized and induce the accumulation of inflammatory cells in the periprosthetic tissue have not been fully elucidated. Recent studies have shown that toll-like receptors (TLRs) contribute to the cellular interaction with wear particles. Wear particles are recognized by monocytes/macrophages through TLRs coupled with the adaptor protein MyD88. After the initial interaction, wear particles induce both local and systemic migration of monocytes/macrophages to the periprosthetic region. The cellular migration is mediated through chemokines including interleukin-8, macrophage chemotactic protein-1, and macrophage inhibitory protein-1 in the periprosthetic tissues. Interfering with chemokine-receptor axis can inhibit cellular migration and inflammatory response. This paper highlights recent advances in TLR, and chemokine participated in the pathogenesis of aseptic loosening. A comprehensive understanding of the recognition and migration mechanism is critical to the development of measures that prevent wear particle-induced aseptic loosening of orthopaedic implants. PMID:23193363

Displaced intracapsular neck of femur fractures: Outcome of 810 hydroxyapetite coated (HAC) uncemented hemiarthroplasties.

PubMed

Nawaz, S Z; Keightley, A J; Desai, A; Granville-Chapman, J; Elliott, D; Newman, K; Khaleel, A

2017-04-01

A Cochrane review influenced new NICE guidelines, which recommended surgeons: Offer cemented implants to patients undergoing surgery with arthroplasty. However our trust routinely uses HAC uncemented stem (Taperloc ® , Biomet) hemiarthroplasties. A review of a consecutive series of uncemented HAC stem hemiarthroplasties including measures such as intro-operative complications, mortality and revision surgery. Prospectively collected data between January 2008 and June 2014 was used, with medical record and radiographic reviews performed. 810 consecutive Taperloc uncemented hemiarthroplasty with monopolar heads were performed in 763 patients, with a minimum 12 month follow-up (12-90) follow-up. Mean age 83yrs; 71% female. Meantime to operation was 28.5h. 30day mortality: 4.4% (33/763). One year mortality was 11.2% (89/763). 2.5% (20/810) were admitted on a separate admission with the periprosthetic fracture. 0.6% (5/810) were revised to total hip replacement for subsidence and associated pain. Only 1% (8/810) had intraoperative calcar fractures, all of which were treated with intraoperative cabling with no evidence of clinically relevant subsidence or medium term complications requiring revision surgery within a year. To the author's knowledge this is largest outcome series for modern design uncemented hemiarthroplasty. Our study shows comparable data to cemented hemiarthroplasty but no deaths in the first 2days post-op. Our series also demonstrates a well below average mortality figures which are clearly multifactorial but believe uncemented prosthesis play a role. We believe that uncemented proven stem design hemiarthroplasty remains a safe and good surgical option for displaced intracapsular fractures. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Catastrophic metallosis after tumoral knee prosthesis failure: A case report.

PubMed

La Verde, Luca; Fenga, Domenico; Spinelli, Maria Silvia; Campo, Francesco Rosario; Florio, Michela; Rosa, Michele Attilio

2017-01-01

Metallosis is a condition characterized by an infiltration of periprosthetic soft tissues and bone by metallic debris resulting from wear or failure of joint arthroplasties. Authors describe a case of a 45-year-old man treated for an osteosarcoma of the distal femur with a modular prosthesis when he was 18 years old, he developed massive metallosis with skin dyspigmentation after 17 years. His medical\\surgical history was remarkable for a left tumoral knee prosthesis implanted 21 years ago. Two years before revision, the patient had a car accident with a two-points prosthesis breakage and despite the surgeon's advice, the patient refused surgery. In two years, prosthesis malfunction caused a progressive catastrophic soft tissues infiltration of metallic debris. Authors suggest that if prosthesis fracture is detected, revision surgery should be attempted as earlier as possible. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Survival of primary condylar-constrained total knee arthroplasty at a minimum of 7 years.

PubMed

Maynard, Lance M; Sauber, Timothy J; Kostopoulos, Vasileios K; Lavigne, Gregory S; Sewecke, Jeffrey J; Sotereanos, Nicholas G

2014-06-01

The purpose of the present study is to retrospectively analyze clinical and radiographic outcomes in primary constrained condylar knee arthroplasty at a minimum follow-up of 7 years. Given the concern for early aseptic loosening in constrained implants, we focused on this outcome. Our cohort consists of 127 constrained condylar knees. The mean age of patients in the study was 68.3 years, with a mean follow-up of 110.7 months. The diagnosis was primary osteoarthritis in 92%. There were four periprosthetic distal femur fractures, with a rate of revision of 0.8%. No implants were revised for aseptic loosening. Kaplan-Meier survivorship analysis with removal of any component as the end point revealed that the 10-year rate of survival of the primary CCK was 97.6% (95% CI, 94%-100%). Copyright © 2014. Published by Elsevier Inc.

Clinical and Radiologic Outcomes of a Fully Hydroxyapatite-Coated Femoral Revision Stem: Excessive Stress Shielding Incidence and its Consequences.

PubMed

Sanli, Ilknur; Arts, Jacobus Johannes Christiaan; Geurts, Jan

2016-01-01

Stress shielding remains a concern in total hip arthroplasty. The consequences of stress shielding in hydroxyapatite-coated femoral component revisions were evaluated in a prospective cohort study. A total of 106 patients operated on by revision total hip arthroplasty were identified. Sixty-three patients were eligible for clinical and radiologic assessment of osseointegration, bone remodeling, and stress shielding. Five patients showed evidence of excessive stress shielding. One patient experienced a periprosthetic fracture. No adverse events occurred in the remaining patients with a low rate of thigh pain and reliable osseointegration. This is the only available study concerning mid- to long-term consequences of excessive stress shielding in hydroxyapatite-coated revision stems. We advocate surgeons using these stems to remain vigilant and be aware of possible stress shielding side effects. Copyright © 2016 Elsevier Inc. All rights reserved.

Low sensitivity of implant sonication when screening for infection in revision surgery

PubMed Central

Van Diek, Floor M; Albers, Christiaan G M; Van Hooff, Miranda L; Meis, Jacques F; Goosen, Jon H M

2017-01-01

Background and purpose Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria. Perioperatively, 6 periprosthetic interface tissue biopsies were obtained from each patient and the implants removed were sonicated. The sensitivity and specificity of periprosthetic tissue culture and sonication fluid cultures were determined. Results Preoperatively, 75 revision cases were classified as having PJI (33 early and 42 late) and 177 were unsuspected of having infection. Compared with tissue culture, the sensitivity of the sonication fluid analysis was low: 0.47 (95% CI: 0.35–0.59) for sonication as compared to 0.68 (95% CI: 0.56–0.78) for tissue culture. The specificity of the sonication fluid analysis was higher than that for tissue culture: 0.99 (95% CI: 0.96–1.0) as compared to 0.80 (95% CI: 0.74–0.86). Interpretation Sonication is a highly specific test for diagnosis of PJI. However, due to the low sensitivity, a negative sonication result does not rule out the presence of PJI. Thus, sonication is not of value for screening of microorganisms during revision surgery. PMID:28287012

The integrity of welded interfaces in ultra-high molecular weight polyethylene: Part 2--interface toughness.

PubMed

Haughie, David W; Buckley, C Paul; Wu, Junjie

2006-07-01

In Part 2 of a study of welding of ultra-high molecular weight polyethylene (UHMWPE), experiments were conducted to measure the interfacial fracture energy of butt welds, for various welding times and temperatures above the melting point. Their toughness was investigated at 37 degrees C in terms of their fracture energy, obtained by adapting the essential work of fracture (EWF) method. However, a proportion of the welded samples (generally decreasing with increasing welding time or temperature) failed in dual ductile/brittle mode, hence invalidating the EWF test. Even those failing in purely ductile mode showed a measurable interface work of fracture only for the highest weld temperature and time: 188 degrees C and 90 min. Results from the model presented in Part 1 show that this corresponds to the maximum reptated molecular weight reaching close to the peak in the molar mass distribution. Hence this work provides the first experimental evidence that the slow rate of self-diffusion in UHMWPE leads to welded interfaces acting as low-toughness crack paths. Since such interfaces exist around every powder particle in processed UHMWPE this problem cannot be avoided, and it must be accommodated in design of hip and knee bearing surfaces made from this polymer.

Deformation and fracture of explosion-welded Ti/Al plates: A synchrotron-based study

DOE Office of Scientific and Technical Information (OSTI.GOV)

E, J. C.; Huang, J. Y.; Bie, B. X.

Here, explosion-welded Ti/Al plates are characterized with energy dispersive spectroscopy and x-ray computed tomography, and exhibit smooth, well-jointed, interface. We perform dynamic and quasi-static uniaxial tension experiments on Ti/Al with the loading direction either perpendicular or parallel to the Ti/Al interface, using a mini split Hopkinson tension bar and a material testing system in conjunction with time-resolved synchrotron x-ray imaging. X-ray imaging and strain-field mapping reveal different deformation mechanisms responsible for anisotropic bulk-scale responses, including yield strength, ductility and rate sensitivity. Deformation and fracture are achieved predominantly in Al layer for perpendicular loading, but both Ti and Al layers asmore » well as the interface play a role for parallel loading. The rate sensitivity of Ti/Al follows those of the constituent metals. For perpendicular loading, single deformation band develops in Al layer under quasi-static loading, while multiple deformation bands nucleate simultaneously under dynamic loading, leading to a higher dynamic fracture strain. For parallel loading, the interface impedes the growth of deformation and results in increased ductility of Ti/Al under quasi-static loading, while interface fracture occurs under dynamic loading due to the disparity in Poisson's contraction.« less

Deformation and fracture of explosion-welded Ti/Al plates: A synchrotron-based study

DOE PAGES

E, J. C.; Huang, J. Y.; Bie, B. X.; ...

2016-08-02

Here, explosion-welded Ti/Al plates are characterized with energy dispersive spectroscopy and x-ray computed tomography, and exhibit smooth, well-jointed, interface. We perform dynamic and quasi-static uniaxial tension experiments on Ti/Al with the loading direction either perpendicular or parallel to the Ti/Al interface, using a mini split Hopkinson tension bar and a material testing system in conjunction with time-resolved synchrotron x-ray imaging. X-ray imaging and strain-field mapping reveal different deformation mechanisms responsible for anisotropic bulk-scale responses, including yield strength, ductility and rate sensitivity. Deformation and fracture are achieved predominantly in Al layer for perpendicular loading, but both Ti and Al layers asmore » well as the interface play a role for parallel loading. The rate sensitivity of Ti/Al follows those of the constituent metals. For perpendicular loading, single deformation band develops in Al layer under quasi-static loading, while multiple deformation bands nucleate simultaneously under dynamic loading, leading to a higher dynamic fracture strain. For parallel loading, the interface impedes the growth of deformation and results in increased ductility of Ti/Al under quasi-static loading, while interface fracture occurs under dynamic loading due to the disparity in Poisson's contraction.« less

The influence of bone damage on press-fit mechanics.

PubMed

Bishop, Nicholas E; Höhn, Jan-Christian; Rothstock, Stephan; Damm, Niklas B; Morlock, Michael M

2014-04-11

Press-fitting is used to anchor uncemented implants in bone. It relies in part on friction resistance to relative motion at the implant-bone interface to allow bone ingrowth and long-term stability. Frictional shear capacity is related to the interference fit of the implant and the roughness of its surface. It was hypothesised here that a rough implant could generate trabecular bone damage during implantation, which would reduce its stability. A device was constructed to simulate implantation by displacement of angled platens with varying surface finishes (polished, beaded and flaked) onto the surface of an embedded trabecular bone cube, to different nominal interferences. Push-in (implantation) and Pull-out forces were measured and micro-CT scans were made before and after testing to assess permanent bone deformation. Depth of permanent trabecular bone deformation ('damage'), Pull-out force and Radial force all increased with implantation displacement and with implantation force, for all surface roughnesses. The proposed hypothesis was rejected, since primary stability did not decrease with trabecular bone damage. In fact, Pull-out force linearly increased with push-in force, independently of trabecular bone damage or implant surface. This similar behaviour for the different surfaces might be explained by the compaction of bone into the surfaces during push-in so that Pull-out resistance is governed by bone-on-bone, rather than implant surface-on-bone friction. The data suggest that maximum stability is achieved for the maximum implantation force possible (regardless of trabecular bone damage or surface roughness), but this must be limited to prevent periprosthetic cortical bone fracture, patient damage and component malpositioning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Edge Fracture in Complex Fluids.

PubMed

Hemingway, Ewan J; Kusumaatmaja, Halim; Fielding, Suzanne M

2017-07-14

We study theoretically the edge fracture instability in sheared complex fluids, by means of linear stability analysis and direct nonlinear simulations. We derive an exact analytical expression for the onset of edge fracture in terms of the shear-rate derivative of the fluid's second normal stress difference, the shear-rate derivative of the shear stress, the jump in shear stress across the interface between the fluid and the outside medium (usually air), the surface tension of that interface, and the rheometer gap size. We provide a full mechanistic understanding of the edge fracture instability, carefully validated against our simulations. These findings, which are robust with respect to choice of rheological constitutive model, also suggest a possible route to mitigating edge fracture, potentially allowing experimentalists to achieve and accurately measure flows stronger than hitherto possible.

Ankylosing Spondylitis Increases Perioperative and Postoperative Complications After Total Hip Arthroplasty.

PubMed

Blizzard, Daniel J; Penrose, Colin T; Sheets, Charles Z; Seyler, Thorsten M; Bolognesi, Michael P; Brown, Christopher R

2017-08-01

Ankylosing spondylitis (AS) is a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive sagittal balance, and altered biomechanics. The purpose of this study is to determine the complication profile of patients with AS undergoing total hip arthroplasty (THA). The Medicare sample was searched from 2005 to 2012 yielding 1006 patients with AS who subsequently underwent THA. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for 90-day, 2-year, and the final postoperative follow-up for complications including hip dislocation, periprosthetic fracture, wound complication, revision THA, and postoperative infection. Compared to controls, AS patients had an RR of 2.50 (CI, 1.04-5.99) of THA component breakage at 90-days post-operatively and 1.99 (CI, 1.10-3.59) at 2-years. The RR of periprosthetic hip dislocation was elevated at 90 days (1.44; CI, 0.93-2.22) and significantly increased at 2-years (1.67; CI, 1.25-2.23) and overall follow-up (1.49; CI, 1.14-1.93). Similarly, the RR for THA revision was elevated at 90-days (1.46; CI, 0.97-2.18) and significantly increased at 2-years (1.69; CI, 1.33-2.14) and overall follow-up (1.51; CI, 1.23-1.85). Patients with AS are at increased risk for complications after THA. Altered biomechanics from a rigid, kyphotic spine place increased demand on the hip joints. The elevated perioperative and postoperative risks should be discussed preoperatively, and these patients may require increased preoperative medical optimization as well as possible changes in component selection and position to compensate for altered spinopelvic biomechanics. Copyright © 2017 Elsevier Inc. All rights reserved.

Specific Infectious Organisms Associated With Poor Outcomes in Treatment for Hip Periprosthetic Infection.

PubMed

Cunningham, Daniel J; Kavolus, Joseph J; Bolognesi, Michael P; Wellman, Samuel S; Seyler, Thorsten M

2017-06-01

Periprosthetic hip infection treatment remains a significant challenge for orthopedics. Some studies have suggested that methicillin resistance and gram-negative organism type are associated with increased treatment failure. The aim of this research is to determine if specific organisms were associated with poor outcomes in treatment for hip periprosthetic infection. Records were reviewed of all patients between 2005 and 2015 who underwent treatment for infected partial or total hip arthroplasty. Characteristics of each patient's treatment course were determined including baseline characteristics, infecting organism(s), infection status at final follow-up, surgeries for infection, and time in hospital. Baseline characteristics and organisms that were associated with clinical outcomes in univariate analysis were incorporated into multivariable outcomes models. When compared with patients infected with other organism(s), patients infected with the following organisms had significantly decreased infection-free rates: Pseudomonas, methicillin-resistant Staphylococcus aureus (MRSA), and Proteus. Infection with certain organisms was associated with 1.13-2.58 additional surgeries: methicillin-sensitive S aureus, coagulase-negative Staphylococcus, MRSA, Pseudomonas, Peptostreptococcus, Klebsiella, Candida, diphtheroids, Propionibacterium acnes, and Proteus species. Specific organisms were associated with 8.56-24.54 additional days in hospital for infection: methicillin-sensitive S aureus, coagulase-negative Staphylococcus, Proteus, MRSA, Enterococcus, Pseudomonas, Klebsiella, beta-hemolytic Streptococcus, and diphtheroids. Higher comorbidity score was also associated with greater length of hospitalization. MRSA, Pseudomonas, and Proteus were associated with all 3 outcomes of lower infection-free rate, more surgery, and more time in hospital in treatment for hip periprosthetic infection. Organism-specific outcome information may help individualize patient-physician discussions about the expected course of treatment for hip periprosthetic infection. Copyright © 2017 Elsevier Inc. All rights reserved.

* Murine Model of Progressive Orthopedic Wear Particle-Induced Chronic Inflammation and Osteolysis.

PubMed

Pajarinen, Jukka; Nabeshima, Akira; Lin, Tzu-Hua; Sato, Taishi; Gibon, Emmanuel; Jämsen, Eemeli; Lu, Laura; Nathan, Karthik; Yao, Zhenyu; Goodman, Stuart B

2017-12-01

Periprosthetic osteolysis and subsequent aseptic loosening of total joint replacements are driven by byproducts of wear released from the implant. Wear particles cause macrophage-mediated inflammation that culminates with periprosthetic bone loss. Most current animal models of particle-induced osteolysis are based on the acute inflammatory reaction induced by wear debris, which is distinct from the slowly progressive clinical scenario. To address this limitation, we previously developed a murine model of periprosthetic osteolysis that is based on slow continuous delivery of wear particles into the murine distal femur over a period of 4 weeks. The particle delivery was accomplished by using subcutaneously implanted osmotic pumps and tubing, and a hollow titanium rod press-fit into the distal femur. In this study, we report a modification of our prior model in which particle delivery is extended to 8 weeks to better mimic the progressive development of periprosthetic osteolysis and allow the assessment of interventions in a setting where the chronic particle-induced osteolysis is already present at the initiation of the treatment. Compared to 4-week samples, extending the particle delivery to 8 weeks significantly exacerbated the local bone loss observed with μCT and the amount of both peri-implant F4/80 + macrophages and tartrate-resistant acid phosphatase-positive osteoclasts detected with immunohistochemical and histochemical staining. Furthermore, systemic recruitment of reporter macrophages to peri-implant tissues observed with bioluminescence imaging continued even at the later stages of particle-induced inflammation. This modified model system could provide new insights into the mechanisms of chronic inflammatory bone loss and be particularly useful in assessing the efficacy of treatments in a setting that resembles the clinical scenario of developing periprosthetic osteolysis more closely than currently existing model systems.

Periprosthetic wear particle migration and distribution modelling and the implication for osteolysis in cementless total hip replacement.

PubMed

Alidousti, Hamidreza; Taylor, Mark; Bressloff, Neil W

2014-04-01

In total hip replacement (THR), wear particles play a significant role in osteolysis and have been observed in locations as remote as the tip of femoral stem. However, there is no clear understanding of the factors and mechanisms causing, or contributing to particle migration to the periprosthetic tissue. Interfacial gaps provide a route for particle laden joint fluid to transport wear particles to the periprosthetic tissue and cause osteolysis. It is likely that capsular pressure, gap dimensions and micromotion of the gap during cyclic loading of an implant, play defining roles to facilitate particle migration. In order to obtain a better understanding of the above mechanisms and factors, transient two-dimensional computational fluid dynamic simulations have been performed for the flow in the lateral side of a cementless stem-femur system including the joint capsule, a gap in communication with the capsule and the surrounding bone. A discrete phase model to describe particle motion has been employed. Key findings from these simulations include: (1) Particles were shown to enter the periprosthetic tissue along the entire length of the gap but with higher concentrations at both proximal and distal ends of the gap and a maximum rate of particle accumulation in the distal regions. (2) High capsular pressure, rather than gap micromotion, has been shown to be the main driving force for particle migration to periprosthetic tissue. (3) Implant micromotion was shown to pump out rather than draw in particles to the interfacial gaps. (4) Particle concentrations are consistent with known distributions of (i) focal osteolysis at the distal end of the gap and (ii) linear osteolysis along the entire gap length. Copyright © 2014 Elsevier Ltd. All rights reserved.

Performance of automated multiplex PCR using sonication fluid for diagnosis of periprosthetic joint infection: a prospective cohort.

PubMed

Renz, Nora; Feihl, Susanne; Cabric, Sabrina; Trampuz, Andrej

2017-12-01

Sonication of explanted prostheses improved the microbiological diagnosis of periprosthetic joint infections (PJI). We evaluated the performance of automated multiplex polymerase chain reaction (PCR) using sonication fluid for the microbiological diagnosis of PJI. In a prospective cohort using uniform definition criteria for PJI, explanted joint prostheses were investigated by sonication and the resulting sonication fluid was analyzed by culture and multiplex PCR. McNemar's Chi-squared test was used to compare the performance of diagnostic tests. Among 111 patients, PJI was diagnosed in 78 (70%) and aseptic failure in 33 (30%). For the diagnosis of PJI, the sensitivity and specificity of periprosthetic tissue culture was 51 and 100%, of sonication fluid culture 58 and 100%, and of sonication fluid PCR 51 and 94%, respectively. Among 70 microorganisms, periprosthetic tissue culture grew 52 (74%), sonication fluid culture grew 50 (71%) and sonication fluid PCR detected 37 pathogens (53%). If only organisms are considered, for which primers are included in the test panel, PCR detected 37 of 58 pathogens (64%). The sonication fluid PCR missed 19 pathogens (predominantly oral streptococci and anaerobes), whereas 7 additional microorganisms were detected only by PCR (including Cutibacterium spp. and coagulase-negative staphylococci). The performance of multiplex PCR using sonication fluid is comparable to culture of periprosthetic tissue or sonication fluid. The advantages of PCR are short processing time (< 5 h) and fully automated procedure. However, culture technique is still needed due to the low sensitivity and the need of comprehensive susceptibility testing. Modification of primers or inclusion of additional ones may improve the performance of PCR, especially of low-virulent organisms.

Success rates for initial eradication of peri-prosthetic knee infection treated with a two-stage procedure.

PubMed

Kaminski, Andrzej; Citak, Mustafa; Schildhauer, Thomas Armin; Fehmer, Tobias

2014-01-01

In Germany, rates of primary total knee arthroplasty procedures and exchange arthroplasty procedures continue to rise. Late-onset peri-prosthetic infection constitutes a serious complication whose management may be dependent upon the spectrum of micro-organisms involved. The aim of this study was to provide a retrospective analysis of the effectiveness of initial eradication measures performed as part of a two-stage procedure. Between 2002 and 2008, a total of 328 patients who had received a first-time diagnosis of chronic peri-prosthetic knee infection following total knee arthroplasty (TKA) subsequently underwent surgery at our clinic. The surgical approach consisted of a two-stage procedure, with the initial procedure consisting of the removal of the prosthesis and radical debridement, followed by insertion of an antibiotic-loaded static spacer. The effectiveness of the procedure was assessed after six weeks, with each patient undergoing a number of clinical and laboratory-based tests, including knee joint aspiration. Staphylococcus aureus strains were responsible for 68% (n=223) of the total number of cases of peri-prosthetic knee infection. 19% of cases (n=62) showed evidence of gram-negative bacteria, while MRSA accounted for 15% (n=49) of cases. Six weeks after completion of the above-named treatment regimen, eradication of infection was considered successful in 289 patients (88.1%). Eradication was unsuccessful in 22% of MRSA infections (n=11) and 7% of MSSA infections (n=23). The treatment regimen outlined in this report is capable of achieving satisfactory results in the management of late-onset peri-prosthetic knee infection, with one exception: patients with infections caused by MRSA showed high failure rates.

Improved Diagnosis of Prosthetic Joint Infection by Culturing Periprosthetic Tissue Specimens in Blood Culture Bottles

PubMed Central

Peel, Trisha N.; Dylla, Brenda L.; Hughes, John G.; Lynch, David T.; Greenwood-Quaintance, Kerryl E.; Cheng, Allen C.; Mandrekar, Jayawant N.

2016-01-01

ABSTRACT Despite known low sensitivity, culture of periprosthetic tissue specimens on agars and in broths is routine. Culture of periprosthetic tissue samples in blood culture bottles (BCBs) is potentially more convenient, but it has been evaluated in a limited way and has not been widely adopted. The aim of this study was to compare the sensitivity and specificity of inoculation of periprosthetic tissue specimens into blood culture bottles with standard agar and thioglycolate broth culture, applying Bayesian latent class modeling (LCM) in addition to applying the Infectious Diseases Society of America (IDSA) criteria for prosthetic joint infection. This prospective cohort study was conducted over a 9-month period (August 2013 to April 2014) at the Mayo Clinic, Rochester, MN, and included all consecutive patients undergoing revision arthroplasty. Overall, 369 subjects were studied; 117 (32%) met IDSA criteria for prosthetic joint infection, and 82% had late chronic infection. Applying LCM, inoculation of tissues into BCBs was associated with a 47% improvement in sensitivity compared to the sensitivity of conventional agar and broth cultures (92.1 versus 62.6%, respectively); this magnitude of change was similar when IDSA criteria were applied (60.7 versus 44.4%, respectively; P = 0.003). The time to microorganism detection was shorter with BCBs than with standard media (P < 0.0001), with aerobic and anaerobic BCBs yielding positive results within a median of 21 and 23 h, respectively. Results of our study demonstrate that the semiautomated method of periprosthetic tissue culture in blood culture bottles is more sensitive than and as specific as agar and thioglycolate broth cultures and yields results faster. PMID:26733067

Simulation of two-phase flow in horizontal fracture networks with numerical manifold method

NASA Astrophysics Data System (ADS)

Ma, G. W.; Wang, H. D.; Fan, L. F.; Wang, B.

2017-10-01

The paper presents simulation of two-phase flow in discrete fracture networks with numerical manifold method (NMM). Each phase of fluids is considered to be confined within the assumed discrete interfaces in the present method. The homogeneous model is modified to approach the mixed fluids. A new mathematical cover formation for fracture intersection is proposed to satisfy the mass conservation. NMM simulations of two-phase flow in a single fracture, intersection, and fracture network are illustrated graphically and validated by the analytical method or the finite element method. Results show that the motion status of discrete interface significantly depends on the ratio of mobility of two fluids rather than the value of the mobility. The variation of fluid velocity in each fracture segment and the driven fluid content are also influenced by the ratio of mobility. The advantages of NMM in the simulation of two-phase flow in a fracture network are demonstrated in the present study, which can be further developed for practical engineering applications.

Crack deflection in brittle media with heterogeneous interfaces and its application in shale fracking

NASA Astrophysics Data System (ADS)

Zeng, Xiaguang; Wei, Yujie

Driven by the rapid progress in exploiting unconventional energy resources such as shale gas, there is growing interest in hydraulic fracture of brittle yet heterogeneous shales. In particular, how hydraulic cracks interact with natural weak zones in sedimentary rocks to form permeable cracking networks is of significance in engineering practice. Such a process is typically influenced by crack deflection, material anisotropy, crack-surface friction, crustal stresses, and so on. In this work, we extend the He-Hutchinson theory (He and Hutchinson, 1989) to give the closed-form formulae of the strain energy release rate of a hydraulic crack with arbitrary angles with respect to the crustal stress. The critical conditions in which the hydraulic crack deflects into weak interfaces and exhibits a dependence on crack-surface friction and crustal stress anisotropy are given in explicit formulae. We reveal analytically that, with increasing pressure, hydraulic fracture in shales may sequentially undergo friction locking, mode II fracture, and mixed mode fracture. Mode II fracture dominates the hydraulic fracturing process and the impinging angle between the hydraulic crack and the weak interface is the determining factor that accounts for crack deflection; the lower friction coefficient between cracked planes and the greater crustal stress difference favor hydraulic fracturing. In addition to shale fracking, the analytical solution of crack deflection could be used in failure analysis of other brittle media.

Biomechanics of bone-fracture fixation by stiffness-graded plates in comparison with stainless-steel plates

PubMed Central

Ganesh, VK; Ramakrishna, K; Ghista, Dhanjoo N

2005-01-01

Background In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress-shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress-shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress-shielding of the layer of the bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. Method In order to address this problem, we propose to use stiffness-graded plates. Accordingly, we have computed (by finite-element analysis) the stress distribution in the fractured bone fixed by composite plates, whose stiffness is graded both longitudinally and transversely. Results It can be seen that the stiffness-graded composite-plates cause less stress-shielding (as an example: at 50% of the healing stage, stress at the fracture interface is compressive in nature i.e. 0.002 GPa for stainless steel plate whereas stiffness graded plates provides tensile stress of 0.002 GPa. This means that stiffness graded plate is allowing the 50% healed bone to participate in loadings). Stiffness-graded plates are more flexible, and hence permit more bending of the fractured bone. This results in higher compressive stresses induced at the fractured faces accelerate bone-healing. On the other hand, away from the fracture interface the reduced stiffness and elastic modulus of the plate causes the neutral axis of the composite structure to be lowered into the bone resulting in the higher tensile stress in the bone-layer underneath the plate, wherein is conducive to the bone preserving its tensile strength. Conclusion Stiffness graded plates (with in-built variable stiffness) are deemed to offer less stress-shielding to the bone, providing higher compressive stress at the fractured interface (to induce accelerated healing) as well as higher tensile stress in the intact portion of the bone (to prevent bone remodeling and osteoporosis). PMID:16045807

Multiscale Modeling of Intergranular Fracture in Aluminum: Constitutive Relation For Interface Debonding

NASA Technical Reports Server (NTRS)

Yamakov, V.; Saether, E.; Glaessgen, E. H.

2008-01-01

Intergranular fracture is a dominant mode of failure in ultrafine grained materials. In the present study, the atomistic mechanisms of grain-boundary debonding during intergranular fracture in aluminum are modeled using a coupled molecular dynamics finite element simulation. Using a statistical mechanics approach, a cohesive-zone law in the form of a traction-displacement constitutive relationship, characterizing the load transfer across the plane of a growing edge crack, is extracted from atomistic simulations and then recast in a form suitable for inclusion within a continuum finite element model. The cohesive-zone law derived by the presented technique is free of finite size effects and is statistically representative for describing the interfacial debonding of a grain boundary (GB) interface examined at atomic length scales. By incorporating the cohesive-zone law in cohesive-zone finite elements, the debonding of a GB interface can be simulated in a coupled continuum-atomistic model, in which a crack starts in the continuum environment, smoothly penetrates the continuum-atomistic interface, and continues its propagation in the atomistic environment. This study is a step towards relating atomistically derived decohesion laws to macroscopic predictions of fracture and constructing multiscale models for nanocrystalline and ultrafine grained materials.

Field investigation into unsaturated flow and transport in a fault: Model analyses

USGS Publications Warehouse

Liu, H.-H.; Salve, R.; Wang, J.-S.; Bodvarsson, G.S.; Hudson, D.

2004-01-01

Results of a fault test performed in the unsaturated zone of Yucca Mountain, Nevada, were analyzed using a three-dimensional numerical model. The fault was explicitly represented as a discrete feature and the surrounding rock was treated as a dual-continuum (fracture-matrix) system. Model calibration against seepage and water-travel-velocity data suggests that lithophysal cavities connected to fractures can considerably enhance the effective fracture porosity and therefore retard water flow in fractures. Comparisons between simulation results and tracer concentration data also indicate that matrix diffusion is an important mechanism for solute transport in unsaturated fractured rock. We found that an increased fault-matrix and fracture-matrix interface areas were needed to match the observed tracer data, which is consistent with previous studies. The study results suggest that the current site-scale model for the unsaturated zone of Yucca Mountain may underestimate radionuclide transport time within the unsaturated zone, because an increased fracture-matrix interface area and the increased effective fracture porosity arising from lithophysal cavities are not considered in the current site-scale model. ?? 2004 Published by Elsevier B.V.

Bone remodelling after femoral short stem implantation in total hip arthroplasty: 1-year results from a randomized DEXA study.

PubMed

Freitag, Tobias; Hein, Marie-Anne; Wernerus, Dirk; Reichel, Heiko; Bieger, Ralf

2016-01-01

Short stem prostheses have been developed to preserve proximal femoral bone stock. This prospective, randomized study compared periprosthetic bone remodelling following short and straight stem implantation 1 year after surgery. One hundred and forty-four consecutive patients undergoing total hip arthroplasty were randomized to either a Fitmore short or a cementless straight stem (both Zimmer, Winterthur, Switzerland). Periprosthetic bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry performed the day before surgery and at 7 days, 3 months and 1 year postoperatively. Furthermore, the HHS and the WOMAC were obtained. One hundred and thirty-eight patients completed 1-year follow-up. Periprosthetic BMD changes at 1 year were most pronounced in the proximal medial region of interest (ROI) 7 with -17.2% after short stem and -16.7% after straight implantation (p = 0.67). However, there was significantly less BMD reduction in ROI 6 following short (-4.7%) versus straight stem (-10.8%) implantation (p = 0.01). There were no significant differences between the two groups in terms of the HHS and the WOMAC either before or after surgery. One year after surgery, both stems showed an implant-specific periprosthetic bone remodelling. Nevertheless, proximal load transfer was more pronounced after short stem implantation than with a straight stem.

[Mixed knee arthrodesis a rescue alternative in knee periprosthetic joint infection].

PubMed

López-Cervantes, Roberto Enrique; Rivera-Villa, Adrián Huematzin; Miguel-Pérez, Adrián; Morales-de Los Santos, René; Torres-González, Rubén; Pérez-Atanasio, José Manuel

2016-01-01

Knee arthrodesis is a rescue procedure for patients with knee periprosthetic joint infection who are not candidates for a revision surgery. The actual methods present a high complication rate with only moderate efectivity. We retrospectively analyzed 17 cases, of patients with knee periprosthetic joint infection and bone loss treated by intramedular expandable nail and monoplanar external fixator with a mínimum evolution of 1 year, evaluating the medical records and digitalized X-rays by 2 sub specialized doctors in osteoarticular rescue surgery. From the 17 patients, 88.2% were classified as Anderson Orthopaedic Research Institute classification grade (III) and the 11.2% IIB. We obtained fusion in 82.5%, staged Hammer (I-II) in a mean time of 6.33 months. Achieving independent gait was reported in 88.2%. Our complication rate was 47.1%, most of them minor complications except for a supracondylar amputation. Our infection recurrence rate was 35.4%. Mean intervention rate was 2.47 surgeries, all without any operative room complication. We achieved a fusion rate similar to other available knee arthrodesis methods in a similar treatment time; with lower complication rate, making it a suitable rescue alternative for knee arthrodesis in patients with significant bone loss and knee periprosthetic joint infection.

The deformation of the front of a 3D interface crack propagating quasistatically in a medium with random fracture properties

NASA Astrophysics Data System (ADS)

Pindra, Nadjime; Lazarus, Véronique; Leblond, Jean-Baptiste

One studies the evolution in time of the deformation of the front of a semi-infinite 3D interface crack propagating quasistatically in an infinite heterogeneous elastic body. The fracture properties are assumed to be lower on the interface than in the materials so that crack propagation is channelled along the interface, and to vary randomly within the crack plane. The work is based on earlier formulae which provide the first-order change of the stress intensity factors along the front of a semi-infinite interface crack arising from some small but otherwise arbitrary in-plane perturbation of this front. The main object of study is the long-time behavior of various statistical measures of the deformation of the crack front. Special attention is paid to the influences of the mismatch of elastic properties, the type of propagation law (fatigue or brittle fracture) and the stable or unstable character of 2D crack propagation (depending on the loading) upon the development of this deformation.

Current-Assisted Diffusion Bonding of Extruded Ti-22Al-25Nb Alloy by Spark Plasma Sintering: Interfacial Microstructure and Mechanical Properties

NASA Astrophysics Data System (ADS)

Yang, Jianlei; Wang, Guofeng; Jiao, Xueyan; Gu, Yibin; Liu, Qing; Li, You

2018-05-01

Spark plasma sintering (SPS) technology was used to current-assisted bond extruded Ti-22Al-25Nb alloy. The effects of bonding temperature (920-980 °C) and bonding time (10-30 min) on the microstructure evolution and shear strength of this alloy were investigated systematically. The temperature distribution in the specimen during the current-assisted bonding process was also analyzed by numerical simulation. It is noted that the highest temperature was obtained at the bonding interface. As the bonding temperature and bonding time increased, the voids in the interface shrank increasingly until they vanished. A complete metallurgical bonding interface could be produced at 960 °C/20 min/10 MPa, exhibiting the highest shear strength of 269.3 MPa. In addition, the shear strength of the bonded specimen depended on its interfacial microstructure. With increased bonding temperature, the fracture mode transformed from the intergranular fracture at the bonding interface to the cleavage fracture in the substrate.

Wellbore cement fracture evolution at the cement–basalt caprock interface during geologic carbon sequestration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jung, Hun Bok; Kabilan, Senthil; Carson, James P.

2014-08-07

Composite Portland cement-basalt caprock cores with fractures, as well as neat Portland cement columns, were prepared to understand the geochemical and geomechanical effects on the integrity of wellbores with defects during geologic carbon sequestration. The samples were reacted with CO2-saturated groundwater at 50 ºC and 10 MPa for 3 months under static conditions, while one cement-basalt core was subjected to mechanical stress at 2.7 MPa before the CO2 reaction. Micro-XRD and SEM-EDS data collected along the cement-basalt interface after 3-month reaction with CO2-saturated groundwater indicate that carbonation of cement matrix was extensive with the precipitation of calcite, aragonite, and vaterite,more » whereas the alteration of basalt caprock was minor. X-ray microtomography (XMT) provided three-dimensional (3-D) visualization of the opening and interconnection of cement fractures due to mechanical stress. Computational fluid dynamics (CFD) modeling further revealed that this stress led to the increase in fluid flow and hence permeability. After the CO2-reaction, XMT images displayed that calcium carbonate precipitation occurred extensively within the fractures in the cement matrix, but only partially along the fracture located at the cement-basalt interface. The 3-D visualization and CFD modeling also showed that the precipitation of calcium carbonate within the cement fractures after the CO2-reaction resulted in the disconnection of cement fractures and permeability decrease. The permeability calculated based on CFD modeling was in agreement with the experimentally determined permeability. This study demonstrates that XMT imaging coupled with CFD modeling represent a powerful tool to visualize and quantify fracture evolution and permeability change in geologic materials and to predict their behavior during geologic carbon sequestration or hydraulic fracturing for shale gas production and enhanced geothermal systems.« less

Revision shoulder arthroplasty from resurfacing to non-cemented short-stem reverse prosthesis.

PubMed

Natera, L; Bruguera, J; Atoun, E; Levy, O

2016-01-01

To assess the surgical parameters and the clinical and radiological outcomes of revisions of resurfacing shoulder arthroplasty to non-cemented short-stem reverse total shoulder arthroplasty. A total of 23 revisions from resurfacing shoulder arthroplasty to reverse total shoulder arthroplasty were performed. The mean age was 70.3±11.95 years. The patients included 82.6% (19/23) revised for cuff failure; 13.04% (3/23) cuff failure and aseptic loosening, and 4.35% (1/23) peri-prosthetic fracture. The need for humeral osteotomy or structural allograft, operation length, blood loss, blood transfusions and intraoperative fractures were recorded. Minimum follow-up 25 months. No humeral osteotomy or humeral structural allograft was required, and 2/23 (8.69%) required allograft for glenoid reconstruction. The mean operation time was 113.35±21.30minutes. Intra-operative blood loss was 374±245.09 mls. Blood transfusion was required in one case. Intra-operative fracture occurred in 1 case. The Constant score improved from 17.32 to 59.78 (age/sex adjusted, 84). Overall satisfaction improved from 1.37 to 8.04. The range of motion increased 79.57° in forward elevation; 72.88° in abduction; 38.06° in internal rotation; and 13.57° in external rotation. There was no evidence of radiolucency, subsidence, or bone resorption. Revisions of resurfacing implants to non-cemented short-stem reverse prosthesis show good clinical and radiological outcomes, with minimal intra-operative complexities. IV, case series. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

Structural analysis characterization of permeability pathways across reservoir-seal interface - South-Eastern Utah; Results from integrated sedimentological, structural, and geochemical studies.

NASA Astrophysics Data System (ADS)

Petrie, E. S.; Evans, J. P.; Richey, D.; Flores, S.; Barton, C.; Mozley, P.

2015-12-01

Sedimentary rocks in the San Rafael Swell, Utah, were deformed by Laramide compression and subsequent Neogene extension. We evaluate the effect of fault damage zone morphology as a function of structural position, and changes in mechanical stratigraphy on the distribution of secondary minerals across the reservoir-seal pair of the Navajo Sandstone and overlying Carmel Formation. We decipher paleo-fluid migration and examine the effect faults and fractures have on reservoir permeability and efficacy of top seal for a range of geo-engineering applications. Map-scale faults have an increased probability of allowing upward migration of fluids along the fault plane and within the damage zone, potentially bypassing the top seal. Field mapping, mesoscopic structural analyses, petrography, and geochemical observations demonstrate that fault zone thickness increases at structural intersections, fault relay zones, fault-related folds, and fault tips. Higher densities of faults with meters of slip and dense fracture populations are present in relay zones relative to single, discrete faults. Curvature analysis of the San Rafael monocline and fracture density data show that fracture density is highest where curvature is highest in the syncline hinge and near faults. Fractures cross the reservoir-seal interface where fracture density is highest and structural diagensis includes mineralization events and bleaching and calcite and gypsum mineralization. The link between fracture distributions and structural setting implys that transmissive fractures have predictable orientations and density distributions. At the m- to cm- scale, deformation-band faults and joints in the Navajo Sandstone penetrate the reservoir-seal interface and transition into open-mode fractures in the caprock seal. Scanline analysis and petrography of veins provide evidence for subsurface mineralization and fracture reactivation, suggesting that the fractures act as loci for fluid flow through time. Heterolithic caprock seals with variable fracture distributions and morphology highlight the strong link between the variation in material properties and the response to changing stress conditions. The variable connectivity of fractures and the changes in fracture density plays a critical role in subsurface fluid flow.

Interface toughness of a zirconia-veneer system and the effect of a liner application.

PubMed

Wang, Gaoqi; Zhang, Song; Bian, Cuirong; Kong, Hui

2014-09-01

Chipping of veneering porcelain and delamination of a zirconia-veneer interface are 2 common clinical failure modes for zirconia-based restorations and may be partially due to weak interface bonding. The effect of liner on the bond strength of the interface has not been clearly identified. The purpose of the research was to evaluate the interface toughness between the zirconia core and veneering porcelain by means of a fracture mechanics test and to assess the effect of liner on the bond strength of the interface. Thirty bilayered beam-shape specimens were prepared and divided into 2 groups according to liner application. The specimens in each group were subdivided into 3 subgroups in accordance with 3 different veneer thicknesses. A fracture mechanics test was used on each specimen, and the energy release rate, G, and phase angle, ψ, were calculated according to the experimental results. A video microscope was used to monitor the crack propagation, and a scanning electron microscope was used to identify the fracture mode after testing. Two-way ANOVA and the Tukey honestly significant difference test were performed to analyze the experimental data (α=.05) . At each phase angle, the interfaces without a liner had higher mean G values than the interfaces with a liner. Both of the interfaces showed mixed failure mode with thin layers of a veneer or a liner that remained on the zirconia surfaces. Liner application before veneering reduced the interface toughness between zirconia and veneer. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Area of Interest 1, CO 2 at the Interface. Nature and Dynamics of the Reservoir/Caprock Contact and Implications for Carbon Storage Performance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mozley, Peter; Evans, James; Dewers, Thomas

2014-10-31

We examined the influence of geologic features present at the reservoir/caprock interface on the transmission of supercritical CO 2 into and through caprock. We focused on the case of deformation-band faults in reservoir lithologies that intersect the interface and transition to opening-mode fractures in caprock lithologies. Deformation-band faults are exceeding common in potential CO 2 injection units and our fieldwork in Utah indicates that this sort of transition is common. To quantify the impact of these interface features on flow and transport we first described the sedimentology and permeability characteristics of selected sites along the Navajo Sandstone (reservoir lithology) andmore » Carmel Formation (caprock lithology) interface, and along the Slickrock Member (reservoir lithology) and Earthy Member (caprock lithology) of the Entrada Sandstone interface, and used this information to construct conceptual permeability models for numerical analysis. We then examined the impact of these structures on flow using single-phase and multiphase numerical flow models for these study sites. Key findings include: (1) Deformation-band faults strongly compartmentalize the reservoir and largely block cross-fault flow of supercritical CO 2. (2) Significant flow of CO 2 through the fractures is possible, however, the magnitude is dependent on the small-scale geometry of the contact between the opening-mode fracture and the deformation band fault. (3) Due to the presence of permeable units in the caprock, caprock units are capable of storing significant volumes of CO 2, particularly when the fracture network does not extend all the way through the caprock. The large-scale distribution of these deformation-bandfault-to-opening-mode-fractures is related to the curvature of the beds, with greater densities of fractures in high curvature regions. We also examined core and outcrops from the Mount Simon Sandstone and Eau Claire Formation reservoir/caprock interface in order to extend our work to a reservoir/caprock pair this is currently being assessed for long-term carbon storage. These analyses indicate that interface features similar to those observed at the Utah sites 3 were not observed. Although not directly related to our main study topic, one byproduct of our investigation is documentation of exceptionally high degrees of heterogeneity in the pore-size distribution of the Mount Simon Sandstone. This suggests that the unit has a greater-than-normal potential for residual trapping of supercritical CO 2.« less

Fracture toughness versus micro-tensile bond strength testing of adhesive-dentin interfaces.

PubMed

De Munck, Jan; Luehrs, Anne-Katrin; Poitevin, André; Van Ende, Annelies; Van Meerbeek, Bart

2013-06-01

To assess interfacial fracture toughness of different adhesive approaches and compare to a standard micro-tensile bond-strength (μTBS) test. Chevron-notched beam fracture toughness (CNB) was measured following a modified ISO 24370 standard. Composite bars with dimensions of 3.0×4.0×25 mm were prepared, with the adhesive-dentin interface in the middle. At the adhesive-dentin interface, a chevron notch was prepared using a 0.15 mm thin diamond blade mounted in a water-cooled diamond saw. Each specimen was loaded until failure in a 4-point bend test setup and the fracture toughness was calculated according to the ISO specifications. Similarly, adhesive-dentin micro-specimens (1.0×1.0×8-10 mm) were stressed in tensile until failure to determine the μTBS. A positive correlation (r(2)=0.64) was observed between CNB and μTBS, which however was only nearly statistically significant, mainly due to the dissimilar outcome of Scotchbond Universal (3M ESPE). While few μTBS specimens failed at the adhesive-dentin interface, almost all CNB specimens failed interfacially at the notch tip. Weibull moduli for interfacial fracture toughness were much higher than for μTBS (3.8-11.5 versus 2.7-4.8, respectively), especially relevant with regard to early failures. Although the ranking of the adhesives on their bonding effectiveness tested using CNB and μTBS corresponded well, the outcome of CNB appeared more reliable and less variable. Fracture toughness measurement is however more laborious and requires specific equipment. The μTBS nevertheless appeared to remain a valid method to assess bonding effectiveness in a versatile way. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Bone toughness at the molecular scale: A model for fracture toughness using crosslinked osteopontin on synthetic and biogenic mineral substrates.

PubMed

Cavelier, S; Dastjerdi, A K; McKee, M D; Barthelat, F

2018-05-01

The most prominent structural components in bone are collagen and mineral. However, bone additionally contains a substantial amount of noncollagenous proteins (most notably of the SIBLING protein family), some of which may act as cohesive/adhesive "binders" for the composite hybrid collagen/mineral scaffolding, whether in the bulk phase of bone, or at its interfaces. One such noncollagenous protein - osteopontin (OPN) - appears to be critical to the deformability and fracture toughness of bone. In the present study, we used a reconstructed synthetic mineral-OPN-mineral interface, and a biogenic (natural tooth dentin) mineral/collagen-OPN-mineral/collagen interface, to measure the fracture toughness of OPN on mineralized substrates. We used this system to test the hypothesis that OPN crosslinking by the enzyme tissue transglutaminase 2 (TG2) that is found in bone enhances interfacial adhesion to increase the fracture toughness of bone. For this, we prepared double-cantilever beam substrates of synthetic pure hydroxyapatite mineral, and of narwhal dentin, and directly apposed them to one another under different intervening OPN/crosslinking conditions, and fracture toughness was tested using a miniaturized loading stage. The work-of-fracture of the OPN interface was measured for different OPN formulations (monomer vs. polymer), crosslinking states, and substrate composition. Noncrosslinked OPN provided negligible adhesion on pure hydroxyapatite, whereas OPN crosslinking (by the chemical crosslinker glutaraldehyde, and TG2 enzyme) provided strong interfacial adhesion for both hydroxyapatite and dentin using monomeric and polymeric OPN. Pre-coating of the substrate beams with monomeric OPN further improved the adhesive performance of the samples, likely by allowing effective binding of this nascent OPN form to mineral/matrix components, with this pre-attachment providing a protein layer for additional crosslinking between the substrates. Copyright © 2018 Elsevier Inc. All rights reserved.

Three-dimensional fracture instability of a displacement-weakening planar interface under locally peaked nonuniform loading

NASA Astrophysics Data System (ADS)

Uenishi, Koji

2018-06-01

We consider stability of fracture on a three-dimensional planar interface subjected to a loading stress that is locally peaked spatially, the level of which increases quasi-statically in time. Similar to the earlier study on the two-dimensional case (Uenishi and Rice, 2003; Rice and Uenishi, 2010), as the loading stress increases, a crack, or a region of displacement discontinuity (opening gap in tension or slip for shear fracture), develops on the interface where the stress is presumed to decrease according to a displacement-weakening constitutive relation. Upon reaching the instability point at which no further quasi-static solution for the extension of the crack on the interface exists, dynamic fracture follows. For the investigation of this instability point, we employ a dimensional analysis as well as an energy approach that gives a Rayleigh-Ritz approximation for the dependence of crack size and maximum displacement discontinuity on the level and quadratic shape of the loading stress distribution. We show that, if the linear displacement-weakening law is applied and the crack may be assumed of an elliptical form, the critical crack size at instability is independent of the curvature of the loading stress distribution and it is of the same order for all two- and three-dimensional cases.

First-Principle Investigation on the Bonding Mechanism of the Silicon Particles on the Copper Foil in Cold Spraying

NASA Astrophysics Data System (ADS)

Song, Jun; Liu, Juanfang; Chen, Qinghua

For lithium-ion batteries, the composite silicon-based electrodes can prevent from losing electrical contact and hence retain the capacity over many cycles. To uncover the adhesion mechanism on the interface formed by the copper foil and the thin silicon coatings during the cold gas dynamic spraying (CGDS) at the microscopic level, the first-principle calculations are performed to investigate the interface properties between them. The ideal work of adhesion, fracture toughness and the interface electronic properties are analyzed. It is found that all the atoms on the interface have vertical displacements, and covalent and ionic bonds are formed between the interfacial Cu and Si atoms which increases the bonding strength. However, the ideal work of adhesion on the interface is lower than one of the Cu bulk and Si bulk, so that fracture would be easier to take place on the interface.

Crack growth in bonded elastic half planes

NASA Technical Reports Server (NTRS)

Goree, J. G.

1975-01-01

Two solutions were developed for the two dimensional problem of bonded linearly elastic half-planes. For each solution, numerical results are presented for the stress intensity factors, strain energy release rate, stresses, and displacements. The behavior predicted by the studies was investigated experimentally using polymers for the material pairs. Close agreement was found for the critical stress intensity factor at fracture for the perpendicular crack near the interface. Fracture along the interface proved to be inconclusive due to difficulties in obtaining a brittle bond. Some interesting and predictable behavior regarding the potential for the crack to cross the interface was observed and is discussed.

Fracture healing in a magma: An experimental approach and implications for volcanic seismicity and degassing

NASA Astrophysics Data System (ADS)

Yoshimura, Shumpei; Nakamura, Michihiko

2010-09-01

The healing of magmatic fractures is considered essential to repetitive seismicity and the closure of degassing paths during emplacement of lavas. To estimate the healing time of magmatic fractures, we performed healing experiments on rhyolitic melts at 850°-1000°C and 1.6-3.2 MPa for 0.5-94 h. Two cylindrical obsidian cores were juxtaposed on surfaces prepared by cutting the cores both with and without polishing. These were annealed in an open-system cell. The contact interface became coherent and finally disappeared. The water content across the contact initially decreased toward the interface via diffusive dehydration, but later homogenized. This change was interpreted to reflect atomic-scale closure of the interface, probably by chemical bonding. We defined this closure interval as microscopic healing time and determined this by fitting the measured profiles with a diffusion model. The microscopic healing time was strongly dependent on temperature and roughness of the interface and was, for the nonpolished interfaces, 67-74, 4.0-4.9, and 0.36-0.38 h at 850°, 900°, and 950°C, respectively, whereas for the polished examples it was 1-3 and 0.5-0.6 h at 850° and 900°C, respectively. This microscopic healing time is consistent with the period of actual seismicity and is prolonged sufficiently to permit the formation of millimeter-thick bubble-free obsidian layers along fractures in vesicular lavas through bubble resorption due to diffusive degassing.

Intermittent Administration of Parathyroid Hormone [1-34] Prevents Particle-Induced Periprosthetic Osteolysis in a Rat Model.

PubMed

Bi, Fanggang; Shi, Zhongli; Zhou, Chenhe; Liu, An; Shen, Yue; Yan, Shigui

2015-01-01

We examined whether intermittent administration of parathyroid hormone [1-34] (PTH[1-34]; 60 μg/kg/day) can prevent the negative effects of titanium (Ti) particles on implant fixation and periprosthetic osteolysis in a rat model. Eighteen adult male rats (12 weeks old, bones still growing) received intramedullary Ti implants in their bilateral femurs; 6 rats from the blank group received vehicle injections, and 12 rats from the control group and PTH treatment group received Ti particle injections at the time of operation and intra-articular injections 2 and 4 weeks postoperatively. Six of the rats that received Ti particles from the PTH group also received PTH[1-34] treatment. Six weeks postoperatively, all specimens were collected for assessment by X-ray, micro-CT, biomechanical, scanning electron microscopy (SEM), and dynamic histomorphometry. A lower BMD, BV/TV, Tb.N, maximal fixation strength, and mineral apposition rate were observed in the control group compared to the blank group, demonstrating that a periprosthetic osteolysis model had been successfully established. Administration of PTH[1-34] significantly increased the bone mineral density of the distal femur, BV/TV, Tb.N, Tb.Th, Tb.Sp, Con.D, SMI, and maximal fixation strength in the PTH group compared to that in the control group. SEM revealed higher bone-implant contact, thicker lamellar bone, and larger trabecular bone area in the PTH group than in the control group. A higher mineral apposition rate was observed in the PTH group compared to both the blank and control groups. These findings imply that intermittent administration of PTH[1-34] prevents periprosthetic osteolysis by promoting bone formation. The effects of PTH[1-34] were evaluated at a suprapharmacological dosage to the human equivalent in rats; therefore, additional studies are required to demonstrate its therapeutic potential in periprosthetic osteolysis.

Laboratory Workflow Analysis of Culture of Periprosthetic Tissues in Blood Culture Bottles.

PubMed

Peel, Trisha N; Sedarski, John A; Dylla, Brenda L; Shannon, Samantha K; Amirahmadi, Fazlollaah; Hughes, John G; Cheng, Allen C; Patel, Robin

2017-09-01

Culture of periprosthetic tissue specimens in blood culture bottles is more sensitive than conventional techniques, but the impact on laboratory workflow has yet to be addressed. Herein, we examined the impact of culture of periprosthetic tissues in blood culture bottles on laboratory workflow and cost. The workflow was process mapped, decision tree models were constructed using probabilities of positive and negative cultures drawn from our published study (T. N. Peel, B. L. Dylla, J. G. Hughes, D. T. Lynch, K. E. Greenwood-Quaintance, A. C. Cheng, J. N. Mandrekar, and R. Patel, mBio 7:e01776-15, 2016, https://doi.org/10.1128/mBio.01776-15), and the processing times and resource costs from the laboratory staff time viewpoint were used to compare periprosthetic tissues culture processes using conventional techniques with culture in blood culture bottles. Sensitivity analysis was performed using various rates of positive cultures. Annualized labor savings were estimated based on salary costs from the U.S. Labor Bureau for Laboratory staff. The model demonstrated a 60.1% reduction in mean total staff time with the adoption of tissue inoculation into blood culture bottles compared to conventional techniques (mean ± standard deviation, 30.7 ± 27.6 versus 77.0 ± 35.3 h per month, respectively; P < 0.001). The estimated annualized labor cost savings of culture using blood culture bottles was $10,876.83 (±$337.16). Sensitivity analysis was performed using various rates of culture positivity (5 to 50%). Culture in blood culture bottles was cost-effective, based on the estimated labor cost savings of $2,132.71 for each percent increase in test accuracy. In conclusion, culture of periprosthetic tissue in blood culture bottles is not only more accurate than but is also cost-saving compared to conventional culture methods. Copyright © 2017 American Society for Microbiology.

Effect of bisphosphonates on periprosthetic bone loss after total knee arthroplasty: a meta-analysis of randomized controlled trials.

PubMed

Shi, Mingmin; Chen, Lei; Wu, Haobo; Wang, Yangxin; Wang, Wei; Zhang, Yujie; Yan, Shigui

2018-05-30

Aseptic loosening and osteolysis are the most common indications after TKA for revision surgery. This meta-analysis which included high-quality randomized controlled trials (RCTs) aimed to analyze the effect of bisphosphonates (BPs) on maintaining periprosthetic bone mineral density (BMD) after total knee arthroplasty. PubMed, AMED, EMBASE, the Cochrane library, ISI Web of Science, and China National Knowledge Infrastructure were systematically searched, five RCTs were included and the total number of participants was 188. The weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total BMD of knee and the BMD of different periprosthetic regions. A descriptive review was performed for BP-related adverse effects. The BPs group presented significantly higher total BMD in proximal part of the tibia than the control group at 3 and 6 months (P < 0.05), but no significant difference at 12 months (P = 0.09). The BPs group presented significantly higher BMD in the distal aspect of the femur than that in the control group at 3, 6, 12 months. The BPs group presented significantly higher periprosthetic BMD than that in the control group at 3, 6 and 12 months in tibial medial and lateral metaphyseal region, and femoral anterior, central and posterior metaphyseal region (p < 0.05), but no significant difference for tibial diaphyseal region at 3, 6, and 12 months. None of the included studies described severe or fatal adverse effects related to BPs. BPs have a short-term effect on reducing periprosthetic bone loss after total knee arthroplasty. Compared with diaphyseal region, BPs are more effective on the preservation of BMD in medial lateral metaphyseal regions of proximal tibia and in anterior, central, and posterior metaphyseal region of distal femur.

Are periprosthetic tissue reactions observed after revision of total disc replacement comparable to the reactions observed after total hip or knee revision surgery?

PubMed Central

Punt, Ilona M.; Austen, Shennah; Cleutjens, Jack P.M.; Kurtz, Steven M.; ten Broeke, René H.M.; van Rhijn, Lodewijk W.; Willems, Paul C.; van Ooij, André

2011-01-01

Study design Comparative study. Objective To compare periprosthetic tissue reactions observed after total disc replacement (TDR), total hip arthroplasty (THA) and total knee arthroplasty (TKA) revision surgery. Summary of background data Prosthetic wear debris leading to particle disease, followed by osteolysis, is often observed after THA and TKA. Although the presence of polyethylene (PE) particles and periprosthetic inflammation after TDR has been proven recently, osteolysis is rarely observed. The clinical relevance of PE wear debris in the spine remains poorly understood. Methods Number, size and shape of PE particles, as well as quantity and type of inflammatory cells in periprosthetic tissue retrieved during Charité TDR (n=22), THA (n=10) and TKA (n=4) revision surgery were compared. Tissue samples were stained with hematoxylin/eosin and examined by using light microscopy with bright field and polarized light. Results After THA, large numbers of PE particles <6 µm were observed, which were mainly phagocytosed by macrophages. The TKA group had a broad size range with many larger PE particles and more giant cells. In TDR, the size range was similar to that observed in TKA. However, the smallest particles were the most prevalent with 75% of the particles being <6 µm, as seen in revision THA. In TDR, both macrophages and giant cells were present with a higher number of macrophages. Conclusions Both small and large PE particles are present after TDR revision surgery compatible with both THA and TKA wear patterns. The similarities between periprosthetic tissue reactions in the different groups may give more insight in the clinical relevance of PE particles and inflammatory cells in the lumbar spine. The current findings may help to improve TDR design as applied from technologies previously developed in THA and TKA with the goal of a longer survival of TDR. PMID:21336235

Adhesion at Entangled Polymer Interfaces: A Unified Approach..

NASA Astrophysics Data System (ADS)

Wool, Richard

2006-03-01

A unified theory of fracture of polymer interfaces was developed which was based on the Rigidity Percolation model of fracture [R.P. Wool, J.Polym.Sci. Part A: Polym Phys., 43,168(2005)]. The polymer fractured critically when the normalized entanglement density p, approached the percolation threshold pc. The fracture energy was found to be G1c ˜ [p-pc]. When applied to interfaces of width X, containing an areal density σ of chains, each contributing L chain entanglements, the percolation term p ˜ σL/X and the percolation threshold was related to σc, Lc, or Xc. For welding of A/A symmetric interfaces, p = σL/X, and pc Lc/M 0, such that when σ/X ˜1/M for randomly distributed chain ends, p˜L ˜ (t/M)^1/2, G/G* = (t/τ*)^1/2, where the weld time τ* ˜ M. When the chain ends are segregated to the surface, σ is constant with time and G/G* = [t/τ*]^1/4. For sub-Tg welding, there exists a surface mobile layer (due to the critical Lindemann Atom fraction) of depth X ˜ 1/δT^ν such that G ˜ δT-2ν, where the critical exponent v = 0.8. For incompatible A/B interfaces of Helfand width d, normalized width w = d/Rge, and entanglement density Nent ˜ d/Le, p ˜ d such that, G1c ˜ [d-dc], G1c ˜ [w-1], and G ˜ [Nent-Nc]. For incompatible A/B interfaces reinforced by an areal density σ of compatibilizer chains, L and X are constant, p ˜ σ, pc ˜σc, such that G1c ˜ [σ-σc], which is in excellent agreement with experimental data.

Mini-interfacial fracture toughness as a new validated enamel-bonding effectiveness test.

PubMed

Pongprueksa, Pong; De Munck, Jan; Barreto, Bruno C; Karunratanakul, Kavin; Van Meerbeek, Bart

2016-09-01

Today׳s most commonly applied bonding effectiveness tests are criticized for their high variability and low reliability, the latter in particular with regard to measuring the actual strength of the adhesive interface. in continuation of previous research conducted at dentin, we hereby aimed to validate the novel mini-interfacial fracture toughness (mini-iFT) test on its applicability to assess bonding effectiveness of contemporary adhesives when bonded to enamel. The 3-step etch&rinse (E&R) adhesive OptiBond FL (Kerr), the 2-step self-etch (SE) adhesive Clearfil SE Bond (Kuraray Noritake) and the two multi-mode adhesives Clearfil S(3) Bond Plus (Kuraray Noritake) and Scotchbond Universal (3M ESPE), both used following a 2-step E&R and 1-step SE mode, were applied to clinically relevant, flattened enamel surfaces. A composite (Filtek Z100; 3M ESPE) build-up was made in layers. After 1-week water storage at 37°C, all specimens were sectioned perpendicular to the interface to obtain rectangular sticks. A mini-iFT notch was prepared at the adhesive-enamel interface using a thin diamond blade under water cooling. Finally, the specimens were loaded in a 4-point bending test until failure. the mini-iFT onto human enamel was significantly higher for the adhesives applied in E&R mode versus those applied in SE mode. The lowest mini-iFT was found for the adhesives applied following a 1-step SE approach. SEM fracture analysis revealed that all fractures originated at the adhesive-enamel interface and that the induced crack propagated preferentially along this interface. mini-iFT appeared a valid alternative method to assess the mechanical properties of adhesive-enamel interfaces. Copyright © 2016 Elsevier Ltd. All rights reserved.

Manipulating electronic and mechanical properties at metal-ceramic interfaces with a nanomolecular layer

NASA Astrophysics Data System (ADS)

Kwan, Matthew P.

This work demonstrates that inserting nanomolecular layers (NMLs) can profoundly change and/or lead to novel electronic and mechanical properties of metal-ceramic interfaces. The first set of results demonstrate that organophosphonate NMLs up to 1.8 nm thick can alter metal work functions by +/- 0.6 eV. This work function change is a strong function of the NML terminal groups (methyl, mercaptan, carboxylic acid, or phosphonic acid), morphology (up right, lying down, or mixed orientation), and the nature of the bonding (covalent, polar, or Van der Waals) between NML and the adjacent layers. Additionally, while NML-ceramic bond type and strength can influence and counteract the effect of NML morphology, the metal-NML bond appears to be independent of the morphology of the NML underlayer. The second set of results demonstrate that inserting an organosilane NML at a metal-ceramic interface can lead to multifold fracture toughening under both static (stress corrosion) and cyclic loads (fatigue) tested in four-point bend. Nanolayer-induced interface strengthening during static loading activates metal plasticity above the metal yield strength, leading to two-fold fracture toughening. Metal plasticity-induced toughening increases as temperature is increased up to 85 °C due to decreasing yield stress. In the fatigue fracture tests I report for the first time a loading-frequency-dependent tripling in fracture toughening in the 75-300 Hz range upon inserting a mercapto-silane NML at the weakest interface of a ceramic-polymer-metal-ceramic stack. This unusual behavior arises from the NML strengthened interface enabling load transfer to- and plasticity in the polymer layer, while the fatigue toughening magnitude and frequency range are determined by polymer rheology.

Geochemical and Geomechanical Effects on Wellbore Cement Fractures

DOE PAGES

Um, Wooyong; Jung, Hun Bok; Kabilan, Senthil; ...

2014-12-31

Experimental studies were conducted using batch reactors, X-ray microtomograpy (XMT), and computational fluid dynamics (CFD) simulation to determine changes in cement fracture surfaces, fluid flow pathways, and permeability with geochemical and geomechanical processes. Composite Portland cement-basalt caprock core with artificial fractures was prepared and reacted with CO2-saturated groundwater at 50°C and 10 MPa for 3 to 3.5 months under static conditions to understand the geochemical and geomechanical effects on the integrity of wellbores containing defects. Cement-basalt interface samples were subjected to mechanical stress at 2.7 MPa before the CO2 reaction. XMT provided three-dimensional (3-D) visualization of the opening and interconnectionmore » of cement fractures due to mechanical stress. After the CO2 reaction, XMT images revealed that calcium carbonate precipitation occurred extensively within the fractures in the cement matrix, but only partially along fractures located at the cement-basalt interface. The permeability calculated based on CFD simulation was in agreement with the experimentally measured permeability. The experimental results imply that the wellbore cement with fractures is likely to be healed during exposure to CO2-saturated groundwater under static conditions, whereas fractures along the cement-caprock interface are still likely to remain vulnerable to the leakage of CO2. CFD simulation for the flow of different fluids (CO2-saturated brine and supercritical CO2) using a pressure difference of 20 kPa and 200 kPa along ~2 cm-long cement fractures showed that a pressure gradient increase resulted in an increase of CO2 fluids flux by a factor of only ~3-9 because the friction of CO2 fluids on cement fracture surfaces increased with higher flow rate as well. At the same pressure gradient, the simulated flow rate was higher for supercritical CO2 than CO2-saturated brine by a factor of only ~2-3, because the viscosity of supercritical CO2 is much lower than that of CO2-saturated brine. The study suggests that in deep geological reservoirs the geochemical and geomechanical processes have coupled effects on the wellbore cement fracture evolution and fluid flow along the fracture surfaces.« less

Complications of tibio-talar-calcaneal fusion using intramedullary nails.

PubMed

Fenton, P; Bali, N; Matheshwari, R; Youssef, B; Meda, K

2014-12-01

Hindfoot nails are being increasingly used, however significant complications can occur. The purpose of this study was to assess the complications following the use of hindfoot nails at our institution. We identified patients from a retrospective database. All underwent hindfoot nailing under the care of the senior author. Details of complications were recorded. We identified 52 patients undergoing 55 procedures. Mean follow up was 44.8 months (18-69). Forty patients achieved ankle fusion and 36 subtalar joint fusion. Complications included prominent metalwork in 13 patients, CRPS in five and one peri-prosthetic fracture. Nine developed deep infection, and of these limb salvage was achieved in six patients by removal of metalwork, debridement and insertion of antibiotic loaded cement beads. The remaining three patients underwent below knee amputation. Significant complications can occur, although limb preservation was possible in most cases of deep infection. Hindfoot nailing should be reserved as salvage procedure. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Experimental studies of rock fracture behavior related to hydraulic fracture

NASA Astrophysics Data System (ADS)

Ma, Zifeng

The objective of this experimental investigation stems from the uncontrollable of the hydraulic fracture shape in the oil and gas production field. A small-scale laboratory investigation of crack propagation in sandstone was first performed with the objective to simulate the field fracture growth. Test results showed that the fracture resistance increased with crack extension, assuming that there was an interaction between crack faces (bridging, interlocking, and friction). An acoustic emission test was conducted to examine the existence of the interaction by locating AE events and analyzing waveform. Furthermore, the effects of confining stress, loading rate, stress field, and strength heterogeneous on the tortuosity of the fracture surface were experimentally investigated in the study. Finally, a test was designed and conducted to investigate the crack propagation in a stratified media with permeability contrast. Crack was observed to arrested in an interface. The phenomenon of delamination along an interface between layers with permeability contrast was observed. The delamination was proposed to be the cause of crack arrest and crack jump in the saturated stratified materials under confinement test.

Utility of polymer cerclage cables in revision shoulder arthroplasty.

PubMed

Edwards, T Bradley; Stuart, Kyle D; Trappey, George J; O'Connor, Daniel P; Sarin, Vineet K

2011-04-11

Revision shoulder arthroplasty often requires humeral osteotomy for stem extraction or is complicated by periprosthetic fracture. In these situations, various modes of fixation are used, including cerclage wires, cable plates, and allograft strut augmentation. The use of metal wires and cables, however, has been associated with soft tissue irritation, sharps injuries, and accelerated wear of joint arthroplasty bearing surfaces. As an alternative to traditional metal cables, the SuperCable (Kinamed Inc, Camarillo, California) contains braided ultra-high molecular-weight polyethylene fibers surrounding a nylon core. To date, no studies have examined the use of nonmetallic cerclage cables in shoulder arthroplasty.A retrospective review was performed of 11 patients who underwent shoulder arthroplasty for which nonmetallic cerclage cables were used. Clinical and radiographic data were examined regarding patient age, procedure performed, indication for cerclage cabling, time to healing of osteotomy or fracture, and any complications associated with the use of these cerclage cables. Minimum follow-up was 1 year. Ten patients underwent reverse total shoulder arthroplasty, and 1 patient underwent revision unconstrained total shoulder arthroplasty. Mean follow-up was 20.5 months. Ten patients required humeral osteotomy for stem or cement removal. Allograft augmentation was performed in 7 patients. Mean time to healing was 3.2 months. No patients experienced loosening or migration of hardware or allograft, and no complications directly related to the use of nonmetallic cerclage cables were identified. Copyright 2011, SLACK Incorporated.

Comparison of air exhausts for surgical body suits (space suits) and the potential for periprosthetic joint infection.

PubMed

Ling, F; Halabi, S; Jones, C

2018-07-01

Periprosthetic joint infection is a major complication of total joint replacement surgery and is associated with significant morbidity, mortality and financial burden. Surgical body suits (space suits), originally designed to reduce the incidence of infection, have paradoxically been implicated in increased periprosthetic joint infection rates recently. Air exhausted from space suits may contribute to this increased rate of periprosthetic joint infection. To investigate the flow of air exhausted from space suits commonly used in modern operating theatres. The exhaust airflow patterns of four commercially available space suit systems were compared using a fog machine and serial still photographs. The space suit systems tested all air exhausted into the operating room. The single fan systems with a standard surgical gown exhausted air laterally from the posterior gown fold at approximately the level of the surgical field. The single fan system with a dedicated zippered suit exhausted air at a level below the surgical field. The dual fan system exhausted air out of the top of the helmet at a level above the surgical field. Space suit systems currently in use in joint replacement surgery differ significantly from traditional body exhaust systems; rather than removing contaminated air from the operating environment, modern systems exhaust this air into the operating room, in some cases potentially towards the sterile instrument tray and the surgical field. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Radionuclide Transport in Fracture-Granite Interface Zones

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Q; Mori, A

In situ radionuclide migration experiments, followed by excavation and sample characterization, were conducted in a water-conducting shear zone at the Grimsel Test Site (GTS) in Switzerland to study diffusion paths of radionuclides in fractured granite. In this work, we employed a micro-scale mapping technique that interfaces laser ablation sampling with inductively coupled plasma-mass spectrometry (LA/ICP-MS) to measure the fine-scale (micron-range) distribution of actinides ({sup 234}U, {sup 235}U, and {sup 237}Np) in the fracture-granite interface zones. Long-lived {sup 234}U, {sup 235}U, and {sup 237}Np were detected in flow channels, as well as in the adjacent rock matrix, using the sensitive, feature-basedmore » mapping of the LA/ICP-MS technique. The injected sorbing actinides are mainly located within the advective flowing fractures and the immediately adjacent regions. The water-conducting fracture studied in this work is bounded on one side by mylonite and the other by granitic matrix regions. These actinides did not penetrate into the mylonite side as much as the relatively higher-porosity granite matrix, most likely due to the low porosity, hydraulic conductivity, and diffusivity of the fracture wall (a thickness of about 0.4 mm separates the mylonite region from the fracture) and the mylonite region itself. Overall, the maximum penetration depth detected with this technique for the more diffusive {sup 237}Np over the field experimental time scale of about 60 days was about 10 mm in the granitic matrix, illustrating the importance of matrix diffusion in retarding radionuclide transport from the advective fractures. Laboratory tests and numerical modeling of radionuclide diffusion into granitic matrix was conducted to complement and help interpret the field results. Measured apparent diffusivity of multiple tracers in granite provided consistent predictions for radionuclide transport in the fractured granitic rock.« less

Symmetrical or Non-Symmetrical Debonds at Fiber-Matrix Interfaces: A Study by BEM and Finite Fracture Mechanics on Elastic Interfaces

NASA Astrophysics Data System (ADS)

Muñoz-Reja, Mar; Távara, Luis; Mantič, Vladislav

A recently proposed criterion is used to study the behavior of debonds produced at a fiber-matrix interface. The criterion is based on the Linear Elastic-(Perfectly) Brittle Interface Model (LEBIM) combined with a Finite Fracture Mechanics (FFM) approach, where the stress and energy criteria are suitably coupled. Special attention is given to the discussion about the symmetry of the debond onset and growth in an isolated single fiber specimen under uniaxial transverse tension. A common composite material system, glass fiber-epoxy matrix, is considered. The present methodology uses a two-dimensional (2D) Boundary Element Method (BEM) code to carry out the analysis of interface failure. The present results show that a non-symmetrical interface crack configuration (debonds at one side only) is produced by a lower critical remote load than the symmetrical case (debonds at both sides). Thus, the non-symmetrical solution is the preferred one, which agrees with the experimental evidences found in the literature.

More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly

PubMed Central

Chammout, Ghazi; Muren, Olle; Laurencikas, Evaldas; Bodén, Henrik; Kelly-Pettersson, Paula; Sjöö, Helene; Stark, André; Sköldenberg, Olof

2017-01-01

Background and purpose Total hip replacement (THR) is the preferred method for the active and lucid elderly patient with a displaced femoral neck fracture (FNF). Controversy still exists regarding the use of cemented or uncemented stems in these patients. We compared the effectiveness and safety between a modern cemented, and a modern uncemented hydroxyapatite-coated femoral stem in patients 65–79 years of age who were treated with THR for displaced FNF. Patients and methods In a single-center, single-blinded randomized controlled trial, we included 69 patients, mean age 75 (65–79) and with a displaced FNF (Garden III–IV). 35 patients were randomized to a cemented THR and 34 to a reverse-hybrid THR with an uncemented stem. Primary endpoints were: prevalence of all hip-related complications and health-related quality of life, evaluated with EuroQol-5D (EQ-5D) index up to 2 years after surgery. Secondary outcomes included: overall mortality, general medical complications, and hip function. The patients were followed up at 3, 12, and 24 months. Results According to the calculation of sample size, 140 patients would be required for the primary endpoints, but the study was stopped when only half of the sample size was included (n = 69). An interim analysis at that time showed that the total number of early hip-related complications was substantially higher in the uncemented group, 9 (among them, 3 dislocations and 4 periprosthetic fractures) as compared to 1 in the cemented group. The mortality and functional outcome scores were similar in the 2 groups. Interpretation We do not recommend uncemented femoral stems for the treatment of elderly patients with displaced FNFs. PMID:27967333

Expandable proximal femoral nail versus gamma proximal femoral nail for the treatment of AO/OTA 31A1-3 fractures.

PubMed

Michael, Drexler; Yaniv, Warschawski; Tal, Frenkel Rutenberg; Kessler Evan, G; Eyal, Amar; Nimrod, Snir; Ehud, Rath; Gilad, Eizenberg; Ely, Steinberg L

2016-02-01

The gamma-proximal femoral nail (GPFN) and the expandable proximal femoral nail (EPFN) are two commonly used intramedullary devices for the treatment of AO 31A1-3 proximal femur fractures. The aim of this study was to compare outcomes and complication rates in patients treated by both devices. A total of 299 patients (149 in the GPFN group and 150 in the EPFN group, average age 83.6 years) were treated for AO 31A1-3 proximal femur fractures in our institution between July 2008 and February 2013. Time from presentation to surgery, level of experience of the surgeon, operative time, amount of blood loss and number of blood transfusions were recorded. Postoperative radiological variables, including peg/screw location, tip to apex distance and orthopaedic complications, as, malunion, nonunion, surgical wound infection rates, cutouts, periprosthetic fractures and the incidence of non-orthopaedic complications. Functional results were estimated using the modified Harris Hip Score, and quality of life was queried by the SF-36 questionnaire. The GPFN and the EPFN fixation methods were similar in terms of functional outcomes, complication rates and quality of life assessments. More patients (107 vs. 73) from the GPFN group were operated within 48 h from presentation (44.8 h vs. 49.9 h for the EPFN group, p=0.351), and their surgery duration and hospitalisation were significantly longer (18.5 days vs. 26 days, respectively, p<0.001). The GPFN patients were frequently operated by junior surgeons: 90% (135) while 50.6% (76) of the EPFN operations were performed by senior doctors. Other intraoperative measures were similar between groups. Cutout was the most common complication affecting 6.7% of the GPFN group and 3.3% of the EPFN group (p=0.182). Good clinical outcomes and low complication rates in the GPFN and the EPFN groups indicate essentially equivalent safety and reliability on the part of both devices for the treatment of proximal femoral fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

On the interfacial fracture of porcelain/zirconia and graded zirconia dental structures.

PubMed

Chai, Herzl; Lee, James J-W; Mieleszko, Adam J; Chu, Stephen J; Zhang, Yu

2014-08-01

Porcelain fused to zirconia (PFZ) restorations are widely used in prosthetic dentistry. However, their susceptibility to fracture remains a practical problem. The failure of PFZ prostheses often involves crack initiation and growth in the porcelain, which may be followed by fracture along the porcelain/zirconia (P/Z) interface. In this work, we characterized the process of fracture in two PFZ systems, as well as a newly developed graded glass-zirconia structure with emphases placed on resistance to interfacial cracking. Thin porcelain layers were fused onto Y-TZP plates with or without the presence of a glass binder. The specimens were loaded in a four-point-bending fixture with the thin porcelain veneer in tension, simulating the lower portion of the connectors and marginal areas of a fixed dental prosthesis (FDP) during occlusal loading. The evolution of damage was observed by a video camera. The fracture was characterized by unstable growth of cracks perpendicular to the P/Z interface (channel cracks) in the porcelain layer, which was followed by stable cracking along the P/Z interface. The interfacial fracture energy GC was determined by a finite-element analysis taking into account stress-shielding effects due to the presence of adjacent channel cracks. The resulting GC was considerably less than commonly reported values for similar systems. Fracture in the graded Y-TZP samples occurred via a single channel crack at a much greater stress than for PFZ. No delamination between the residual glass layer and graded zirconia occurred in any of the tests. Combined with its enhanced resistance to edge chipping and good esthetic quality, graded Y-TZP emerges as a viable material concept for dental restorations. Copyright © 2014 Acta Materialia Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Um, Wooyong; Rod, Kenton A.; Jung, Hun Bok

Cement samples were reacted with CO 2-saturated groundwater, with or without added H2S (1 wt.%), at 50°C and 10 MPa for up to 13 months (CO 2 only) or for up to 3.5 months (CO 2 + H 2S) under static conditions. After the reaction, X-ray computed tomography images revealed that calcium carbonate precipitation (CaCO 3) occurred extensively within the fractures in the cement matrix, but only partially along fractures at the cement-basalt interface. Exposure of a fractured cement sample to CO2-saturated groundwater (50°C and 10 MPa) over a period of 13 months demonstrated progressive healing of cement fractures bymore » CaCO 3(s) precipitation. After reaction with CO 2 + H 2S-saturated groundwater, CaCO 3 (s) precipitation also occurred more extensively within the cement fracture than along the cement-basalt caprock interfaces. X-ray diffraction analysis showed that major cement carbonation products of the CO 2 + H 2S-saturated groundwater were calcite, aragonite, and vaterite, all consistent with cement carbonation by CO 2-saturated groundwater. While pyrite is thermodynamically favored to form, due to the low H 2S concentration it was not identified by XRD in this study. The cement alteration rate into neat Portland cement columns by CO 2-saturated groundwater was similar at ~0.02 mm/d, regardless of the cement-curing pressure and temperature (P-T) conditions, or the presence of H 2S in the brine. The experimental results imply that the wellbore cement with fractures is likely to be healed during exposure to CO 2- or CO 2 + H 2S-saturated groundwater, whereas fractures along the cement-caprock interface are likely to remain open and vulnerable to the leakage of CO 2.« less

The fracture strength by a torsion test at the implant-abutment interface.

PubMed

Watanabe, Fumihiko; Hiroyasu, Kazuhiko; Ueda, Kazuhiko

2015-12-01

Fractured connections between implants and implant abutments or abutment screws are frequently encountered in a clinical setting. The purpose of this study was to investigate fracture strength using a torsion test at the interface between the implant and the abutment. Thirty screw-type implant with diameters of 3.3, 3.8, 4.3, 5.0, and 6.0 mm were submitted to a torsion test. Implants of each size were connected to abutments with abutment screws tightened to 20 N · cm. Mechanical stress was applied with a rotational speed of 3.6 °/min until fracture occurred, and maximum torque (fracture torque) and torsional yield strength were measured. The mean values were calculated and then compared using Tukey's test. The abutments were then removed, and the implant-abutment interfaces were examined using a scanning electron microscope (SEM). No significant differences in mean fracture torque were found among 3.3, 3.8, and 4.3 mm-diameter implants, but significant differences were found between these sizes and 5.0 and 6.0 mm-diameter implants (p < 0.01). Concerning mean torsional yield strength, significant differences were found between 3.3, 3.8, and 4.3 mm-diameter and 5.0 and 6.0 mm-diameter implants (p < 0.01). Observations under the SEM showed that all the projections of the abutment corresponding to the internal notches of the implant body had been destroyed. Smaller diameter implants demonstrated lower fracture torque and torsional yield strength than implants with larger diameters. In internal tube-in-tube connections, three abutment projections corresponding to rotation-prevention notches were destroyed in each implant.

4D synchrotron X-ray imaging to understand porosity development in shales during exposure to hydraulic fracturing fluid

NASA Astrophysics Data System (ADS)

Kiss, A. M.; Bargar, J.; Kohli, A. H.; Harrison, A. L.; Jew, A. D.; Lim, J. H.; Liu, Y.; Maher, K.; Zoback, M. D.; Brown, G. E.

2016-12-01

Unconventional (shale) reservoirs have emerged as the most important source of petroleum resources in the United States and represent a two-fold decrease in greenhouse gas emissions compared to coal. Despite recent progress, hydraulic fracturing operations present substantial technical, economic, and environmental challenges, including inefficient recovery, wastewater production and disposal, contaminant and greenhouse gas pollution, and induced seismicity. A relatively unexplored facet of hydraulic fracturing operations is the fluid-rock interface, where hydraulic fracturing fluid (HFF) contacts shale along faults and fractures. Widely used, water-based fracturing fluids contain oxidants and acid, which react strongly with shale minerals. Consequently, fluid injection and soaking induces a host of fluid-rock interactions, most notably the dissolution of carbonates and sulfides, producing enhanced or "secondary" porosity networks, as well as mineral precipitation. The competition between these mechanisms determines how HFF affects reactive surface area and permeability of the shale matrix. The resultant microstructural and chemical changes may also create capillary barriers that can trap hydrocarbons and water. A mechanistic understanding of the microstructure and chemistry of the shale-HFF interface is needed to design new methodologies and fracturing fluids. Shales were imaged using synchrotron micro-X-ray computed tomography before, during, and after exposure to HFF to characterize changes to the initial 3D structure. CT reconstructions reveal how the secondary porosity networks advance into the shale matrix. Shale samples span a range of lithologies from siliceous to calcareous to organic-rich. By testing shales of different lithologies, we have obtained insights into the mineralogic controls on secondary pore network development and the morphologies at the shale-HFF interface and the ultimate composition of produced water from different facies. These results show that mineral texture is a major control over secondary porosity network morphology.

Fracture mechanics analysis of the dentine-luting cement interface.

PubMed

Ryan, A K; Mitchell, C A; Orr, J F

2002-01-01

The objectives of this study were to determine the fracture toughness of adhesive interfaces between dentine and clinically relevant, thin layers of dental luting cements. Cements tested included a conventional glass-ionomer, F (Fuji 1), a resin-modified glass-ionomer, FP (Fuji Plus) and a compomer cement, D (DyractCem). Ten miniature short-bar chevron notch specimens were manufactured for each cement, each comprising a 40 microm thick chevron of lute, between two 1.5 mm thick blocks of bovine dentine, encased in resin composite. The interfacial K(IC) results (MN/m3/2) were median (range): F; 0.152 (0.14-0.16), FP; 0.306 (0.27-0.37), D; 0.351 (0.31-0.37). Non-parametric statistical analysis showed that the fracture toughness of F was significantly lower (p <0.05) than those of FP or D, and all were significantly lower than values for monolithic cement specimens. Scanning electron microscopy of the specimens suggested crack propagation along the interface. However, energy dispersive X-ray analysis indicated that failure was cohesive within the cement. It is concluded that the fracture toughness of luting cement was lowered by cement-dentine interactions.

Low-grade infection after a total knee arthroplasty caused by Actinomyces naeslundii.

PubMed

Hedke, J; Skripitz, R; Ellenrieder, M; Frickmann, H; Köller, T; Podbielski, A; Mittelmeier, W

2012-08-01

Here, we present a case of an 85-year-old woman with a low-grade-infection caused by Actinomyces naeslundii after total-knee arthroplasty (TKA) followed by septic loosening. Actinomyces naeslundii was cultured from a tissue sample from the knee joint capsule/synovial tissue obtained after the initial TKA. A review of the literature revealed two cases of periprosthetic infection and another three cases of arthritis due to Actinomyces naeslundii. So far, no standard treatment for periprosthetic infections caused by Actinomyces species has been established.

Weak interfaces for UV cure nanoimprint lithography

NASA Astrophysics Data System (ADS)

Houle, Frances; Fornof, Ann; Simonyi, Eva; Miller, Dolores; Truong, Hoa

2008-03-01

Nanoimprint lithography using a photocurable organic resist provides a means of patterning substrates with a spatial resolution in the few nm range. The usefulness of the technique is limited by defect generation during template removal, which involves fracture at the interface between the template and the newly cured polymer. Although it is critical to have the lowest possible interfacial fracture toughness (Gc less than 0.1 Jm-2) to avoid cohesive failure in the polymer, there is little understanding on how to achieve this using reacting low viscosity resist fluids. Studies of debonding of a series of free-radical cured polyhedral silsesquioxane crosslinker formulations containing selected reactive diluents from fluorosilane-coated quartz template materials will be described. At constant diluent fraction the storage modulus of cured resists follows trends in initial reaction rate, not diluent Tg. Adhesion is uncorrelated with both Tg and storage modulus. XPS studies of near-interface compositions indicate that component segregation within the resist fluid on contact with the template, prior to cure, plays a significant role in controlling the fracture process.

Improved Diagnosis of Prosthetic Joint Infection by Culturing Periprosthetic Tissue Specimens in Blood Culture Bottles.

PubMed

Peel, Trisha N; Dylla, Brenda L; Hughes, John G; Lynch, David T; Greenwood-Quaintance, Kerryl E; Cheng, Allen C; Mandrekar, Jayawant N; Patel, Robin

2016-01-05

Despite known low sensitivity, culture of periprosthetic tissue specimens on agars and in broths is routine. Culture of periprosthetic tissue samples in blood culture bottles (BCBs) is potentially more convenient, but it has been evaluated in a limited way and has not been widely adopted. The aim of this study was to compare the sensitivity and specificity of inoculation of periprosthetic tissue specimens into blood culture bottles with standard agar and thioglycolate broth culture, applying Bayesian latent class modeling (LCM) in addition to applying the Infectious Diseases Society of America (IDSA) criteria for prosthetic joint infection. This prospective cohort study was conducted over a 9-month period (August 2013 to April 2014) at the Mayo Clinic, Rochester, MN, and included all consecutive patients undergoing revision arthroplasty. Overall, 369 subjects were studied; 117 (32%) met IDSA criteria for prosthetic joint infection, and 82% had late chronic infection. Applying LCM, inoculation of tissues into BCBs was associated with a 47% improvement in sensitivity compared to the sensitivity of conventional agar and broth cultures (92.1 versus 62.6%, respectively); this magnitude of change was similar when IDSA criteria were applied (60.7 versus 44.4%, respectively; P = 0.003). The time to microorganism detection was shorter with BCBs than with standard media (P < 0.0001), with aerobic and anaerobic BCBs yielding positive results within a median of 21 and 23 h, respectively. Results of our study demonstrate that the semiautomated method of periprosthetic tissue culture in blood culture bottles is more sensitive than and as specific as agar and thioglycolate broth cultures and yields results faster. Prosthetic joint infections are a devastating complication of arthroplasty surgery. Despite this, current microbiological techniques to detect and diagnose infections are imperfect. This study examined a new approach to diagnosing infections, through the inoculation of tissue samples from around the prosthetic joint into blood culture bottles. This study demonstrated that, compared to current laboratory practices, this new technique increased the detection of infection. These findings are important for patient care to allow timely and accurate diagnosis of infection. Copyright © 2016 Peel et al.

Antibiogram for Periprosthetic Infections: A Tool for Better Informed Selection of Empiric Antibiotics for Surgical Site Infections.

PubMed

Chidester, Jeremy R; Danci, Ioana; Lewis, Priya; Biskup, Nataliya; Kim, Hahns; Gupta, Subhas

2016-05-01

Periprosthetic infection after breast reconstruction is not an uncommon complication, with incidence up to 24%. These infections are often treated empirically without knowing the causative bacteria or its sensitivities to various antibiotics. Even if cultures are obtained, results may not be available for several days. A retrospective chart review of 553 patients at a single institution between January 2009 and July 2014 was performed, identifying patients who (1) underwent implant-based breast reconstruction and subsequently suffered an infection and (2) had cultures available with sensitivities. We reviewed patient demographics, implant characteristics, prophylactic intravenous antibiotics, oral antibiotic maintenance used, microbiologic details, and outcomes. The goal was to identify the most common causative bacteria, as well as their sensitivities to commonly used antibiotics, to help guide antibiotic decision-making. Of the 553 patients who underwent implant-based reconstruction, 114 (20.6%) patients suffered periprosthetic infections. Of these patients, 32 (28.1%) patients (56 reconstructions, with 33 tissue expanders and 23 implants) had cultures performed revealing 43 bacterial species, with the most common being Staphylococcus aureus (23.2%) and Pseudomonas aeruginosa (26.8%). Ceftazidime and piperacillin/tazobactam were equally effective covering 100% of Pseudomonas, enteric, and atypical organisms (P = 1), whereas vancomycin covered 100% of gram-positive organisms. Trimethoprim/sulfamethoxazole covered 100% of S. aureus, whereas clindamycin only covered 71% of S. aureus (P = 0.03). Additionally, trimethoprim/sulfamethoxazole was better able to cover atypical and enteric organisms. Ciprofloxacin covered 71% of Pseudomonas compared with 56% for levofloxacin (P = 0.14). Interestingly, cephalexin, a common choice for perioperative prophylaxis, was highly ineffective for gram-positive species in patients who later returned with infections. This study supports the efficacy of current intravenous antibiotics protocols but questions the efficacy of both clindamycin and levofloxacin in empirically treating periprosthetic infections and cephalexin in providing effective perioperative prophylaxis against skin flora. Because bacterial sensitivities vary by location and patient population, this study encourages other centers to develop their own antibiogram specifically tailored to periprosthetic infections to improve antimicrobial decision making and potentially improve implant salvage.

DigiFract: A software and data model implementation for flexible acquisition and processing of fracture data from outcrops

NASA Astrophysics Data System (ADS)

Hardebol, N. J.; Bertotti, G.

2013-04-01

This paper presents the development and use of our new DigiFract software designed for acquiring fracture data from outcrops more efficiently and more completely than done with other methods. Fracture surveys often aim at measuring spatial information (such as spacing) directly in the field. Instead, DigiFract focuses on collecting geometries and attributes and derives spatial information through subsequent analyses. Our primary development goal was to support field acquisition in a systematic digital format and optimized for a varied range of (spatial) analyses. DigiFract is developed using the programming interface of the Quantum Geographic Information System (GIS) with versatile functionality for spatial raster and vector data handling. Among other features, this includes spatial referencing of outcrop photos, and tools for digitizing geometries and assigning attribute information through a graphical user interface. While a GIS typically operates in map-view, DigiFract collects features on a surface of arbitrary orientation in 3D space. This surface is overlain with an outcrop photo and serves as reference frame for digitizing geologic features. Data is managed through a data model and stored in shapefiles or in a spatial database system. Fracture attributes, such as spacing or length, is intrinsic information of the digitized geometry and becomes explicit through follow-up data processing. Orientation statistics, scan-line or scan-window analyses can be performed from the graphical user interface or can be obtained through flexible Python scripts that directly access the fractdatamodel and analysisLib core modules of DigiFract. This workflow has been applied in various studies and enabled a faster collection of larger and more accurate fracture datasets. The studies delivered a better characterization of fractured reservoirs analogues in terms of fracture orientation and intensity distributions. Furthermore, the data organisation and analyses provided more independent constraints on the bed-confined or through-going nature of fractures relative to the stratigraphic layering.

A CT scan protocol for the detection of radiographic loosening of the glenoid component after total shoulder arthroplasty

PubMed Central

2014-01-01

Background and purpose It is difficult to evaluate glenoid component periprosthetic radiolucencies in total shoulder arthroplasties (TSAs) using plain radiographs. This study was performed to evaluate whether computed tomography (CT) using a specific patient position in the CT scanner provides a better method for assessing radiolucencies in TSA. Methods Following TSA, 11 patients were CT scanned in a lateral decubitus position with maximum forward flexion, which aligns the glenoid orientation with the axis of the CT scanner. Follow-up CT scanning is part of our routine patient care. Glenoid component periprosthetic lucency was assessed according to the Molé score and it was compared to routine plain radiographs by 5 observers. Results The protocol almost completely eliminated metal artifacts in the CT images and allowed accurate assessment of periprosthetic lucency of the glenoid fixation. Positioning of the patient within the CT scanner as described was possible for all 11 patients. A radiolucent line was identified in 54 of the 55 observed CT scans and osteolysis was identified in 25 observations. The average radiolucent line Molé score was 3.4 (SD 2.7) points with plain radiographs and 9.5 (SD 0.8) points with CT scans (p = 0.001). The mean intra-observer variance was lower in the CT scan group than in the plain radiograph group (p = 0.001). Interpretation The CT scan protocol we used is of clinical value in routine assessment of glenoid periprosthetic lucency after TSA. The technique improves the ability to detect and monitor radiolucent lines and, therefore, possibly implant loosening also. PMID:24286563

Reduction of metal artifacts from unilateral hip arthroplasty on dual-energy CT with metal artifact reduction software.

PubMed

Yue, Dong; Fan Rong, Cheng; Ning, Cai; Liang, Hu; Ai Lian, Liu; Ru Xin, Wang; Ya Hong, Luo

2018-07-01

Background The evaluation of hip arthroplasty is a challenge in computed tomography (CT). The virtual monochromatic spectral (VMS) images with metal artifact reduction software (MARs) in spectral CT can reduce the artifacts and improve the image quality. Purpose To evaluate the effects of VMS images and MARs for metal artifact reduction in patients with unilateral hip arthroplasty. Material and Methods Thirty-five patients underwent dual-energy CT. Four sets of VMS images without MARs and four sets of VMS images with MARs were obtained. Artifact index (AI), CT number, and SD value were assessed at the periprosthetic region and the pelvic organs. The scores of two observers for different images and the inter-observer agreement were evaluated. Results The AIs in 120 and 140 keV images were significantly lower than those in 80 and 100 keV images. The AIs of the periprosthetic region in VMS images with MARs were significantly lower than those in VMS images without MARs, while the AIs of pelvic organs were not significantly different. VMS images with MARs improved the accuracy of CT numbers for the periprosthetic region. The inter-observer agreements were good for all the images. VMS images with MARs at 120 and 140 keV had higher subjective scores and could improve the image quality, leading to reliable diagnosis of prosthesis-related problems. Conclusion VMS images with MARs at 120 and 140 keV could significantly reduce the artifacts from hip arthroplasty and improve the image quality at the periprosthetic region but had no obvious advantage for pelvic organs.

Practical management of periprosthetic leakage in patients rehabilitated with a Provox® 2 voice prosthesis after total laryngectomy.

PubMed

Friedlander, Eviatar; Pinacho Martínez, Paloma; Poletti Serafini, Daniel; Martín-Oviedo, Carlos; Martínez Guirado, Tomás; Scola Yurrita, Bartolomé

Periprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. This was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques. We present a method to reduce the diameter of the tracheoesophageal fistula by removing the voice prosthesis and placing a nasogastric tube through the fistula. In the 3 groups treated with silicone collar (n=5, 13 procedures), hyaluronic acid injection (n=5, 9 procedures) and the combination of both techniques (n=3, 5 procedures), we observed an increase in prosthesis lifespan of an average of 56 days (range 7-118 days), 32 days (range 3-55 days) and 63 days (range 28-136 days), respectively. The tracheoesophageal fistula diameter reduction was performed in 100% (n=6) of patients. The use of silicone collars, injection of hyaluronic acid into the tracheoesophageal wall and the combination of both techniques for the treatment of periprosthesis leakage increase the lifespan of the prosthesis. Temporary prosthesis removal and placement of nasogastric tube has also been shown effective in our experience. These techniques are simple, inexpensive and reproducible, thereby reducing healthcare costs. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Ibandronate and cementless total hip arthroplasty: densitometric measurement of periprosthetic bone mass and new therapeutic approach to the prevention of aseptic loosening

PubMed Central

Muratore, Maurizio; Quarta, Eugenio; Quarta, Laura; Calcagnile, Fabio; Grimaldi, Antonella; Orgiani, M. Antonio; Marsilio, Antonio; Rollo, Giuseppe

2012-01-01

Summary Studies of the mechanisms of periprosthetic bone loss have led to the development of pharmacologic strategies intended to enhance bone mass recovery after surgery and consequently prevent aseptic loosening and prolong the implant survival. Bisphosphonates, potent anti-resorptive drugs widely used in the treatment of osteoporosis and other disorders of bone metabolism, were shown to be particularly effective in reducing periprosthetic bone resorption in the first year after hip and knee arthroplasty, both cemented and cementless. Based on these results, we investigated the inhibitory effects of ibandronate on periprosthetic bone loss in a 2-year study of postmenopausal women that underwent cementless total hip arthroplasty. In the first 6 months both groups (A, treated with ibandronate 3 mg i.v. within five days after surgery and then with oral ibandronate 150 mg/month, plus calcium and vitamin D supplementation; and B, treated with calcium and vitamin D supplementation only) experienced bone loss, though to a lesser extent in group A. After 12 months, group A showed a remarkable BMD recovery, that was statistically significant versus baseline values (about +1, 74% of global BMD) and most evident in region R1 (+3, 81%) and R2 (+4, 12%); in group B, on the contrary, BMD values were unchanged compared with those at 6 months post-surgery. Quality of life scores also showed a greater improvement in group A, both at 6 and 12 months after surgery, likely because of the pain-reducing effects of ibandronate treatment. PMID:22783337

Total-hip arthroplasty: Periprosthetic indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur colloid imaging in suspected infection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palestro, C.J.; Kim, C.K.; Swyer, A.J.

1990-12-01

Indium-111-labeled leukocyte images of 92 cemented total-hip arthroplasties were correlated with final diagnoses. Prostheses were divided into four zones: head (including acetabulum), trochanter, shaft, and tip. The presence (or absence) and intensity of activity in each zone was noted, and compared to the corresponding contralateral zone. Though present in all 23 infected arthroplasties, periprosthetic activity was also present in 77% of uninfected arthroplasties, and was greater than the contralateral zone 51% of the time. When analyzed by zone, head zone activity was the best criterion for infection (87% sensitivity, 94% specificity, 92% accuracy). Fifty of the arthroplasties were studied withmore » combined labeled leukocyte/sulfur colloid imaging. Using incongruence of images as the criterion for infection, the sensitivity, specificity, and accuracy of the study were 100%, 97%, and 98%, respectively. While variable periprosthetic activity makes labeled leukocyte imaging alone unreliable for diagnosing hip arthroplasty infection, the addition of sulfur colloid imaging results in a highly accurate diagnostic procedure.« less

What are the local and systemic biologic reactions and mediators to wear debris, and what host factors determine or modulate the biologic response to wear particles?

PubMed

Tuan, Rocky S; Lee, Francis Young-In; T Konttinen, Yrjö; Wilkinson, J Mark; Smith, Robert Lane

2008-01-01

New clinical and basic science data on the cellular and molecular mechanisms by which wear particles stimulate the host inflammatory response have provided deeper insight into the pathophysiology of periprosthetic bone loss. Interactions among wear particles, macrophages, osteoblasts, bone marrow-derived mesenchymal stem cells, fibroblasts, endothelial cells, and T cells contribute to the production of pro-inflammatory and pro-osteoclastogenic cytokines such as TNF-alpha, RANKL, M-SCF, PGE2, IL-1, IL-6, and IL-8. These cytokines not only promote osteoclastogenesis but interfere with osteogenesis led by osteoprogenitor cells. Recent studies indicate that genetic variations in TNF-alpha, IL-1, and FRZB can result in subtle changes in gene function, giving rise to altered susceptibility or severity for periprosthetic inflammation and bone loss. Continuing research on the biologic effects and mechanisms of action of wear particles will provide a rational basis for the development of novel and effective ways of diagnosis, prevention, and treatment of periprosthetic inflammatory bone loss.

Characterizing Facesheet/Core Disbonding in Honeycomb Core Sandwich Structure

NASA Technical Reports Server (NTRS)

Rinker, Martin; Ratcliffe, James G.; Adams, Daniel O.; Krueger, Ronald

2013-01-01

Results are presented from an experimental investigation into facesheet core disbonding in carbon fiber reinforced plastic/Nomex honeycomb sandwich structures using a Single Cantilever Beam test. Specimens with three, six and twelve-ply facesheets were tested. Specimens with different honeycomb cores consisting of four different cell sizes were also tested, in addition to specimens with three different widths. Three different data reduction methods were employed for computing apparent fracture toughness values from the test data, namely an area method, a compliance calibration technique and a modified beam theory method. The compliance calibration and modified beam theory approaches yielded comparable apparent fracture toughness values, which were generally lower than those computed using the area method. Disbonding in the three-ply facesheet specimens took place at the facesheet/core interface and yielded the lowest apparent fracture toughness values. Disbonding in the six and twelve-ply facesheet specimens took place within the core, near to the facesheet/core interface. Specimen width was not found to have a significant effect on apparent fracture toughness. The amount of scatter in the apparent fracture toughness data was found to increase with honeycomb core cell size.

Role of large-scale slip in mode II fracture of bimaterial interface produced by diffusion bonding

NASA Astrophysics Data System (ADS)

Fox, M. R.; Ghosh, A. K.

2001-08-01

Bimaterial interfaces present in diffusion-bonded (and in-situ) composites are often not flat interfaces. The unevenness of the interface can result not only from interface reaction products but also from long-range waviness associated with the surfaces of the component phases bonded together. Experimental studies aimed at determining interface mechanical properties generally ignore the departure in the local stress due to waviness and assume a theoretically flat interface. Furthermore, the commonly used testing methods involving superimposed tension often renders the interface so extremely brittle that if microplastic effects were present it becomes impossible to perceive them. This article examines the role of waviness of the interface and microplastic effects on crack initiation. To do this, a test was selected that provides significant stability against crack growth by superimposing compressive stresses. Mode II interface fracture was studied for NiAl/Mo model laminates using a recently developed asymmetrically loaded shear (ALS) interface shear test. The ALS test may be viewed as opposite of the laminate bend test. In the bend test, shear at the interface is created via tension on one surface of the bend, while in the ALS test, shear is created by compression on one side of the interface relative to the other. Normal to the interface, near the crack tip, an initially compressive state is replaced by slight tension due to Poisson’s expansion of the unbonded part of the compressed beam.

Application of Phase-Field Techniques to Hydraulically- and Deformation-Induced Fracture.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Culp, David; Miller, Nathan; Schweizer, Laura

Phase-field techniques provide an alternative approach to fracture problems which mitigate some of the computational expense associated with tracking the crack interface and the coalescence of individual fractures. The technique is extended to apply to hydraulically driven fracture such as would occur during fracking or CO 2 sequestration. Additionally, the technique is applied to a stainless steel specimen used in the Sandia Fracture Challenge. It was found that the phase-field model performs very well, at least qualitatively, in both deformation-induced fracture and hydraulically-induced fracture, though spurious hourglassing modes were observed during coupled hydralically-induced fracture. Future work would include performing additionalmore » quantitative benchmark tests and updating the model as needed.« less

Modeling Strength Degradation of Fiber-Reinforced Ceramic-Matrix Composites Subjected to Cyclic Loading at Elevated Temperatures in Oxidative Environments

NASA Astrophysics Data System (ADS)

Longbiao, Li

2018-02-01

In this paper, the strength degradation of non-oxide and oxide/oxide fiber-reinforced ceramic-matrix composites (CMCs) subjected to cyclic loading at elevated temperatures in oxidative environments has been investigated. Considering damage mechanisms of matrix cracking, interface debonding, interface wear, interface oxidation and fibers fracture, the composite residual strength model has been established by combining the micro stress field of the damaged composites, the damage models, and the fracture criterion. The relationships between the composite residual strength, fatigue peak stress, interface debonding, fibers failure and cycle number have been established. The effects of peak stress level, initial and steady-state interface shear stress, fiber Weibull modulus and fiber strength, and testing temperature on the degradation of composite strength and fibers failure have been investigated. The evolution of residual strength versus cycle number curves of non-oxide and oxide/oxide CMCs under cyclic loading at elevated temperatures in oxidative environments have been predicted.

Gas and Oil Flow through Wellbore Flaws

NASA Astrophysics Data System (ADS)

Hatambeigi, M.; Anwar, I.; Reda Taha, M.; Bettin, G.; Chojnicki, K. N.; Stormont, J.

2017-12-01

We have measured gas and oil flow through laboratory samples that represent two important potential flow paths in wellbores associated with the Strategic Petroleum Reserve (SPR): cement-steel interfaces (microannuli) and cement fractures. Cement fractures were created by tensile splitting of cement cores. Samples to represent microannuli were created by placing thin steel sheets within split cement cores so flow is channeled along the cement-steel interface. The test sequence included alternating gas and oil flow measurements. The test fluids were nitrogen and silicone oil with properties similar to a typical crude oil stored in the SPR. After correcting for non-linear (inertial) flow when necessary, flows were interpreted as effective permeability and hydraulic aperture using the cubic law. For both samples with cement fractures and those with cement-steel interfaces, initial gas and oil permeabilities were comparable. Once saturated with oil, a displacement pressure had to be overcome to establish gas flow through a sample, and the subsequent gas permeability were reduced by more than 50% compared to its initial value. Keywords: wellbore integrity, leakage, fracture, microannulus, SPR. Sandia National Laboratories is a multi-mission laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of NTESS/Honeywell, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000. SAND2017-8168 A

The treatment of recurrent chronic infected knee arthroplasty with a 2-stage procedure.

PubMed

Antoci, Valentin; Phillips, Matthew J; Antoci, Valentin; Krackow, Kenneth A

2009-01-01

We report the case of a patient with recurrent periprosthetic infections after total knee arthroplasty associated with bone destruction and massive bone loss that was successfully treated with a 2-stage procedure-resection arthroplasty with insertion of an antibiotic-impregnated cement rod-spacer and systemic antibiotics and then a resection arthrodesis of the knee with the use of an intercalary allograft fixed with a long intramedullary nail. This technique is a viable option for the treatment of recurrent periprosthetic infections after total knee arthroplasty associated with bone destruction, massive bone loss, and severe instability.

Fracture and damage; Winter Annual Meeting of the American Society of Mechanical Engineers, Anaheim, CA, Nov. 8-13, 1992

NASA Technical Reports Server (NTRS)

Nagar, Arvind (Editor)

1992-01-01

The latest developments in the area of fracture and damage at high temperatures are discussed, in particular: modeling; analysis and experimental techniques for interface damage in composites including the effects of residual stresses and temperatures; and crack growth, inelastic deformation and fracture parameters for isotropic materials. Also included are damage modeling and experiments at elevated temperatures.

Experimental research on the relationship between fit accuracy and fracture resistance of zirconia abutments.

PubMed

Sui, Xinxin; Wei, Huasha; Wang, Dashan; Han, Yan; Deng, Jing; Wang, Yongliang; Wang, Junjun; Yang, Jianjun

2014-10-01

The purpose of the study was to investigate the correlation between fit accuracy and fracture resistance of zirconia abutments, as well as its feasibility for clinical applications. Twenty self-made zirconia abutments were tested with 30 Osstem GSII implants. First, 10 Osstem GSII implants were cut into two parts along the long axis and assembled with the zirconia abutments. The microgaps between the implants and the zirconia abutments were measured under a scanning electron microscope. Second, the zirconia abutments were assembled with 20 un-cut implants and photographed before and after being fixed with a central screw of 30-Ncm torque. The dental films were measured by Digora for Windows 2.6 software. Then the fracture resistance of zirconia abutments was measured using the universal testing machine at 90°. All results were analyzed using SPSS13.0 software. The average internal-hexagon microgaps between the implants and zirconia abutments were 19.38±1.34μm. The average Morse taper microgap in the implant-abutment interface was 17.55±1.68μm. The dental film showed that the Morse taper gap in the implant-abutment interface disappeared after being fixed with a central screw of 30-Ncm torque, and the average moving distance of the zirconia abutments to the implants was 0.19±0.02mm. The average fracture resistance of zirconia abutments was 282.93±17.28N. The internal-hexagon microgap between the implants and zirconia abutments was negatively related to the fracture resistance of the abutments (r1=-0.97, p<0.01). The Morse taper microgap in the implant-abutment interface was negatively related to the fracture resistance of the abutments (r2=-0.84, p<0.01). The microgap between implant and abutment was negatively related to the fracture resistance of the abutment, while the internal-hexagon microgap has better correlation than the Morse taper microgap. The closure of microgap is helpful to improve the fracture resistance of zirconia abutments. The fracture resistance of zirconia abutments can satisfy the clinical application. Copyright © 2014 Elsevier Ltd. All rights reserved.

AuNP-PE interface/phase and its effects on the tensile behaviour of AuNP-PE composites

NASA Astrophysics Data System (ADS)

Wang, Yue; Wang, Ruijie; Wang, Chengyuan; Yu, Xiaozhu

2018-06-01

A comprehensive study was conducted for a gold nanoparticle (AuNP)-polyethylene (PE) composite. Molecular dynamic (MD) simulations were employed to construct the AuNP-PE systems, achieve their constitutive relations, and measure their tensile properties. Specifically, the AuNP-PE interface/phase was studied via the mass density profile, and its effect was evaluated by comparing the composite with a pure PE matrix. These research studies were followed by the study of the fracture mechanisms and the size and volume fraction effects of AuNPs. Efforts were also made to reveal the underlying physics of the MD simulations. In the present work, an AuNP-PE interface and a densified PE interphase were achieved due to the AuNP-PE van der Waals interaction. Such an interface/phase is found to enhance the Young's modulus and yield stress but decrease the fracture strength and strain.

Microstructure and hydrogen induced failure mechanisms in iron-nickel weldments

NASA Astrophysics Data System (ADS)

Fenske, Jamey Alan

A recent series of inexplicable catastrophic failures of specific subsea dissimilar metal Fe-Ni butter welds has illuminated a fundamental lack of understanding of both the microstructure created along the fusion line as well as its impact on the hydrogen susceptibility of these interfaces. In order to remedy this, the present work compares and contrasts the microstructure and hydrogen-induced fracture morphology of AISI 8630-IN 625 and F22-IN 625 dissimilar metal weld interfaces as a function of post-weld heat treatment duration. A variety of techniques were used to study details of both the microstructure and fracture morphology including optical microscopy, scanning electron microscopy, secondary ion mass spectrometry, transmission electron microscopy, electron backscatter diffraction, and energy dispersive x-ray spectroscopy. For both systems, the microstructure along the weld interface consisted of a coarse grain heat-affected zone in the Fe-base metal followed by discontinuous martensitic partially-mixed zones and a continuous partially-mixed zone on the Ni-side of the fusion line. Within the partially mixed zone on the Ni-side there exists a 200 nm-wide transition zone within a 20 mum-wide planar solidification region followed by a cellular dendritic region with Nb-Mo rich carbides decorating the dendrite boundaries. The size, area fraction and composition of the discontinuous PMZ were determined to be controlled by uneven mixing in the liquid weld pool influenced by convection currents produced from the welding procedure. The virgin martensitic microstructure produced in these regions is formed as consequence of a both the local composition and the post-weld heat treatment. The local higher Ni content results in these regions being retransformed into austenite during the post-weld heat treatment and then virgin martensite while cooling to room temperature. Although there were differences in the volume of the discontinuous partially mixed-zones, the major difference in the weld metal interfaces was the presence of M 7C3 precipitates in the planar solidification region. The formation of these precipitates, which were found in what was previously referred to as the "featureless-zone," were determined to be dependent on the carbon content of the Fe-base metal and the duration of the post-weld heat treatment. A high density of these ordered 100 nm-long by 10 nm-wide needle-like precipitates were found in the AISI 8630-IN 625 weldment in the 10 hour post-weld heat treatment condition while only the initial stages of their nucleation were evident in the F22-IN 625 15 hour post-weld heat treatment specimen. The study of the fractured specimens revealed that the M7C 3 carbides play a key role in the susceptibility to hydrogen embrittlement of the Fe-Ni butter weldments. The fractures initially nucleate along the isolated Fe-base metal -- discontinuous partially mixed zone interfaces. The M7C3 carbides accumulate hydrogen and then provide a low energy fracture path between the discontinuous partially mixed zones leading to catastrophic failure. The result is a fracture morphology that alternates between flat regions produced by fracture along the discontinuous partially mixed zones and cleavage-like fracture regions produced by fracture along the ordered carbide matrix interfaces.

Intermetallic Compound Growth and Stress Development in Al-Cu Diffusion Couple

NASA Astrophysics Data System (ADS)

Mishler, M.; Ouvarov-Bancalero, V.; Chae, Seung H.; Nguyen, Luu; Kim, Choong-Un

2018-01-01

This paper reports experimental observations evidencing that the intermetallic compound phase interfaced with Cu in the Al-Cu diffusion couple is most likely α2-Cu3Al phase, not γ-Cu9Al4 phase as previously assumed, and that its growth to a critical thickness may result in interface failure by stress-driven fracture. These conclusions are made based on an interdiffusion study of a diffusion couple made of a thick Cu plate coated with ˜ 2- μm-thick Al thin film. The interface microstructure and lattice parameter were characterized using scanning electron microscopy and x-ray diffraction analysis. Specimens aged at temperature between 623 K (350°C) and 723 K (450°C) for various hours produced consistent results supporting the main conclusions. It is found that disordered α2-Cu3Al phase grows in a similar manner to solid-state epitaxy, probably owing to its structural similarity to the Cu lattice. The increase in the interface strain that accompanies the α2-Cu3Al phase growth ultimately leads to interface fracture proceeding from crack initiation and growth along the interface. This mechanism provides the most consistent explanation for interface failures observed in other studies.

The effect of fatigue and environment on the adhesion and delamination of thin polymer films

NASA Astrophysics Data System (ADS)

Snodgrass, Jeffrey Matthew

Polymers are increasingly used in the interconnect and packaging levels of microelectronic devices. Thus, adhesion of polymer films to their adjacent inorganic layers is critical to the manufacturability and reliability of microelectronic components. Weak interfacial adhesion can result in delamination, causing a loss of package hermeticity or the failure of electrical contacts. Recently, interface fracture mechanics techniques have been applied to the problem of thin film delamination and are now used to measure interface adhesion. These techniques allow for characterization of interface adhesion in terms of the critical strain energy release rate, GC, in units of J/m2. In this dissertation, studies are described that quantify the effects of fundamental parameters on the critical adhesion and resistance to subcritical (time-dependent) delamination of benzocyclobutene (BCB)/silica and epoxy underfill/polyimide interfaces. Results are presented detailing the action of small-molecule adhesion promoters on the critical interface adhesion energy of BCB/silica. Silane coupling agents with different functional end groups were used to increase chemical bonding at this interface in order to achieve optimized adhesion. Testing was performed at different mode mixities to evaluate the effect of loading mode on the polymer interface fracture. Subcritical debonding data were measured under two different loading conditions and results are presented in terms of the debond growth rate as a function of applied strain energy release rate. Monotonic loading was used to examine environment-assisted delamination processes, while fatigue loading was used to understand the effects of thermomechanical cycling. Debond growth rates over the range of 10-3 to 10-9 m/s were characterized under mode I and mixed-mode loading. Atomic force microscopy and X-ray photoelectron spectroscopy were used to characterize the fracture surfaces of these interfaces and to generate detailed information about the debond fracture path and mechanisms. The AFM and XPS results suggest that the failure mode of BCB/silica interfaces is cohesive in the BCB layer, in a region very close to the interface. Mechanical fatigue was found to considerably accelerate subcritical debond growth rates and decrease debond growth thresholds to as low as 25% of the critical adhesion energy. Fatigue loading produced fatigue striations on the BCB surface with a striation height of ˜1--2 nm and a spacing that was correlated with the debond growth rate. Finally, a model is presented for the mechanism of striation formation.

Fracture mechanics; Proceedings of the 22nd National Symposium, Atlanta, GA, June 26-28, 1990. Vols. 1 & 2

NASA Technical Reports Server (NTRS)

Ernst, Hugo A. (Editor); Saxena, Ashok (Editor); Mcdowell, David L. (Editor); Atluri, Satya N. (Editor); Newman, James C., Jr. (Editor); Raju, Ivatury S. (Editor); Epstein, Jonathan S. (Editor)

1992-01-01

Current research on fracture mechanics is reviewed, focusing on ductile fracture; high-temperature and time-dependent fracture; 3D problems; interface fracture; microstructural aspects of fatigue and fracture; and fracture predictions and applications. Particular attention is given to the determination and comparison of crack resistance curves from wide plates and fracture mechanics specimens; a relationship between R-curves in contained and uncontained yield; the creep crack growth behavior of titanium alloy Ti-6242; a crack growth response in three heat resistant materials at elevated temperature; a crack-surface-contact model for determining effective-stress-intensity factors; interfacial dislocations in anisotropic bimaterials; an effect of intergranular crack branching on fracture toughness evaluation; the fracture toughness behavior of exservice chromium-molybdenum steels; the application of fracture mechanics to assess the significance of proof loading; and a load ratio method for estimating crack extension.

10-year evaluation of the cementless low-contact- stress rotating-platform total knee arthroplasty.

PubMed

Efstathopoulos, Nikolaos; Mavrogenis, Andreas F; Lallos, Stergios; Nikolaou, Vassilios; Papagelopoulos, Panayiotis J; Savvidou, Olga D; Korres, Demetrios S

2009-01-01

We present the clinical and radiographic outcomes of the cementless low-contact-stress (LCS) rotating-platform total knee arthroplasty. Overall, 423 prostheses were implanted in 393 consecutive patients (30 patients had bilateral total knee replacement) for primary varus gonarthrosis (381 patients) and rheumatoid arthritis (12 patients). There were 81 men and 312 women with a mean age of 73 years (range, 58-85 years). Patella replacement was not performed in any case. Clinical and radiographic evaluation was performed using the Knee Society Score (KSS) and the Knee Society Assessment Form, respectively. The mean follow-up was 10 years (range, 5-15 years). Three patients were lost to follow-up. Survival of the prostheses was 98% at 10 years; three prostheses required revision for deep infection, bearing dislocation, and periprosthetic fracture. The mean KSS improved significantly, from 42 and 44 points preoperatively to 90 and 79 points, respectively, at the latest evaluation (P < 0.001); results were excellent in 278 cases, good in 106, fair in 27, and poor in nine. Radiolucent lines were observed in 80 cases; revision arthroplasty was not performed in any of these cases. Complications included deep infection in one patient, bearing dislocation in one, skin necrosis in four, and a supracondylar fracture in one. The cementless LCS rotating-platform total knee arthroplasty is associated with excellent mid- and long-term results for patients with osteoarthritis and rheumatoid arthritis of the knee.

The Particle Shape of WC Governing the Fracture Mechanism of Particle Reinforced Iron Matrix Composites.

PubMed

Li, Zulai; Wang, Pengfei; Shan, Quan; Jiang, Yehua; Wei, He; Tan, Jun

2018-06-11

In this work, tungsten carbide particles (WC p , spherical and irregular particles)-reinforced iron matrix composites were manufactured utilizing a liquid sintering technique. The mechanical properties and the fracture mechanism of WC p /iron matrix composites were investigated theoretically and experimentally. The crack schematic diagram and fracture simulation diagram of WC p /iron matrix composites were summarized, indicating that the micro-crack was initiated both from the interface for spherical and irregular WC p /iron matrix composites. However, irregular WC p had a tendency to form spherical WC p . The micro-cracks then expanded to a wide macro-crack at the interface, leading to a final failure of the composites. In comparison with the spherical WC p , the irregular WC p were prone to break due to the stress concentration resulting in being prone to generating brittle cracking. The study on the fracture mechanisms of WC p /iron matrix composites might provide a theoretical guidance for the design and engineering application of particle reinforced composites.

The role of synovial fluid analysis in the detection of periprosthetic hip and knee infections: a systematic review and meta-analysis.

PubMed

De Fine, Marcello; Giavaresi, Gianluca; Fini, Milena; Illuminati, Andrea; Terrando, Silvio; Pignatti, Giovanni

2018-05-01

This study tried to ascertain (1) the accuracy of synovial fluid white blood cell count and polymorphonucleate percentage in the diagnosis of periprosthetic hip and knee infections, (2) which test yielded superior test performance, and (3) the influence on diagnostic accuracy of study characteristics such as patient number, study design, study level, anatomic site, and threshold value. A systematic search was conducted including papers assessing more effective cutoffs for synovial fluid tests, having comparative design, evaluating an exclusive cohort of hip or knee prostheses, including a clear definition of infected cases, and reporting sufficient data for the calculation of true-positive, false-positive, false-negative, and true-negative. A total of 375 articles were collected and, given the inclusion criteria, ten manuscripts were included. These studies assessed 1155 hip prostheses (276 infected cases) and 1235 knee prostheses (401 infected cases). The specificity of synovial fluid white blood cell count was significantly increased by using the threshold value ≥ 3000 cell/μL (p = 0.006); the sensitivity of polymorphonucleate percentage was significantly higher in detecting knee infections (p = 0.034). Both tests had a high specificity and sensitivity in detecting periprosthetic joint infections, and no clear superiority of one over the other existed. Furthermore, cutoff and anatomic site significantly influenced synovial fluid white blood cell count and polymorphonucleate percentage, respectively. Synovial fluid analysis is adequate in differentiating patients with periprosthetic hip and knee infections. Our data confirms international guidelines suggesting the use of 3000 cell/μL as cutoff threshold for synovial fluid white blood cell count. Since an anatomic site effect has been demonstrated, the goal of future studies will be to identify different cutoffs for hip and knee prostheses.

Diagnosing periprosthetic infection: false-positive intraoperative Gram stains.

PubMed

Oethinger, Margret; Warner, Debra K; Schindler, Susan A; Kobayashi, Hideo; Bauer, Thomas W

2011-04-01

Intraoperative Gram stains have a reported low sensitivity but high specificity when used to help diagnose periprosthetic infections. In early 2008, we recognized an unexpectedly high frequency of apparent false-positive Gram stains from revision arthroplasties. The purpose of this report is to describe the cause of these false-positive test results. We calculated the sensitivity and specificity of all intraoperative Gram stains submitted from revision arthroplasty cases during a 3-month interval using microbiologic cultures of the same samples as the gold standard. Methods of specimen harvesting, handling, transport, distribution, specimen processing including tissue grinding/macerating, Gram staining, and interpretation were studied. After a test modification, results of specimens were prospectively collected for a second 3-month interval, and the sensitivity and specificity of intraoperative Gram stains were calculated. The retrospective review of 269 Gram stains submitted from revision arthroplasties indicated historic sensitivity and specificity values of 23% and 92%, respectively. Systematic analysis of all steps of the procedure identified Gram-stained but nonviable bacteria in commercial broth reagents used as diluents for maceration of periprosthetic membranes before Gram staining and culture. Polymerase chain reaction and sequencing showed mixed bacterial DNA. Evaluation of 390 specimens after initiating standardized Millipore filtering of diluent fluid revealed a reduced number of positive Gram stains, yielding 9% sensitivity and 99% specificity. Clusters of false-positive Gram stains have been reported in other clinical conditions. They are apparently rare related to diagnosing periprosthetic infections but have severe consequences if used to guide treatment. Even occasional false-positive Gram stains should prompt review of laboratory methods. Our observations implicate dead bacteria in microbiologic reagents as potential sources of false-positive Gram stains.

A Randomized, Clinical Trial of Preadmission Chlorhexidine Skin Preparation for Lower Extremity Total Joint Arthroplasty.

PubMed

Kapadia, Bhaveen H; Elmallah, Randa K; Mont, Michael A

2016-12-01

Periprosthetic infections are devastating postoperative complications of total joint arthroplasty (TJA), with native skin flora commonly identified as causative organisms. We compared 2% chlorhexidine gluconate-impregnated cloths to standard-of-care antiseptic bathing in patients before TJA, to evaluate periprosthetic infection risk at 1-year follow-up. This was a prospective, randomized, controlled trial at a single institution of patients undergoing hip or knee arthroplasty. Chlorhexidine-treated patients (275 arthroplasties) applied 2% chlorhexidine gluconate-impregnated cloths the night before and morning of admission. The standard-of-care cohort (279 arthroplasties) bathed with soap and water preadmission. Patients were excluded according to the following: (1) unable to comply with study requirements, (2) pregnant, (3) <18 years, (4) medical history of immunosuppression or steroid use, (5) chronic hepatitis B/C infection, (6) had infection around joint requiring surgery, or (7) chose not to participate. A total of 539 patients (554 arthroplasties) were included in the final population. There were no significant differences in American Society of Anesthesiologists grade, cut time, risk scores, or diabetes and smoking prevalence between cohorts (P > .05). A lower periprosthetic infection rate was found in the chlorhexidine cohort (0.4%) when compared to standard-of-care cohorts (2.9%). The infection odds ratio was 8.15 (95% confidence interval = 1.01-65.6; P = .049) for the standard-of-care cohort compared to the chlorhexidine cohort. No differences in assessed risk factors were found between groups. No severe adverse events were observed. Preoperative chlorhexidine cloth use decreased the risk of periprosthetic infection. This may be an appropriate antiseptic protocol to implement for patients undergoing lower extremity TJA. Copyright © 2016 Elsevier Inc. All rights reserved.

Cobalt deposition in mineralized bone tissue after metal-on-metal hip resurfacing: Quantitative μ-X-ray-fluorescence analysis of implant material incorporation in periprosthetic tissue.

PubMed

Hahn, Michael; Busse, Björn; Procop, Mathias; Zustin, Jozef; Amling, Michael; Katzer, Alexander

2017-10-01

Most resurfacing systems are manufactured from cobalt-chromium alloys with metal-on-metal (MoM) bearing couples. Because the quantity of particulate metal and corrosion products which can be released into the periprosthetic milieu is greater in MoM bearings than in metal-on-polyethylene (MoP) bearings, it is hypothesized that the quantity and distribution of debris released by the MoM components induce a compositional change in the periprosthetic bone. To determine the validity of this claim, nondestructive µ-X-ray fluorescence analysis was carried out on undecalcified histological samples from 13 femoral heads which had undergone surface replacement. These samples were extracted from the patients after gradient time points due to required revision surgery. Samples from nonintervened femoral heads as well as from a MoP resurfaced implant served as controls. Light microscopy and µ-X-ray fluorescence analyses revealed that cobalt debris was found not only in the soft tissue around the prosthesis and the bone marrow, but also in the mineralized bone tissue. Mineralized bone exposed to surface replacements showed significant increases in cobalt concentrations in comparison with control specimens without an implant. A maximum cobalt concentration in mineralized hard tissue of up to 380 ppm was detected as early as 2 years after implantation. Values of this magnitude are not found in implants with a MoP surface bearing until a lifetime of more than 20 years. This study demonstrates that hip resurfacing implants with MoM bearings present a potential long-term health risk due to rapid cobalt ion accumulation in periprosthetic hard tissue. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1855-1862, 2017. © 2016 Wiley Periodicals, Inc.

FROMS3D: New Software for 3-D Visualization of Fracture Network System in Fractured Rock Masses

NASA Astrophysics Data System (ADS)

Noh, Y. H.; Um, J. G.; Choi, Y.

2014-12-01

A new software (FROMS3D) is presented to visualize fracture network system in 3-D. The software consists of several modules that play roles in management of borehole and field fracture data, fracture network modelling, visualization of fracture geometry in 3-D and calculation and visualization of intersections and equivalent pipes between fractures. Intel Parallel Studio XE 2013, Visual Studio.NET 2010 and the open source VTK library were utilized as development tools to efficiently implement the modules and the graphical user interface of the software. The results have suggested that the developed software is effective in visualizing 3-D fracture network system, and can provide useful information to tackle the engineering geological problems related to strength, deformability and hydraulic behaviors of the fractured rock masses.

Modular to Monoblock: Difficulties of Detaching the M(2)a-Magnum(TM) Head Are Common in Metal-on-metal Revisions.

PubMed

Mäntymäki, Heikki; Mäkelä, Keijo T; Vahlberg, Tero; Hirviniemi, Joni; Niinimäki, Tuukka

2016-09-01

Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the implant has titanium interfaces between the head and the stem. We have repeatedly encountered difficulty removing the titanium sleeve adapter in the M(2)a-Magnum(TM) implant. Although the manufacturer warns about this complication and cases with these difficulties have been reported to the United States FDA, we believed this topic is important to study, because the frequency of difficulties in head removal is unknown and the complications related to this event have not been characterized. We asked: (1) Do revisions of M(2)a-Magnum(TM) implants differ from those of M(2)a-38(TM) implants in terms of ease of removal of the femoral head? (2) In cases where difficulty with M(2)a-Magnum(TM) head removal occurred, was the operative time, bleeding, risk of periprosthetic fracture, or joint infection increased compared with cases where the M(2)a-Magnum(TM) head was removed without difficulties? Between 2004 and 2014, we revised 296 THAs with metal-on-metal implants that involved M(2)a-Magnum(TM) (123) or M(2)a-38(TM) heads (88); of those, 84 were planned to include a femoral stem revision and insufficient data were available for three operations, so they were excluded from this analysis, leaving 124 THAs in the current retrospective study (70 THAs with M(2)a-Magnum(TM) and 54 THAs with M(2)a-38(TM) heads).The method of modular head removal, any difficulties removing the femoral head from the trunnion, operation time, and complications were recorded based on chart review. All the observed problems of detaching the head or taper adapter were among M(2)a-Magnum(TM) heads; there were no problems detaching the head in revisions of the M(2)a-38(TM) implant. In 29% (20 of 70) of revisions of the M(2)a-Magnum(TM) implant, the modular head could not be detached by knocking it with a punch and a mallet. Seventeen percent (12 of 70) of hips needed an unplanned stem revision owing to difficulties with head removal. In revisions of the M(2)a-Magnum(TM) implant that experienced head-removal problems, the median operative time was longer (144 minutes; range, 75-274 minutes) and bleeding was greater (725 mL; range, 300-2200 mL) compared with revisions of the M(2)a-Magnum(TM) implant without head removal problems (77 minutes, range, 33-197 minutes, p < 0.001; 475 mL, range, 50-1500 mL, p = 0.004). With the numbers available, we did not see differences in terms of the proportion of patients experiencing major complications (periprosthetic fracture or postoperative infections) between the groups (difficult versus easy; 25% [five of 20] versus 8% [four of 50]; odds ratio, 3.8 [95% CI, 0.9-16.2], p = 0.067). The titanium-titanium taper junction can be very difficult to separate during revision THAs, and if not anticipated, this problem can result in larger and more complicated revision procedures in patients who have the M(2)a-Magnum(TM) implant. Although the global use of metal-on-metal implants in THAs has decreased dramatically during the last several years, many thousands remain in service and therefore still might require revision. It is crucial to be prepared with special tools, including a femoral head extraction tool and diamond saw. The patient has to be informed of the possibility of a more extensive operation than preoperatively planned. Level III, therapeutic study.

An Investigation on the Use of a Laser Ablation Treatment on Metallic Surfaces and the Influence of Temperature on Fracture Toughness of Hybrid Co-Cured Metal-PMC Interfaces

NASA Technical Reports Server (NTRS)

Connell, John; Palmieri, Frank; Truong, Hieu; Ochoa, Ozden; Lagoudas, Dimitris

2015-01-01

Hybrid composite laminates that contain alternating layers of titanium alloys and carbon fabric reinforced polyimide matrix composites (PMC) are excellent candidates for light-weight, high-temperature structural materials for high-speed aerospace vehicles. The delamination resistance of the hybrid titanium-PMC interface is of crucial consideration for structural integrity during service. Here, we report the first investigations on the use of laser ablation in combination with sol-gel treatment technique on Ti/NiTi foil surfaces in co-cured hybrid polyimide matrix composite laminates. Mode-I and mode-II fracture toughness of the hybrid Ti/NiTi-PMC interface as a function of temperature were determined via experimental testing and finite element analysis.

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency: A Concise Follow-up, at a Minimum of 10 Years, of Previous Reports.

PubMed

Cuff, Derek J; Pupello, Derek R; Santoni, Brandon G; Clark, Rachel E; Frankle, Mark A

2017-11-15

We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years. Forty patients (42 shoulders) were available for clinical follow-up. In the patients available for study, implant survivorship, with the end point being revision for any reason, was 90.7%. Since our 5-year report, 2 patients underwent revision surgery; 1 patient sustained a periprosthetic fracture 7 years postoperatively and 1 patient had a dislocation because of chronic shoulder instability at 8 years postoperatively. At a minimum follow-up of 10 years, the patients continued to maintain their improved outcome scores and range of motion, which were comparable with earlier follow-up evaluations. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Anterior knee symptoms after S-ROM hinge implantation.

PubMed

Deehan, David J; Gangadharan, Rajkumar; Malviya, Ajay; Sutherland, Alasdair; Holland, James P

2014-01-01

To evaluate the performance of a canal filling hinge device for complex knee arthroplasty. Thirty-seven (4 primary hinge implantation and 33 revision cases) patients who had undergone arthroplasty with the S-ROM third generation hinge device for a combination of massive bone loss or ligamentous insufficiency were prospectively examined with a minimum of 5-year follow-up. Median age at surgery was 72 years (range: 43 to 87 years). Principal indications included aseptic loosening or massive osteolysis (24 cases), infection (8 cases) and periprosthetic fracture (4 cases). All patients exhibited either grade 2 (N = 12) or grade 3 (N = 25) AORI bone loss or a grade 3 medial ligament deficiency. One patient experienced implant failure (71 months), and one patient suffered late deep infection (36 months). Mean WOMAC score improved from 27 to 62. Four patients required patellar resurfacing for persistent pain. The 5-year survivorship was 86%. While the S-ROM device may offer satisfactory medium term outcome for complex end stage knee disease, we report a high rate of debilitating anterior knee symptoms.

Drainage Asperities on Subduction Megathrusts

NASA Astrophysics Data System (ADS)

Sibson, R. H.

2012-12-01

Geophysical observations coupled with force-balance analyses suggest that the seismogenic shear zone interface of subduction megathrusts is generally fluid-overpressured to near-lithostatic values (λv = Pf/σv > 0.9) below the forearc hanging-wall, strongly modulating the profile of frictional shear resistance. Fluid sources include the accretionary prism at shallow levels and, with increasing depth, metamorphic dehydration of material entrained within the subduction shear zone together with progressive metamorphism of oceanic crust in the downgoing slab. Solution transfer in fine-grained material contained within the deeper subduction shear zone (150 < T < 350°C) likely contributes to hydrothermal sealing of fractures. A dramatic difference may therefore exist between low prefailure permeability surrounding the megathrust and high postfailure fracture permeability along the rupture zone and adjacent areas of aftershock activity. Observed postseismic changes in the velocity structure of the fore-arc hanging-wall led Husen and Kissling (2001) to propose massive fluid loss across the subduction interface following the 1995 Antofagasta, Chile, Mw8.0 megathrust rupture. Such trans-megathrust discharges represent a variant of 'fault-valve' action in which the subduction interface itself acts as a seal trapping overpressured fluids derived from metamorphic dehydration beneath. In low-permeability assemblages the maximum sustainable overpressure is limited by the activation or reactivation of brittle faults and fractures under the prevailing stress state. Highest overpressures tend to occur at low differential stress in compressional stress regimes. Loci for fluid discharge are likely determined by stress heterogeneities along the megathrust (e.g. the hangingwall of the rupture at its downdip termination). Discharge sites may be defined by swarm aftershocks defining activated fault-fracture meshes. However, fluid loss across a subduction interface will be enhanced when the stress-state in the forearc hanging-wall switches from compressional reverse-slip faulting before failure to extensional normal-slip faulting postfailure, as occurred during the 2011 Mw9.0 Tohoku megathrust rupture. Mean stress and fault-normal stress then change from being greater than vertical stress prefailure, to less than vertical stress postfailure. Postfailure reductions in overpressure are expected from a combination of poroelastic effects and fluid loss through fault-fracture networks, enhancing vertical permeability. Mineralised fault-fracture meshes in exhumed fore-arc assemblages (e.g. the Alaska-Juneau Au-quartz vein swarm) testify to the episodic discharge of substantial volumes of hydrothermal fluid (< tens of km3). Localized drainage from the subduction interface shear zone increases frictional strength significantly, giving rise to a postfailure strength asperities. Anticipated strength increases from such fluid discharge depends on the magnitude of the drop in overpressure but are potentially large (< hundreds of MPa). Time to the subsequent failure is then governed by reaccumulation of fluid overpressure as well as shear stress along the subduction interface.

Mechanical and thermal stability of molecularly engineered copper-silica interfaces using organosilane nanolayers

NASA Astrophysics Data System (ADS)

Gandhi, Darshan Dinesh

Future generation silicon integrated circuits requires new materials with low dielectric permittivity kappa < 2.0 and ultra-thin barrier layers (e.g., <3 nm) to create high-reliability, high-performance wiring. Preserving the structural and functional integrity of interfaces is a crucial aspect of realizing reliable integrated circuits with nanodevice components. Molecular nanolayers (MNLs) provide the unique ability to tailor interface properties by adjusting molecular termini, layering, branching or length, thereby making them attractive alternatives to conventional barrier materials. Developing a fundamental understanding of the stability and properties of MNLs at thin film interfaces, and their correlation with parameters such as terminal group chemistries molecular length and surface coverage are key to utilizing them in nanodevice applications. This work addresses some of the key challenges pertaining to modifying Cu-silica interfaces with MNLs with appropriate terminal groups. The resultant effects on, and the inter-relationships between, the chemical, mechanical and electrical properties are investigated. Modifying Cu-silica interface with MNLs results in increased Cu diffusioninduced time-to-failure when subject to electrothermal stresses. The extent of enhancement depends on the terminal chemistry of the MNLs interacting with the overlying Cu. Upon annealing, it is found that MNLs form strong covalent linkages at both Cu-MNL and MNL-silica interfaces resulting in unprecedented values of interface toughness, values exceeding 20 Jm-2. Although strong bonding at Cu-MNL and MNL-dielectric interfaces may be sufficient for blocking copper transport across polyelectrolyte MNL bilayers, strong interlayer molecular bonding is a necessary condition for interface toughening. Exposing MNLs to UV light, results in photo-oxidation of the terminal mercaptan groups. These photo-oxidized termini form strong complexes with Cu that results in enhancement by a factor-of-10 in device failure times. Using a combination of UV-exposure prior to Cu metallization and annealing after Cu metallization should result in enhanced device failure times and interface toughness, resulting in chemically isolated and mechanically strong interfaces. This work also shows that passivating Cu surfaces with MNLs can decrease surface leakage currents due to curtailed in-plane Cu transport (low voltages). Formation of strong complexes with Cu can immobilize Cu and reduce the leakage currents and result in higher breakdown voltages. Moreover, the strategy of using MNLs can be applied to passivate pore surfaces in mesoporous silica (MPS) films to suppress water uptake and Cu penetration. The molecularly passivated dielectrics (S-MPS) exhibit 50% lower fracture toughness than unfunctionalized films, and fracture closer to the Cu/S-MPS interface. Electron spectroscopy analyses show that the fracture pathway is governed by the Cu penetration depth into the MPS. Our results show that molecular passivation of porous films not only inhibit metal penetration and water uptake, but also can be used to tune the fracture pathway. The results from this thesis are of importance for harnessing MNLs for the use in future device wiring applications.

Particle Swarm Transport through Immiscible Fluid Layers in a Fracture

NASA Astrophysics Data System (ADS)

Teasdale, N. D.; Boomsma, E.; Pyrak-Nolte, L. J.

2011-12-01

Immiscible fluids occur either naturally (e.g. oil & water) or from anthropogenic processes (e.g. liquid CO2 & water) in the subsurface and complicate the transport of natural or engineered micro- or nano-scale particles. In this study, we examined the effect of immiscible fluids on the formation and evolution of particle swarms in a fracture. A particle swarm is a collection of colloidal-size particles in a dilute suspension that exhibits cohesive behavior. Swarms fall under gravity with a velocity that is greater than the settling velocity of a single particle. Thus a particle swarm of colloidal contaminants can potentially travel farther and faster in a fracture than expected for a dispersion or emulsion of colloidal particles. We investigated the formation, evolution, and break-up of colloidal swarms under gravity in a uniform aperture fracture as hydrophobic/hydrophyllic particle swarms move across an oil-water interface. A uniform aperture fracture was fabricated from two transparent acrylic rectangular prisms (100 mm x 50 mm x 100 mm) that are separated by 1, 2.5, 5, 10 or 50 mm. The fracture was placed, vertically, inside a glass tank containing a layer of pure silicone oil (polydimethylsiloxane) on distilled water. Along the length of the fracture, 30 mm was filled with oil and 70 mm with water. Experiments were conducted using silicone oils with viscosities of 5, 10, 100, or 1000 cSt. Particle swarms (5 μl) were comprised of a 1% concentration (by mass) of 25 micron glass beads (hydrophilic) suspended in a water drop, or a 1% concentration (by mass) of 3 micron polystyrene fluorescent beads (hydrophobic) suspended in a water drop. The swarm behavior was imaged using an optical fluorescent imaging system composed of a CCD camera and by green (525 nm) LED arrays for illumination. Swarms were spherical and remained coherent as they fell through the oil because of the immiscibility of oil and water. However, as a swarm approached the oil-water interface, it decreased in speed and came to rest on the interface while maintaining its spherical shape. After the interface between a swarm and the oil thinned sufficiently, the swarm was rapidly released into the water layer. The time that this took depended on the viscosity of the oil layer, which determines the rate of thinning, and on the size and properties of the particles. The swarm geometry and velocity in the water layer depended on the aperture of the fracture, the viscosity of the oil and the hydrophobicity or hydrophyllicity of the particles in the swarm. Hydrophobic beads result in multiple mini swarms after breaking through the interface rather than a single large swarm like that observed for hydrophilic swarms. After many experiments a pile formed at the bottom of the tank near the center of the fracture, indicating that swarms can lead to locally high concentration of colloidal contaminants. Acknowledgment: The authors wish to acknowledge support of this work by the Geosciences Research Program, Office of Basic Energy Sciences US Department of Energy (DE-FG02-09ER16022) and the Summer Undergraduate Research Fellowship program at Purdue University.

The inhibition of staphylococcus epidermidis biofilm formation by vancomycin-modified titanium alloy and implications for the treatment of periprosthetic infection

PubMed Central

Antoci, Valentin; Adams, Christopher S.; Parvizi, Javad; Davidson, Helen M.; Composto, Russell J.; Freeman, Theresa A.; Wickstrom, Eric; Ducheyne, Paul; Jungkind, Donald; Shapiro, Irving M.; Hickok, Noreen J.

2008-01-01

Peri-prosthetic infections are notoriously difficult to treat as the biomaterial implant is ideal for bacterial adhesion and biofilm formation, resulting in decreased antibiotic sensitivity. Previously, we reported that vancomycin covalently attached to a Ti alloy surface (Vanc-Ti) could prevent bacterial colonization. Herein we examine the effect of this Vanc-Ti surface on Staphylococci epidermidis, a Gram-positive organism prevalent in orthopaedic infections. By direct colony counting and fluorescent visualization of live bacteria, S. epidermidis colonization was significantly inhibited on Vanc-Ti implants. In contrast, the gram negative organism Escherichia coli readily colonized the Vanc-Ti rod, suggesting retention of antibiotic specificity. By histochemical and SEM analysis, Vanc-Ti prevented S. epidermidis biofilm formation, even in the presence of serum. Furthermore, when challenged multiple times with S. epidermidis, Vanc-Ti rods resisted bacterial colonization. Finally, when S. epidermidis was continuously cultured in the presence of Vanc-Ti, the bacteria maintained a Vanc sensitivity equivalent to the parent strain. These findings indicate that antibiotic derivatization of implants can result in a surface that can resist bacterial colonization. This technology holds great promises for the prevention and treatment of periprosthetic infections. PMID:18814909

Pre-operative intra-articular deep tissue sampling with novel retrograde forceps improves the diagnostics in periprosthetic joint infection.

PubMed

Wimmer, Matthias D; Ploeger, Milena M; Friedrich, Max J; Hügle, Thomas; Gravius, Sascha; Randau, Thomas M

2017-07-01

Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes. Thirty patients (male n = 15, 50%; female n = 15, 50%) with 30 suspected PJIs in painful total hip arthroplasties (THAs) were included in this prospective, controlled, non-blinded trial. The results were compared with intra-operatively obtained representative deep tissue samples. In summary, 27 out of 30 patients were diagnosed correctly as infected (17/17) or non-infected (10/13). The sensitivity to predict a PJI using the Retroforce® sampling forceps in addition to standard diagnostics was 85%, the specificity 100%. Retrograde synovial biopsy is a new and rapid diagnostic procedure under local anaesthesia in patients with painful THAs with similar histological results compared to deep tissue sampling.

Evaluation of prosthetic valve obstruction on electrocardiographically gated multidetector-row computed tomography--identification of subprosthetic pannus in the aortic position.

PubMed

Ueda, Tomohiro; Teshima, Hideki; Fukunaga, Shuji; Aoyagi, Shigeaki; Tanaka, Hiroyuki

2013-01-01

This study was performed to evaluate the diagnostic role of electrocardiographically gated multidetector-row computed tomography (MDCT) for prosthetic valve obstruction (PVO) in the aortic position. Between 2002 and 2006, 9 patients were diagnosed with PVO of an aortic bileaflet mechanical valve based on echocardiographic and cineradiographic criteria. These 9 patients were examined using MDCT before replacement of the mechanical valve, and intraoperative findings were compared to morphologic periprosthetic abnormalities observed on MDCT. CT attenuation (Hounsfield units; HU) of the periprosthetic abnormalities was measured to investigate the underlying cause of the PVO. MDCT showed subprosthetic masses extending beyond the prosthetic ring into the orifice of the valve. At reoperation, presence of subprosthetic pannus was confirmed in all of the 9 patients, but no periprosthetic thrombus was found. The mean CT attenuation of the subprosthetic pannus was 170 HU, and it was significantly greater than that obtained from the interventricular septum (108 HU; P<0.0001). MDCT can be used to clearly visualize subprosthetic pannus causing PVO and the mean CT attenuation of subprosthetic pannus is significantly higher than that of the interventricular septum on MDCT.

"Combined Diagnostic Tool" APPlication to a Retrospective Series of Patients Undergoing Total Joint Revision Surgery.

PubMed

Gallazzi, Enrico; Drago, Lorenzo; Baldini, Andrea; Stockley, Ian; George, David A; Scarponi, Sara; Romanò, Carlo L

2017-01-01

Background : Differentiating between septic and aseptic joint prosthesis may be challenging, since no single test is able to confirm or rule out infection. The choice and interpretation of the panel of tests performed in any case often relies on empirical evaluation and poorly validated scores. The "Combined Diagnostic Tool (CDT)" App, a smartphone application for iOS, was developed to allow to automatically calculate the probability of having a of periprosthetic joint infection, on the basis of the relative sensitivity and specificity of the positive and negative diagnostic tests performed in any given patient. Objective : The aim of the present study was to apply the CDT software to investigate the ability of the tests routinely performed in three high-volume European centers to diagnose a periprosthetic infection. Methods : This three-center retrospective study included 120 consecutive patients undergoing total hip or knee revision, and included 65 infected patients (Group A) and 55 patients without infection (Group B). The following parameters were evaluated: number and type of positive and negative diagnostic tests performed pre-, intra- and post-operatively and resultant probability calculated by the CDT App of having a peri-prosthetic joint infection, based on pre-, intra- and post-operative combined tests. Results : Serological tests were the most common performed, with an average 2.7 tests per patient for Group A and 2.2 for Group B, followed by joint aspiration (0.9 and 0.8 tests per patient, respectively) and imaging techniques (0.5 and 0.2 test per patient). Mean CDT App calculated probability of having an infection based on pre-operative tests was 79.4% for patients in Group A and 35.7 in Group B. Twenty-nine patients in Group A had > 10% chance of not having an infection, and 29 of Group B had > 10% chance of having an infection. Conclusion : This is the first retrospective study focused on investigating the number and type of tests commonly performed prior to joint revision surgery and aimed at evaluating their combined ability to diagnose a peri-prosthetic infection. CDT App allowed us to demonstrate that, on average, the routine combination of commonly used tests is unable to diagnose pre-operatively a peri-prosthetic infection with a probability higher than 90%.

Fracture of a Brittle-Particle Ductile Matrix Composite with Applications to a Coating System

NASA Astrophysics Data System (ADS)

Bianculli, Steven J.

In material systems consisting of hard second phase particles in a ductile matrix, failure initiating from cracking of the second phase particles is an important failure mechanism. This dissertation applies the principles of fracture mechanics to consider this problem, first from the standpoint of fracture of the particles, and then the onset of crack propagation from fractured particles. This research was inspired by the observation of the failure mechanism of a commercial zinc-based anti-corrosion coating and the analysis was initially approached as coatings problem. As the work progressed it became evident that failure mechanism was relevant to a broad range of composite material systems and research approach was generalized to consider failure of a system consisting of ellipsoidal second phase particles in a ductile matrix. The starting point for the analysis is the classical Eshelby Problem, which considered stress transfer from the matrix to an ellipsoidal inclusion. The particle fracture problem is approached by considering cracks within particles and how they are affected by the particle/matrix interface, the difference in properties between the particle and matrix, and by particle shape. These effects are mapped out for a wide range of material combinations. The trends developed show that, although the particle fracture problem is very complex, the potential for fracture among a range of particle shapes can, for certain ranges in particle shape, be considered easily on the basis of the Eshelby Stress alone. Additionally, the evaluation of cracks near the curved particle/matrix interface adds to the existing body of work of cracks approaching bi-material interfaces in layered material systems. The onset of crack propagation from fractured particles is then considered as a function of particle shape and mismatch in material properties between the particle and matrix. This behavior is mapped out for a wide range of material combinations. The final section of this dissertation qualitatively considers an approach to determine critical particle sizes, below which crack propagation will not occur for a coating system that exhibited stable cracks in an interfacial layer between the coating and substrate.

Permeability in fractured rocks from deep geothermal boreholes in the Upper Rhine Graben

NASA Astrophysics Data System (ADS)

Vidal, Jeanne; Whitechurch, Hubert; Genter, Albert; Schmittbuhl, Jean; Baujard, Clément

2015-04-01

Permeability in fractured rocks from deep geothermal boreholes in the Upper Rhine Graben Vidal J.1, Whitechurch H.1, Genter A.2, Schmittbuhl J.1, Baujard C.2 1 EOST, Université de Strasbourg 2 ES-Géothermie, Strasbourg The thermal regime of the Upper Rhine Graben (URG) is characterized by a series of geothermal anomalies on its French part near Soultz-sous-Forêts, Rittershoffen and in the surrounding area of Strasbourg. Sedimentary formations of these areas host oil field widely exploited in the past which exhibit exceptionally high temperature gradients. Thus, geothermal anomalies are superimposed to the oil fields which are interpreted as natural brine advection occurring inside a nearly vertical multi-scale fracture system cross-cutting both deep-seated Triassic sediments and Paleozoic crystalline basement. The sediments-basement interface is therefore very challenging for geothermal industry because most of the geothermal resource is trapped there within natural fractures. Several deep geothermal projects exploit local geothermal energy to use the heat or produce electricity and thus target permeable fractured rocks at this interface. In 1980, a geothermal exploration well was drilled close to Strasbourg down to the Permian sediments at 3220 m depth. Bottom hole temperature was estimated to 148°C but the natural flow rate was too low for an economic profitability (<7 L/s). Petrophysics and reservoir investigations based on core analysis revealed a low matrix porosity with fracture zones spatially isolated and sealed in the sandstone formations. Any stimulation operation was planned and the project was abandoned. The Soultz-sous-Forêts project, initiated in 1986, explored during more than 30 years the experimental geothermal site by drilling five boreholes, three of which extend to 5 km depth. They identified a temperature of 200° C at 5 km depth in the granitic basement but with a variable flow rate. Hydraulic and chemical stimulation operations were applied in order to increase the initial low permeability by reactivating and dissolving sealed fractures in basement. The productivity was considerably improved and allows geothermal exploitation at 165° C and 20 L/s. Recent studies revealed the occurrences of permeable fractures in the limestones of Muschelkalk and the sandstones of Buntsandstein also. For the ongoing project at Rittershoffen, two deep boreholes, drilled down to 2.7 km depth target a reservoir in the sandstones of Buntsandstein and in the granitic basement interface. The thermal, hydraulic and chemical stimulations of the first well lead the project to an economic profitability with a temperature of 170° C and an industrial flow rate of 70 L/s. The deep sedimentary cover and the top of the granitic basement are the main target of the geothermal project in the URG. Permeability of fractured rocks after drilling operations or stimulation operations demonstrates the viability of French industrial deep geothermal projects in the URG was also confirmed by several geothermal projects in Germany that target the similar sediments-basement interface (Landau and Insheim) or the deep Triassic sediments (Bruchsal and Brühl). In France, future geothermal projects are planned in particular in Strasbourg suburb to exploit the permeability of deep-seated fractured sediment-basement interface.

Predictions and Experimental Microstructural Characterization of High Strain Rate Failure Modes in Layered Aluminum Composites

NASA Astrophysics Data System (ADS)

Khanikar, Prasenjit

Different aluminum alloys can be combined, as composites, for tailored dynamic applications. Most investigations pertaining to metallic alloy layered composites, however, have been based on quasi-static approaches. The dynamic failure of layered metallic composites, therefore, needs to be characterized in terms of strength, toughness, and fracture response. A dislocation-density based crystalline plasticity formulation, finite-element techniques, rational crystallographic orientation relations and a new fracture methodology were used to predict the failure modes associated with the high strain rate behavior of aluminum layered composites. Two alloy layers, a high strength alloy, aluminum 2195, and an aluminum alloy 2139, with high toughness, were modeled with representative microstructures that included precipitates, dispersed particles, and different grain boundary (GB) distributions. The new fracture methodology, based on an overlap method and phantom nodes, is used with a fracture criteria specialized for fracture on different cleavage planes. One of the objectives of this investigation, therefore, was to determine the optimal arrangements of the 2139 and 2195 aluminum alloys for a metallic layered composite that would combine strength, toughness and fracture resistance for high strain-rate applications. Different layer arrangements were investigated for high strain-rate applications, and the optimal arrangement was with the high toughness 2139 layer on the bottom, which provided extensive shear strain localization, and the high strength 2195 layer on the top for high strength resistance. The layer thickness of the bottom high toughness layer also affected the bending behavior of the roll-boned interface and the potential delamination of the layers. Shear strain localization, dynamic cracking and delamination were the mutually competing failure mechanisms for the layered metallic composite, and control of these failure modes can be optimized for high strain-rate applications. The second major objective of this investigation was the use of recently developed dynamic fracture formulations to model and analyze the crack nucleation and propagation of aluminum layered composites subjected to high strain rate loading conditions and how microstructural effects, such as precipitates, dispersed particles, and GB orientations affect failure evolution. This dynamic fracture approach is used to investigate crack nucleation and crack growth as a function of the different microstructural characteristics of each alloy in layered composites with and without pre-existing cracks. The zigzag nature of the crack paths were mainly due to the microstructural features, such as precipitates and dispersed particles distributions and orientations ahead of the crack front, and it underscored the capabilities of the fracture methodology. The evolution of dislocation density and the formation of localized shear slip contributed to the blunting of the propagating crack. Extensive geometrical and thermal softening due to the localized plastic slip also affected crack path orientations and directions. These softening mechanisms resulted in the switching of cleavage planes, which affected crack path orientations. Interface delamination can also have an important role in the failure and toughening of the layered composites. Different scenarios of delamination were investigated, such as planar crack growth and crack penetration into the layers. The presence of brittle surface oxide platelets in the interface region also significantly influenced the interface delamination process. Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM) and Optical Microscopy (OM) characterization provided further physical insights and validation of the predictive capabilities. The inherent microstructural features of each alloy play a significant role in the dynamic fracture, shear strain localization, and interface delamination of the layered metallic composite. These microstructural features, such as precipitates, dispersed particles, and GB orientations and distributions can be optimized for desired behavior of metallic composites.

Exhibition of veiled features in diffusion bonding of titanium alloy and stainless steel via copper

NASA Astrophysics Data System (ADS)

Thirunavukarasu, Gopinath; Kundu, Sukumar; Laha, Tapas; Roy, Deb; Chatterjee, Subrata

2017-11-01

An investigation was carried out to know the extent of influence of bonding-time on the interface structure and mechanical properties of diffusion bonding (DB) of TiA|Cu|SS. DB of Ti6Al4V (TiA) and 304 stainless steel (SS) using pure copper (Cu) of 200-μm thickness were processed in vacuum using 4-MPa bonding-pressure at 1123 K from 15 to 120 min in steps of 15 min. Preparation of DB was not possible when bonding-time was less than 60 min as the bonding at Cu|SS interface was unsuccessful in spite of effective bonding at TiA|Cu interface; however, successful DB were produced when the bonding-time was 60 min and beyond. DB processed for 60 and 75 min (classified as shorter bonding-time interval) showed distinctive characteristics (structural, mechanical, and fractural) as compared to the DB processed for 90, 105, and 120 min (classified as longer bonding-time interval). DB processed for 60 and 75 min exhibited layer-wise Cu-Ti-based intermetallics at TiA|Cu interface, whereas Cu|SS interface was completely free from reaction products. The layer-wise structure of Cu-Ti-based intermetallics were not observed at TiA|Cu interface in the DB processed for longer bonding-time; however, the Cu|SS interface had layer-wise ternary intermetallic compounds (T1, T2, and T3) of Cu-Fe-Ti-based along with σ phase depending upon the bonding-time chosen. Diffusivity of Ti-atoms in Cu-layer (DTi in Cu-layer) was much greater than the diffusivity of Fe-atoms in Cu-layer (DFe in Cu-layer). Ti-atoms reached Cu|SS interface but Fe-atoms were unable to reach TiA|Cu interface. It was observed that DB fractured at Cu|SS interface when processed for shorter bonding-time interval, whereas the DB processed for longer bonding-time interval fractured apparently at the middle of Cu-foil region predominantly due to the existence of brittle Cu-Fe-Ti-based intermetallics.

Energy release rate analysis on the interface cracks of enamel-cement-bracket fracture using virtual crack closure technique

NASA Astrophysics Data System (ADS)

Samshuri, S. F.; Daud, R.; Rojan, M. A.; Mat, F.; Basaruddin, K. S.; Hassan, R.

2017-10-01

This paper presents the energy method to evaluate fracture behavior of enamel-cement-bracket system based on cement thickness. Finite element (FE) model of enamel-cement-bracket was constructed by using ANSYS Parametric Design Language (APDL). Three different thickness were used in this study, 0.05, 0.2, and 0.271 mm which assigned as thin, medium and thick for both enamel-cement and cement bracket interface cracks. Virtual crack closure technique (VCCT) was implemented as a simulation method to calculated energy release rate (ERR). Simulation results were obtained for each thickness are discussed by using Griffith’s energy balance approach. ERR for thin thickness are found to be the lowest compared to medium and thick. Peak value of ERR also showed a significant different between medium and thick thickness. Therefore, weakest bonding occurred at low cement thickness because less load required to produce enough energy to detach the bracket. For medium and thick thickness, both increased rapidly in energy value at about the mid-point of the enamel-cement interface. This behavior occurred because of the increasing in mechanical and surface energy when the cracks are increasing. However, result for thick thickness are higher at mid-point compared to thin thickness. In conclusion, fracture behavior of enamel cracking process for medium most likely the safest to avoid enamel fracture and withstand bracket debonding.

The double capsules in macro-textured breast implants.

PubMed

Giot, Jean-Philippe; Paek, Laurence S; Nizard, Nathanael; El-Diwany, Mostafa; Gaboury, Louis A; Nelea, Monica; Bou-Merhi, Joseph S; Harris, Patrick G; Danino, Michel A

2015-10-01

Breast implants are amongst the most widely used types of permanent implants in modern medicine and have both aesthetic and reconstructive applications with excellent biocompatibility. The double capsule is a complication associated with textured prostheses that leads to implant displacement; however, its etiology has yet to be elucidated. In this study, 10 double capsules were sampled from breast expander implants for in-depth analysis; histologically, the inner capsular layer demonstrated highly organized collagen in sheets with delamination of fibers. At the prosthesis interface (PI) where the implant shell contacts the inner capsular layer, scanning electron microscopy (SEM) revealed a thin layer which mirrored the three-dimensional characteristics of the implant texture; the external surface of the inner capsular layer facing the intercapsular space (ICS) was flat. SEM examination of the inner capsule layer revealed both a large bacterial presence as well as biofilm deposition at the PI; a significantly lower quantity of bacteria and biofilm were found at the ICS interface. These findings suggest that the double capsule phenomenon's etiopathogenesis is of mechanical origin. Delamination of the periprosthetic capsule leads to the creation of the ICS; the maintained separation of the 2 layers subsequently alters the biostability of the macro-textured breast implant. Copyright © 2015 Elsevier Ltd. All rights reserved.

Tensile and bending fatigue of the adhesive interface to dentin.

PubMed

Belli, Renan; Baratieri, Luiz Narciso; Braem, Marc; Petschelt, Anselm; Lohbauer, Ulrich

2010-12-01

The aim of this study was to evaluate the fatigue limits of the dentin-composite interfaces established either with an etch-and-rinse or an one-step self-etch adhesive systems under tensile and bending configurations. Flat specimens (1.2 mm×5 mm×35 mm) were prepared using a plexiglass mold where dentin sections from human third molars were bonded to a resin composite, exhibiting the interface centrally located. Syntac Classic and G-Bond were used as adhesives and applied according to the manufacturer's instructions. The fluorochrome Rhodamine B was added to the adhesives to allow for fractographic evaluation. Tensile strength was measured in an universal testing machine and the bending strength (n=15) in a Flex machine (Flex, University of Antwerp, Belgium), respectively. Tensile (TFL) and bending fatigue limits (BFL) (n=25) were determined under wet conditions for 10(4) cycles following a staircase approach. Interface morphology and fracture mechanisms were observed using light, confocal laser scanning and scanning electron microscopy. Statistical analysis was performed using three-way ANOVA (mod LSD test, p<0.05). Tensile and bending characteristic strengths at 63.2% failure probability for Syntac were 23.8 MPa and 71.5 MPa, and 24.7 MPa and 72.3 MPa for G-Bond, respectively. Regarding the applied methods, no significant differences were detected between adhesives. However, fatigue limits for G-Bond (TFL=5.9 MPa; BFL=36.2 MPa) were significantly reduced when compared to Syntac (TFL=12.6 MPa; BFL=49.7 MPa). Fracture modes of Syntac were generally of adhesive nature, between the adhesive resin and dentin, while G-Bond showed fracture planes involving the adhesive-dentin interface and the adhesive resin. Cyclic loading under tensile and bending configurations led to a significant strength degradation, with a more pronounced fatigue limit decrease for G-Bond. The greater decrease in fracture strength was observed in the tensile configuration. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Fatigue Life Prediction of Fiber-Reinforced Ceramic-Matrix Composites with Different Fiber Preforms at Room and Elevated Temperatures

PubMed Central

Li, Longbiao

2016-01-01

In this paper, the fatigue life of fiber-reinforced ceramic-matrix composites (CMCs) with different fiber preforms, i.e., unidirectional, cross-ply, 2D (two dimensional), 2.5D and 3D CMCs at room and elevated temperatures in air and oxidative environments, has been predicted using the micromechanics approach. An effective coefficient of the fiber volume fraction along the loading direction (ECFL) was introduced to describe the fiber architecture of preforms. The statistical matrix multicracking model and fracture mechanics interface debonding criterion were used to determine the matrix crack spacing and interface debonded length. Under cyclic fatigue loading, the fiber broken fraction was determined by combining the interface wear model and fiber statistical failure model at room temperature, and interface/fiber oxidation model, interface wear model and fiber statistical failure model at elevated temperatures, based on the assumption that the fiber strength is subjected to two-parameter Weibull distribution and the load carried by broken and intact fibers satisfies the Global Load Sharing (GLS) criterion. When the broken fiber fraction approaches the critical value, the composites fatigue fracture. PMID:28773332

An investigation of the plastic fracture of AISI 4340 and 18 nickel - 200 grade maraging steels

NASA Technical Reports Server (NTRS)

Cox, T. B.; Low, J. R., Jr.

1974-01-01

The mechanisms of plastic fracture (dimpled rupture) in high-purity and commercial 18 Ni, 200 grade maraging steels and quenched and tempered AISI 4340 steels have been studied. Plastic fracture takes place in the maraging alloys through void initiation by fracture of titanium carbo-nitride inclusions and the growth of these voids until impingement results in coalescence and final fracture. The fracture of AISI 4340 steel at a yield strength of 200 ksi occurs by nucleation and subsequent growth of voids formed by fracture of the interface between manganese sulfide inclusions and the matrix. The growth of these inclusion-nucleated voids is interrupted long before coalescence by impingement, by the formation of void sheets which connect neighboring sulfide-nucleated voids.

Fracture mechanics analysis for various fiber/matrix interface loadings

NASA Technical Reports Server (NTRS)

Naik, R. A.; Crews, J. H., Jr.

1991-01-01

Fiber/matrix (F/M) cracking was analyzed to provide better understanding and guidance in developing F/M interface fracture toughness tests. Two configurations, corresponding to F/M cracking at a broken fiber and at the free edge, were investigated. The effects of mechanical loading, thermal cooldown, and friction were investigated. Each configuration was analyzed for two loadings: longitudinal and normal to the fiber. A nonlinear finite element analysis was performed to model friction and slip at the F/M interface. A new procedure for fitting a square-root singularity to calculated stresses was developed to determine stress intensity factors (K sub I and K sub II) for a bimaterial interface crack. For the case of F/M cracking at a broken fiber with longitudinal loading, crack tip conditions were strongly influenced by interface friction. As a result, an F/M interface toughness test based on this case was not recommended because nonlinear data analysis methods would be required. For the free edge crack configuration, both mechanical and thermal loading caused crack opening, thereby avoiding frictional effects. A F/M interface toughness test based on this configuration would provide data for K(sub I)/K(sub II) ratios of about 0.7 and 1.6 for fiber and radial normal loading, respectively. However, thermal effects must be accounted for in the data analysis.

Fracture mechanics analysis for various fiber/matrix interface loadings

NASA Technical Reports Server (NTRS)

Naik, Rajiv A.; Crews, John H., Jr.

1992-01-01

Fiber/matrix (F/M) cracking was analyzed to provide better understanding and guidance in developing F/M interface fracture toughness tests. Two configurations, corresponding to F/M cracking at a broken fiber and at the free edge, were investigated. The effects of mechanical loading, thermal cooldown, and friction were investigated. Each configuration was analyzed for two loadings: longitudinal and normal to the fiber. A nonlinear finite element analysis was performed to model friction and slip at the F/M interface. A new procedure for fitting a square-root singularity to calculated stresses was developed to determine stress intensity factors (K sub I and K sub II) for a bimaterial interface crack. For the case of F/M cracking at a broken fiber with longitudinal loading, crack tip conditions were strongly influenced by interface friction. As a result, an F/M interface toughness test based on this case was not recommended because nonlinear data analysis methods would be required. For the free edge crack configuration, both mechanical and thermal loading caused crack opening, theory avoiding fractional effects. A F/M interface toughness test based on this configuration would provide data for K(sub I/K(sub II) ratios of about 0.7 and 1.6 for fiber and radial normal loading, respectively. However, thermal effects must be accounted for in the data analysis.

Fracture mechanics analysis for various fiber/matrix interface loadings

NASA Technical Reports Server (NTRS)

Naik, R. A.; Crews, J. H., Jr.

1991-01-01

Fiber/matrix (F/M) cracking was analyzed to provide better understanding and guidance in developing F/M interface fracture toughness tests. Two configurations, corresponding to F/M cracking at a broken fiber and at the free edge, were investigated. The effects of mechanical loading, thermal cooldown, and friction were investigated. Each configuration was analyzed for two loadings: longitudinal and normal to the fiber. A nonlinear finite element analysis was performed to model friction and slip at the F/M interface. A new procedure for fitting a square-root singularity to calculated stresses was developed to determine stress intensity factors (K sub I and K sub II) for a bimaterial interface crack. For the case of F/M cracking at a broken fiber with longitudinal loading, crack tip conditions were strongly influenced by interface friction. As a result, an F/M interface toughness test based on this case was not recommended because nonlinear data analysis methods would be required. For the free edge crack configuration, both mechanical and thermal loading caused crack opening, thereby avoiding frictional effects. An F/M interface toughness test based on this configuration would provide data for K(sub I)/K(sub II) ratios of about 0.7 and 1.6 for fiber and radial normal loading, respectively. However, thermal effects must be accounted for in the data analysis.

Mechanical and fracture behavior of veneer-framework composites for all-ceramic dental bridges.

PubMed

Studart, André R; Filser, Frank; Kocher, Peter; Lüthy, Heinz; Gauckler, Ludwig J

2007-01-01

High-strength ceramics are required in dental posterior restorations in order to withstand the excessive tensile stresses that occur during mastication. The aim of this study was to investigate the fracture behavior and the fast-fracture mechanical strength of three veneer-framework composites (Empress 2/IPS Eris, TZP/Cercon S and Inceram-Zirconia/Vita VM7) for all-ceramic dental bridges. The load bearing capacity of the veneer-framework composites were evaluated using a bending mechanical apparatus. The stress distribution through the rectangular-shaped layered samples was assessed using simple beam calculations and used to estimate the fracture strength of the veneer layer. Optical microscopy of fractured specimens was employed to determine the origin of cracks and the fracture mode. Under fast fracture conditions, cracks were observed to initiate on, or close to, the veneer outer surface and propagate towards the inner framework material. Crack deflection occurred at the veneer-framework interface of composites containing a tough framework material (TZP/Cercon S and Inceram-Zirconia/Vita VM7), as opposed to the straight propagation observed in the case of weaker frameworks (Empress 2/IPS Eris). The mechanical strength of dental composites containing a weak framework (K(IC)<3 MPam(1/2)) is ultimately determined by the low fracture strength of the veneer layer, since no crack arresting occurs at the veneer-framework interface. Therefore, high-toughness ceramics (K(IC)>5 MPam(1/2)) should be used as framework materials of posterior all-ceramic bridges, so that cracks propagating from the veneer layer do not lead to a premature failure of the prosthesis.

[Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].

PubMed

Knobe, M; Böttcher, B; Coburn, M; Friess, T; Bollheimer, L C; Heppner, H J; Werner, C J; Bach, J-P; Wollgarten, M; Poßelt, S; Bliemel, C; Bücking, B

2018-04-19

Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). There was a clear tendency to a better overall result in patients receiving multidisciplinary orthogeriatric treatment using a ward visit model of orthogeriatric comanagement, with lower rates of cardiorespiratory complications and mortality. While special care pathways could reduce the rate of myocardial infarction in hip fracture patients, costs and revenues showed no difference between all care models evaluated. However, patients with hip fracture or periprosthetic fracture represent cohorts at clinical and economic risk as well.

Fracture and Fatigue Resistance of Cemented versus Fused CAD-on Veneers over Customized Zirconia Implant Abutments.

PubMed

Nossair, Shereen Ahmed; Aboushelib, Moustafa N; Morsi, Tarek Salah

2015-01-05

To evaluate the fracture mechanics of cemented versus fused CAD-on veneers on customized zirconia implant abutments. Forty-five identical customized CAD/CAM zirconia implant abutments (0.5 mm thick) were prepared and seated on short titanium implant abutments (Ti base). A second scan was made to fabricate 45 CAD-on veneers (IPS Empress CAD, A2). Fifteen CAD-on veneers were cemented on the zirconia abutments (Panavia F2.0). Another 15 were fused to the zirconia abutments using low-fusing glass, while manually layered veneers served as control (n = 15). The restorations were subjected to artificial aging (3.2 million cycles between 5 and 10 kg in a water bath at 37°C) before being axially loaded to failure. Fractured specimens were examined using scanning electron microscopy to detect fracture origin, location, and size of critical crack. Stress at failure was calculated using fractography principles (alpha = 0.05). Cemented CAD-on restorations demonstrated significantly higher (F = 72, p < 0.001) fracture load compared to fused CAD-on and manually layered restorations. Fractographic analysis of fractured specimens indicated that cemented CAD-on veneers failed due to radial cracks originating from the veneer/resin interface. Branching of the critical crack was observed in the bulk of the veneer. Fused CAD-on veneers demonstrated cohesive fracture originating at the thickest part of the veneer ceramic, while manually layered veneers failed due to interfacial fracture at the zirconia/veneer interface. Within the limitations of this study, cemented CAD-on veneers on customized zirconia implant abutments demonstrated higher fracture than fused and manually layered veneers. © 2014 by the American College of Prosthodontists.

Mode I Toughness Measurements of Core/Facesheet Bonds in Honeycomb Sandwich Structures

NASA Technical Reports Server (NTRS)

Nettles, Alan T.; Ratcliffe, James G.

2006-01-01

Composite sandwich structures will be used in many future applications in aerospace, marine and offshore industries due to the fact that the strength and stiffness to mass ratios surpass any other structural type. Sandwich structure also offers advantages over traditional stiffened panels such as ease of manufacturing and repair. During the last three decades, sandwich structure has been used extensively for secondary structure in aircraft (fuselage floors, rudders and radome structure). Sandwich structure is also used as primary structure in rotorcraft, the most common example being the trailing edge of rotor blades. As with other types of composite construction, sandwich structure exhibits several types of failure mode such as facesheet wrinkling, core crushing and sandwich buckling. Facesheet/core debonding has also been observed in the marine and aerospace industry. During this failure mode, peel stresses applied to an existing facesheet/core debond or an interface low in toughness, results in the facesheet being peeled from the core material, possibly leading to a significant loss in structural integrity of the sandwich panel. In an incident during a test on a liquid hydrogen fuel tank of the X-33 prototype vehicle, the outer graphite/epoxy facesheet and honeycomb core became debonded from the inner facesheet along significant areas, leading to failure of the tank. As a consequence of the accident; significant efforts were made to characterize the toughness of the facesheet/core bond. Currently, the only standardized method available for assessing the quality of the facesheet/core interface is the climbing drum peel test (ASTM D1781). During this test a sandwich beam is removed from a panel and the lip of one of the facesheets is attached to a drum, as shown in Fig. 1. The drum is then rotated along the sandwich beam, causing the facesheet to peel from the core. This method has two major drawbacks. First, it is not possible to obtain quantitative fracture data from the test and so the results can only be used in a qualitative manner. Second, only sandwich structure with thin facesheets can be tested (to facilitate wrapping of the facesheet around the climbing drum). In recognition of the need for a more quantitative facesheet/core fracture test, several workers have devised experimental techniques for characterizing the toughness of the facesheet/core interface. In all of these cases, the tests are designed to yield a mode I-dominated fracture toughness of the facesheet/core interface in a manner similar to that used to determine mode I fracture toughness of composite laminates. In the current work, a modified double cantilever beam is used to measure the mode I-dominated fracture toughness of the interface in a sandwich consisting of glass/phenolic honeycomb core reinforced with graphite epoxy facesheets. Two specimen configurations were tested as shown in Fig 2. The first configuration consisted of reinforcing the facesheets with aluminum blocks (Fig. 2a). In the second configuration unreinforced specimens were tested (Fig. 2b). Climbing drum peel tests were also conducted to compare the fracture behavior observed between this test and the modified double cantilever beam. This paper outlines the test procedures and data reduction strategies used to compute fracture toughness values from the tests. The effect of specimen reinforcement on fracture toughness of the facesheet/core interface is discussed.

Double-porosity models for a fissured groundwater reservoir with fracture skin

USGS Publications Warehouse

Moench, Allen F.

1984-01-01

Theories of flow to a well in a double-porosity groundwater reservoir are modified to incorporate effects of a thin layer of low-permeability material or fracture skin that may be present at fracture-block interfaces as a result of mineral deposition or alteration. The commonly used theory for flow in double- porosity formations that is based upon the assumption of pseudo–steady state block-to-fissure flow is shown to be a special case of the theory presented in this paper. The latter is based on the assumption of transient block-to-fissure flow with fracture skin. Under conditions where fracture skin has a hydraulic conductivity that is less than that of the matrix rock, it may be assumed to impede the interchange of fluid between the fissures and blocks. Resistance to flow at fracture-block interfaces tends to reduce spatial variation of hydraulic head gradients within the blocks. This provides theoretical justification for neglecting the divergence of flow in the blocks as required by the pseudo–steady state flow model. Coupled boundary value problems for flow to a well discharging at a constant rate were solved in the Laplace domain. Both slab-shaped and sphere-shaped blocks were considered, as were effects of well bore storage and well bore skin. Results obtained by numerical inversion were used to construct dimensionless-type curves that were applied to well test data, for a pumped well and for an observation well, from the fractured volcanic rock terrane of the Nevada Test Site.

The Role of Interface Shape on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model,.

PubMed

Vaughan, Patrick E; Vogelsberg, Caitlin C M; Vollner, Jennifer M; Fenton, Todd W; Haut, Roger C

2016-09-01

The forensic literature suggests that when adolescents fall onto edged and pointed surfaces, depressed fractures can occur at low energy levels. This study documents impact biomechanics and fracture characteristics of infant porcine skulls dropped onto flat, curved, edged, and focal surfaces. Results showed that the energy needed for fracture initiation was nearly four times higher against a flat surface than against the other surfaces. While characteristic measures of fracture such as number and length of fractures did not vary with impact surface shape, the fracture patterns did depend on impact surface shape. While experimental impacts against the flat surface produced linear fractures initiating at sutural boundaries peripheral to the point of impact (POI), more focal impacts produced depressed fractures initiating at the POI. The study supported case-based forensic literature suggesting cranial fracture patterns depend on impact surface shape and that fracture initiation energy is lower for more focal impacts. © 2016 American Academy of Forensic Sciences.

Interface enhancement of glass fiber reinforced vinyl ester composites with flame-synthesized carbon nanotubes and its enhancing mechanism.

PubMed

Liao, Lingmin; Wang, Xiao; Fang, Pengfei; Liew, Kim Meow; Pan, Chunxu

2011-02-01

Interface enhancement with carbon nanotubes (CNTs) provides a promising approach for improving shock strength and toughness of glass fiber reinforced plastic (GFRP) composites. The effects of incorporating flame-synthesized CNTs (F-CNTs) into GFRP were studied, including on hand lay-up preparation, microstructural characterization, mechanical properties, fracture morphologies, and theoretical calculation. The experimental results showed that: (1) the impact strength of the GFRP modified by F-CNTs increased by more than 15% over that of the GFRP modified by CNTs from chemical vapor deposition; and (2) with the F-CNT enhancement, no interfacial debonding was observed at the interface between the fiber and resin matrix on the GFRP fracture surface, which indicated strong adhesive strength between them. The theoretical calculation revealed that the intrinsic characteristics of the F-CNTs, including lower crystallinity with a large number of defects and chemical functional groups on the surface, promoted their surface activity and dispersibility at the interface, which improved the interfacial bond strength of GFRP.

Metallic and Ceramic Materials Research. Task Order 0005: Metallic, Materials, Methods, Characterization and Testing Research

DTIC Science & Technology

2015-10-01

articles and papers, and is referenced in the text. 15. SUBJECT TERMS high entropy alloys, titanium, inertia welding 16. SECURITY...A. Approved for public release; distribution unlimited. List of Figures Figure 1: (a) Fracture surface of a LSHR/Mar-M247 weld specimen fractured...in Mar-M247 region ~6 mm apart from the weld interface. (b-c) Higher magnification images illustrating (b) a blocky, faceted appearance of fracture

Effects of aperture variability and wettability on immiscible displacement in fractures

NASA Astrophysics Data System (ADS)

Yang, Zhibing; Méheust, Yves; Neuweiler, Insa

2017-04-01

Fluid-fluid displacement in porous and fractured media is an important process. Understanding and controlling this process is key to many practical applications, such as hydrocarbon recovery, geological storage of CO2, groundwater remediation, etc. Here, we numerically study fluid-fluid displacement in rough-walled fractures. We focus on the combined effect of wettability and fracture surface topography on displacement patterns and interface growth. We develop a novel numerical model to simulate dynamic fluid invasion under the influence of capillary and viscous forces. The capillary force is calculated using the two principal curvatures (aperture-induced curvature and in-plane curvature) at the fluid-fluid interface, and the viscous force is taken into account by solving the fluid pressure distribution. The aperture field of a fracture is represented by a spatially correlated random field, which is described by a power spectrum for the fracture wall topography and a cutoff wave-length. We numerically produce displacement patterns ranging from stable displacement, capillary fingering, and viscous fingering, as well as the transitions between them. We show that both reducing the aperture variability and increasing the contact angle (from drainage to weak imbibition) stabilize the displacement due to the influence of the in-plane curvature, an effect analogous to that of the cooperative pore filling in porous media. Implications of these results will be discussed.

Improvement of the mode II interface fracture toughness of glass fiber reinforced plastics/aluminum laminates through vapor grown carbon fiber interleaves.

PubMed

Ning, Huiming; Li, Yuan; Hu, Ning; Cao, Yanping; Yan, Cheng; Azuma, Takesi; Peng, Xianghe; Wu, Liangke; Li, Jinhua; Li, Leilei

2014-06-01

The effects of acid treatment, vapor grown carbon fiber (VGCF) interlayer and the angle, i.e., 0° and 90°, between the rolling stripes of an aluminum (Al) plate and the fiber direction of glass fiber reinforced plastics (GFRP) on the mode II interlaminar mechanical properties of GFRP/Al laminates were investigated. The experimental results of an end notched flexure test demonstrate that the acid treatment and the proper addition of VGCF can effectively improve the critical load and mode II fracture toughness of GFRP/Al laminates. The specimens with acid treatment and 10 g m -2 VGCF addition possess the highest mode II fracture toughness, i.e., 269% and 385% increases in the 0° and 90° specimens, respectively compared to those corresponding pristine ones. Due to the induced anisotropy by the rolling stripes on the aluminum plate, the 90° specimens possess 15.3%-73.6% higher mode II fracture toughness compared to the 0° specimens. The improvement mechanisms were explored by the observation of crack propagation path and fracture surface with optical, laser scanning and scanning electron microscopies. Moreover, finite element analyses were carried out based on the cohesive zone model to verify the experimental fracture toughness and to predict the interface shear strength between the aluminum plates and GFRP laminates.

Improvement of the mode II interface fracture toughness of glass fiber reinforced plastics/aluminum laminates through vapor grown carbon fiber interleaves

PubMed Central

Ning, Huiming; Li, Yuan; Hu, Ning; Cao, Yanping; Yan, Cheng; Azuma, Takesi; Peng, Xianghe; Wu, Liangke; Li, Jinhua; Li, Leilei

2014-01-01

The effects of acid treatment, vapor grown carbon fiber (VGCF) interlayer and the angle, i.e., 0° and 90°, between the rolling stripes of an aluminum (Al) plate and the fiber direction of glass fiber reinforced plastics (GFRP) on the mode II interlaminar mechanical properties of GFRP/Al laminates were investigated. The experimental results of an end notched flexure test demonstrate that the acid treatment and the proper addition of VGCF can effectively improve the critical load and mode II fracture toughness of GFRP/Al laminates. The specimens with acid treatment and 10 g m−2 VGCF addition possess the highest mode II fracture toughness, i.e., 269% and 385% increases in the 0° and 90° specimens, respectively compared to those corresponding pristine ones. Due to the induced anisotropy by the rolling stripes on the aluminum plate, the 90° specimens possess 15.3%–73.6% higher mode II fracture toughness compared to the 0° specimens. The improvement mechanisms were explored by the observation of crack propagation path and fracture surface with optical, laser scanning and scanning electron microscopies. Moreover, finite element analyses were carried out based on the cohesive zone model to verify the experimental fracture toughness and to predict the interface shear strength between the aluminum plates and GFRP laminates. PMID:27877680

Microstructure and Shear Strength in Brazing Joint of Mo-Cu Composite with 304 Stainless Steel by Ni-Cr-P Filler Metal

NASA Astrophysics Data System (ADS)

Wang, Juan; Wang, Jiteng; Li, Yajiang; Zheng, Deshuang

2015-07-01

The brazing of Mo-Cu composite and 304 stainless steel was carried out in vacuum with Ni-Cr-P filler metal at 980 °C for 20 min. Microstructure in Mo-Cu/304 stainless steel joint was investigated by field-emission scanning electron microscope (FE-SEM) with energy dispersive spectrometer (EDS) and shear strength was measured by shearing test. The results indicate that shear strength of the Mo-Cu/304 stainless steel joint is about 155 MPa. There forms eutectic structure of γ-Ni solid solution with Ni3P in the braze seam. Ni-Cu(Mo) and Ni-Fe solid solution are at the interface beside Mo-Cu composite and 304 stainless steel, respectively. Shear fracture exhibits mixed ductile-brittle fracture feature with trans-granular fracture, ductile dimples and tearing edges. Fracture originates from the interface between brazing seam and Mo-Cu composite and it propagates to the braze seam due to the formation of brittle Ni5P2 and Cr3P precipitation.

Vacuum brazing of high volume fraction SiC particles reinforced aluminum matrix composites

NASA Astrophysics Data System (ADS)

Cheng, Dongfeng; Niu, Jitai; Gao, Zeng; Wang, Peng

2015-03-01

This experiment chooses A356 aluminum matrix composites containing 55% SiC particle reinforcing phase as the parent metal and Al-Si-Cu-Zn-Ni alloy metal as the filler metal. The brazing process is carried out in vacuum brazing furnace at the temperature of 550°C and 560°C for 3 min, respectively. The interfacial microstructures and fracture surfaces are investigated by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and energy spectrum analysis (EDS). The result shows that adequacy of element diffusion are superior when brazing at 560°C, because of higher activity and liquidity. Dislocations and twins are observed at the interface between filler and composite due to the different expansion coefficient of the aluminum alloy matrix and SiC particles. The fracture analysis shows that the brittle fracture mainly located at interface of filler and composites.

Rapid Diagnosis of an Ulnar Fracture with Portable Hand-Held Ultrasound

NASA Technical Reports Server (NTRS)

Kirkpatrick, Andrew W.; Brown, Ross; Diebel, Lawrence N.; Nicolaou, Savvas; Marshburn, Tom; Dulchavsky, Scott A.

2002-01-01

Orthopedic fractures are a common injury in operational activities, injuries that often occur in isolated or hostile environments. Clinical ultrasound devices have become more user friendly and lighter allowing them to be easily transported with forward medical teams. The bone-soft tissue interface has a very large acoustic impedance, with a high reflectance that can be used to visualize breaks in contour including fractures. Herein reported is a case of an ulnar fracture that was quickly visualized in the early phase of a multi-system trauma resuscitation with a hand-held ultrasound device. The implications for operational medicine are discussed.

Development of a fixation device for robot assisted fracture reduction of femoral shaft fractures: a biomechanical study.

PubMed

Weber-Spickschen, T S; Oszwald, M; Westphal, R; Krettek, C; Wahl, F; Gosling, T

2010-01-01

Robot assisted fracture reduction of femoral shaft fractures provides precise alignment while reducing the amount of intraoperative imaging. The connection between the robot and the fracture fragment should allow conventional intramedullary nailing, be minimally invasive and provide interim fracture stability. In our study we tested three different reduction tools: a conventional External Fixator, a Reposition-Plate and a Three-Point-Device with two variations (a 40 degrees and a 90 degrees version). We measured relative movements between the tools and the bone fragments in all translation and rotation planes. The Three-Point-Device 90 degrees showed the smallest average relative displacement and was the only device able to withstand the maximum applied load of 70 Nm without failure of any bone fragment. The Three-Point-Device 90 degrees complies with all the stipulated requirements and is a suitable interface for robot assisted fracture reduction of femoral shaft fractures.

An Irreversible Constitutive Law for Modeling the Delamination Process using Interface Elements

NASA Technical Reports Server (NTRS)

Goyal, Vinay K.; Johnson, Eric R.; Davila, Carlos G.; Jaunky, Navin; Ambur, Damodar (Technical Monitor)

2002-01-01

An irreversible constitutive law is postulated for the formulation of interface elements to predict initiation and progression of delamination in composite structures. An exponential function is used for the constitutive law such that it satisfies a multi-axial stress criterion for the onset of delamination, and satisfies a mixed mode fracture criterion for the progression of delamination. A damage parameter is included to prevent the restoration of the previous cohesive state between the interfacial surfaces. To demonstrate the irreversibility capability of the constitutive law, steady-state crack growth is simulated for quasi-static loading-unloading cycle of various fracture test specimens.

An Irreversible Constitutive Law for Modeling the Delamination Process Using Interface Elements

NASA Technical Reports Server (NTRS)

Goyal, Vinay K.; Johnson, Eric R.; Davila, Carlos G.; Jaunky, Navin; Bushnell, Dennis M. (Technical Monitor)

2002-01-01

An irreversible constitutive law is postulated for the formulation of interface elements to predict initiation and progression of delamination in composite structures. An exponential function is used for the constitutive law such that it satisfies a multi-axial stress criterion for the onset of delamination, and satisfies a mixed mode fracture criterion for the progression of delamination. A damage parameter is included to prevent the restoration of the previous cohesive state between the interfacial surfaces. To demonstrate the irreversibility capability of the constitutive law, steady-state crack growth is simulated for quasi-static loading-unloading cycle of various fracture test specimens.

Marginal adaptation, fracture load and macroscopic failure mode of adhesively luted PMMA-based CAD/CAM inlays.

PubMed

Ender, Andreas; Bienz, Stefan; Mörmann, Werner; Mehl, Albert; Attin, Thomas; Stawarczyk, Bogna

2016-02-01

To evaluate marginal adaptation, fracture load and failure types of CAD/CAM polymeric inlays. Standardized prepared human molars (48) were divided into four groups (n=12): (A) PCG (positive control group); adhesively luted glass-ceramic inlays, (B) TRX; CAD/CAM polymeric inlays luted using a self-adhesive resin cement, (C) TAC; CAD/CAM polymeric inlays luted using a conventional resin cement, and (D) NCG (negative control group); direct-filled resin-based composite restorations. All specimens were subjected to a chewing simulator. Before and after chewing fatigue, marginal adaptation was assessed at two interfaces: (1) between dental hard tissues and luting cement and (2) between luting cement and restoration. Thereafter, the specimens were loaded and the fracture loads, as well as the failure types, were determined. The data were analysed using three- and one-way ANOVA with post hoc Scheffé test, two sample Student's t-test (p<0.05). Before and after chewing fatigue, marginal adaptation for interface 1 showed significantly better results for TRX and PCG than for TAC (p=0.001-0.02) and NCG (p=0.001-0.047). For interface 2, marginal adaptation for TAC was significantly inferior to TRX (p<0.001) and PCG (p<0.001). Chewing fatigue had a negative impact on the marginal adaptation of TAC and NCG. No significant differences in fracture load were found between all tested groups. Self-adhesive luted polymeric CAD/CAM inlays showed similar marginal adaptation and fracture load values compared to adhesively luted glass-ceramic inlays. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Acellular dermal matrices in breast implant surgery: defining the problem and proof of concept.

PubMed

Baxter, Richard A

2012-04-01

The use of acellular dermal matrices (ADMs) has become a useful adjunct to implant-based breast reconstruction and revision of the augmented breast. In both instances, the goal is replacement or reinforcement of thinned or missing tissues for implant support and control of the implant pocket. This article reviews the factors that contribute to periprosthetic tissue thinning, and the advantages and limitations of the use of ADMs for revision breast surgery and breast reconstruction. Proof of concept for the use of ADMs in the periprosthetic space is detailed from early clinical experience and histologic analysis documenting vascular ingrowth and cellular repopulation. Copyright © 2012 Elsevier Inc. All rights reserved.

Podoplanin immunopositive lymphatic vessels at the implant interface in a rat model of osteoporotic fractures.

PubMed

Lips, Katrin Susanne; Kauschke, Vivien; Hartmann, Sonja; Thormann, Ulrich; Ray, Seemun; Kampschulte, Marian; Langheinrich, Alexander; Schumacher, Matthias; Gelinsky, Michael; Heinemann, Sascha; Hanke, Thomas; Kautz, Armin R; Schnabelrauch, Matthias; Schnettler, Reinhard; Heiss, Christian; Alt, Volker; Kilian, Olaf

2013-01-01

Insertion of bone substitution materials accelerates healing of osteoporotic fractures. Biodegradable materials are preferred for application in osteoporotic patients to avoid a second surgery for implant replacement. Degraded implant fragments are often absorbed by macrophages that are removed from the fracture side via passage through veins or lymphatic vessels. We investigated if lymphatic vessels occur in osteoporotic bone defects and whether they are regulated by the use of different materials. To address this issue osteoporosis was induced in rats using the classical method of bilateral ovariectomy and additional calcium and vitamin deficient diet. In addition, wedge-shaped defects of 3, 4, or 5 mm were generated in the distal metaphyseal area of femur via osteotomy. The 4 mm defects were subsequently used for implantation studies where bone substitution materials of calcium phosphate cement, composites of collagen and silica, and iron foams with interconnecting pores were inserted. Different materials were partly additionally functionalized by strontium or bisphosphonate whose positive effects in osteoporosis treatment are well known. The lymphatic vessels were identified by immunohistochemistry using an antibody against podoplanin. Podoplanin immunopositive lymphatic vessels were detected in the granulation tissue filling the fracture gap, surrounding the implant and growing into the iron foam through its interconnected pores. Significant more lymphatic capillaries were counted at the implant interface of composite, strontium and bisphosphonate functionalized iron foam. A significant increase was also observed in the number of lymphatics situated in the pores of strontium coated iron foam. In conclusion, our results indicate the occurrence of lymphatic vessels in osteoporotic bone. Our results show that lymphatic vessels are localized at the implant interface and in the fracture gap where they might be involved in the removal of lymphocytes, macrophages, debris and the implants degradation products. Therefore the lymphatic vessels are involved in implant integration and fracture healing.

Podoplanin Immunopositive Lymphatic Vessels at the Implant Interface in a Rat Model of Osteoporotic Fractures

PubMed Central

Lips, Katrin Susanne; Kauschke, Vivien; Hartmann, Sonja; Thormann, Ulrich; Ray, Seemun; Kampschulte, Marian; Langheinrich, Alexander; Schumacher, Matthias; Gelinsky, Michael; Heinemann, Sascha; Hanke, Thomas; Kautz, Armin R.; Schnabelrauch, Matthias; Schnettler, Reinhard; Heiss, Christian; Alt, Volker; Kilian, Olaf

2013-01-01

Insertion of bone substitution materials accelerates healing of osteoporotic fractures. Biodegradable materials are preferred for application in osteoporotic patients to avoid a second surgery for implant replacement. Degraded implant fragments are often absorbed by macrophages that are removed from the fracture side via passage through veins or lymphatic vessels. We investigated if lymphatic vessels occur in osteoporotic bone defects and whether they are regulated by the use of different materials. To address this issue osteoporosis was induced in rats using the classical method of bilateral ovariectomy and additional calcium and vitamin deficient diet. In addition, wedge-shaped defects of 3, 4, or 5 mm were generated in the distal metaphyseal area of femur via osteotomy. The 4 mm defects were subsequently used for implantation studies where bone substitution materials of calcium phosphate cement, composites of collagen and silica, and iron foams with interconnecting pores were inserted. Different materials were partly additionally functionalized by strontium or bisphosphonate whose positive effects in osteoporosis treatment are well known. The lymphatic vessels were identified by immunohistochemistry using an antibody against podoplanin. Podoplanin immunopositive lymphatic vessels were detected in the granulation tissue filling the fracture gap, surrounding the implant and growing into the iron foam through its interconnected pores. Significant more lymphatic capillaries were counted at the implant interface of composite, strontium and bisphosphonate functionalized iron foam. A significant increase was also observed in the number of lymphatics situated in the pores of strontium coated iron foam. In conclusion, our results indicate the occurrence of lymphatic vessels in osteoporotic bone. Our results show that lymphatic vessels are localized at the implant interface and in the fracture gap where they might be involved in the removal of lymphocytes, macrophages, debris and the implants degradation products. Therefore the lymphatic vessels are involved in implant integration and fracture healing. PMID:24130867

Removal of well-fixed components in femoral revision arthroplasty with controlled segmentation of the proximal femur.

PubMed

Megas, Panagiotis; Georgiou, Christos S; Panagopoulos, Andreas; Kouzelis, Antonis

2014-12-31

The transfemoral and the extended trochanteric osteotomies are the most common osteotomies used in femoral revision, both when proximal or diaphyseal fixation of the new component has been decided. We present an alternative approach to the trochanteric osteotomies, most frequently used with distally fixated stems, to overcome their shortcomings of osteotomy migration and nonunion, but, most of all, the uncontrollable fragmentation of the femur. The procedure includes a complete circular femoral osteotomy just below the stem tip to prevent distal fracture propagation and a subsequent preplanned segmentation of the proximal femur for better exposure and fast removal of the old prosthesis. The bone fragments are reattached with cerclage wires to the revision prosthesis, which is safely anchored distally. A modified posterolateral approach is used, as the preservation of the continuity of the abductors, the greater trochanter, and the vastus lateralis is a prerequisite. Between 2006 and 2012, 47 stems (33 women, 14 men, mean age 68 years, range 39-88 years) were revised using this technique. They were 12 (26%) stable and 35 (74%) loose prostheses and were all revised to tapered, fluted, grit-blasted stems. No fracture of the trochanters or the distal femur occurred intraoperatively. Mean follow-up was 28 months (range 6-70 months). No case of trochanteric migration or nonunion of the osteotomies was recorded. Restoration of the preexisting bone defects occurred in 83% of the patients. Three patients required repeat revision due to dislocation and one due to a postoperative periprosthetic fracture. None of the failures was attributed to the procedure itself. This new osteotomy technique may seem aggressive at first, but, at least in our hands, has effectively increased the speed of the femoral revision, particularly for the most difficult well-fixed components, but not at the expense of safety.

Particle Swarm Transport across the Fracture-Matrix Interface

NASA Astrophysics Data System (ADS)

Malenda, M. G.; Pyrak-Nolte, L. J.

2016-12-01

A fundamental understanding of particle transport is required for many diverse applications such as effective proppant injection, for deployment of subsurface imaging micro-particles, and for removal of particulate contaminants from subsurface water systems. One method of particulate transport is the use of particle swarms that act as coherent entities. Previous work found that particle swarms travel farther and faster in single fractures than individual particles when compared to dispersions and emulsions. In this study, gravity-driven experiments were performed to characterize swarm transport across the fracture-matrix interface. Synthetic porous media with a horizontal fracture were created from layers of square-packed 3D printed (PMMA) spherical grains (12 mm diameter). The minimum fracture aperture ranged from 0 - 10 mm. Swarms (5 and 25 µL) were composed of 3.2 micron diameter fluorescent polystryene beads (1-2% by mass). Swarms were released into a fractured porous medium that was submerged in water and was illuminated with a green (528 nm) LED array. Descending swarms were imaged with a CCD camera (2 fps). Whether an intact swarm was transported across a fracture depended on the volume of the swarm, the aperture of the fracture, and the alignment of pores on the two fracture walls. Large aperture fractures caused significant deceleration of a swarm because the swarm was free to expand laterally in the fracture. Swarms tended to remain intact when the pores on the two fracture walls were vertically aligned and traveled in the lower porous medium with speeds that were 30%-50% of their original speed in the upper matrix. When the pores on opposing walls were no longer aligned, swarms were observed to bifurcate around the grain into two smaller slower-moving swarms. Understanding the physics of particle swarms in fractured porous media has important implications for enhancing target particulate injection into the subsurface as well as for contaminant particulate transport. Acknowledgment: This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Basic Energy Sciences, Geosciences Research Program under Award Number (DE-FG02-09ER16022) and by National Science Foundation REU program under Award Number (PHY-1460899) at Purdue University.

Bone remodelling around HA-coated acetabular cups

PubMed Central

Nielsen, P. T.; Søballe, K.

2006-01-01

This study was designed to investigate bone remodelling around the cup in cementless THA. Previous studies indicate an advantage of better sealing of the bone-prosthesis interface by HA/TCP coating of implants, inhibiting polyethylene-induced osteolysis. One hundred patients gave informed consent to participate in a controlled randomized study between porous coated Trilogy versus Trilogy Calcicoat (HA/TCP coated). The cup was inserted in press-fit fixation. The femoral component was a cementless porous coated titanium alloy stem (Bi-Metric), with a modular 28-mm CrCo head. The Harris Hip Score (HHS) and bone mineral density (BMD) determined by DEXA scanning were used to study the effect. Measurements revealed no difference between the two groups after 3 years either in the clinical outcome or in terms of periprosthetic bone density. Patients with a body mass index above normal regained more bone mineral than patients with normal weight. This finding supports the assumption that load is beneficial to bone remodelling. PMID:16761153

Fatigue Properties of Butt Welded Aluminum Alloy and Carbon Steel Joints by Friction Stirring

NASA Astrophysics Data System (ADS)

Okane, M.; Shitaka, T.; Ishida, M.; Chaki, T.; Yasui, T.; Fukumoto, M.

2017-05-01

The butt dissimilar joints of Al-Mg-Si alloy JIS A6063 and carbon steel JIS S45C by means of friction stir welding were prepared for investigating fatigue properties of the joints. The joining tool used has cemented carbide thread probe and a shoulder made of alloy tool steel. All the fatigue tests were carried out under a load-controlled condition with a load ratio R=0.1 in air at room temperature. From the experimental results, it was found that hardness near the interface in A6063 was lower than that of base material. Three types of fatigue fracture occurred even in case of same welding condition. The first one was fracture at boundary between the lower hardness region and base material in A6063, the second type was initiated in the stir zone by FSW process and the last one was fracture at interface. Fatigue strength in case of the second one was lower than others. Furthermore, to investigate the effect of heat treatment on fatigue properties of the dissimilar joints, fatigue tests were also carried out with using the specimens which were heat treated under the same condition to aging process in T6 treatment. Fatigue fracture was initiated at interface between A6063 and S45C in case of the heat treated specimen, but fatigue strength was improved approximately 25% as compared with that of the non-heat treated specimen.

Multi-scale fracture networks within layered shallow water tight carbonates

NASA Astrophysics Data System (ADS)

Panza, Elisa; Agosta, Fabrizio; Rustichelli, Andrea; Vinciguerra, Sergio; Zambrano, Miller; Prosser, Giacomo; Tondi, Emanuele

2015-04-01

The work is aimed at deciphering the contribution of background deformation and persistent fracture zones on the fluid flow properties of tight platform carbonates. Taking advantage of 3D exposures present in the Murge area of southern Italy, the fracture networks crosscutting at different scales the layered Cretaceous limestone of the Altamura Fm. were analyzed. The rock multi-layer is characterized by 10's of cm-thick, sub-horizontal, laterally continuous carbonate beds. Each bed commonly represents a shallowing-upward peritidal cycle made up of homogeneous micritic limestones grading upward to cm-thick stromatolitic limestones and/or fenestral limestones. The bed interfaces are formed by sharp maximum flooding surfaces. Porosity measurements carried out on 40 limestone samples collected from a single carbonate bed show values ranging between 0,5% and 5,5%. Background deformation includes both stratabound and non-stratabound fractures. The former elements consist of bed-perpendicular joints and sheared joints, which are confined within a single bed and often displace small, bed-parallel stylolites. Non-stratabound fractures consist of incipient, cm offset, sub-vertical strike-slip faults, which crosscut the bed interfaces. The aforementioned elements are often confined within individual bed-packages, which are identified by presence of pronounced surfaces locally marked by veneers of reddish clayey paleosoils. Persistent fracture zones consist of 10's of m-high, 10's of cm-offset strike-slip faults that offset the bed-package interfaces and are confined within individual bed-packages association. Laterally discontinuous, cm- to a few m-thick paleokarstic breccia levels separate the different bed-packages associations. Persistent fracture zones include asymmetric fractured damage zones and mm-thick veneers of discontinuous fault rocks. The fracture networks that pervasively crosscut the study limestone multi-layer are investigated by mean of scanline and scanarea methodologies. The dimensional, spatial and scaling properties of both stratabound and non-stratabound fractures are documented along single beds and bed-packages, respectively. Persistent fracture zones are studied from individual bed-package associations. By computing the intensity, height distribution, aspect ratio, aperture of each fracture/fault set, DFN (Discrete Fracture Network) models are built for the aforementioned different scales of observation. DFN models of single beds and bed-packages include stratabound and non-stratabound fractures. Differently, the DFN model of a bed-packages association also includes persistent fracture zones and related damage zones. To check the results of our computations, we also build up a smaller scale, 1m3 geocellular volume in which fractures are inserted one at time in the model. All DFN models do not include the matrix porosity. Porosity and 3D permeability (Kx, Ky, Kz) values are obtained as outputs of the DFN models. The results are consistent with the most prominet set of non-stratabound fractures being the major control on the petrophysical properties of both single beds and bed-packages. As expected, the persistent fractures zones strongly affect both porosity and permeability of the bed-packages association. The results of ongoing laboratory analyses on representative limestone samples not only will provide a quantitative assessment of the physical properties of the matrix in terms of porosity and permeability, but also will shed new light on the geometry, density and anisotropy of microfractures and their role on fluid flow properties.

Use of a shorter humeral stem in revision reverse shoulder arthroplasty.

PubMed

Wagner, Eric R; Statz, Joseph M; Houdek, Matthew T; Cofield, Robert H; Sánchez-Sotelo, Joaquín; Sperling, John W

2017-08-01

The purpose of this study was to examine the outcomes of revision reverse arthroplasty using short bone-preserving humeral components in revising a long-stemmed component. During a 7-year period, 39 patients who underwent revision reverse shoulder arthroplasty using the long to short humeral component technique were included. The mean age was 72 years. Prior implants used in the primary setting included anatomic (n = 26), hemiarthroplasty (n = 11), and reverse (n = 2). At a follow-up of 3 years (2-5), 5 shoulders (13%) required revision surgery, including 1 for a periprosthetic humerus fracture and 4 for glenoid component loosening. The survival free of revision for any reason and revision for humeral disease was 84% and 94%, respectively. One patient experienced a nondisplaced greater tuberosity fracture at 18 months postoperatively that healed without operative intervention. There were no dislocations or infections. Overall, patients experienced excellent overall improvements in their pain levels and shoulder motion (P < .001), with a postoperative 91% satisfaction rate as well as postoperative American Shoulder and Elbow Surgeons score of 68 and Simple Shoulder Test score of 6.7. At most recent radiographic follow-up, 1 (5%) patient had grade 3 humeral lucency. Preserving bone stock through conversion to a shorter reverse humeral stem in the revision setting is a reasonable option with good short- to intermediate-term results and low rates of humeral complications. Using the shorter stem components provides adequate stability and high rates of humeral component ingrowth. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Inhibition of particulate debris-induced osteolysis by alendronate in a rat model.

PubMed

Thadani, Peter J; Waxman, Bryan; Sladek, Eduard; Barmada, Riad; Gonzalez, Mark H

2002-01-01

A rat model was used to study the efficacy of alendronate therapy in inhibition of particle-induced periprosthetic osteolysis. A prosthesis was simulated by inserting a cylindrical polymethylmethacrylate plug into the distal femur of 24 rats allowing the plug to communicate with the joint space. Intra-articular injections of irregularly-shaped ultra-high molecular weight polyethylene particles of 20-200 pm in diameter were administered at 2-week intervals. The rats were randomized into two groups (n=12 each). Group A rats received twice weekly subcutaneous injections of alendronate sodium while group B rats received injections of saline vehicle only. At 10 weeks all rats were sacrificed. The distal femurs were harvested and axial sections were prepared for histologic analysis. Each section was graded on a scale of 1-4, quantifying the degree of osteolysis surrounding the polymethylmethacrylate plug. Microscopic examination showed a significant (P<.0001) difference in the amount of periprosthetic bone. Femurs from group A treated with alendronate demonstrated mostly normal or near-normal periprosthetic trabeculations, whereas femurs from group B treated with saline showed extensive bone resorption. There was no qualitative difference in the inflammatory cellular response between the groups. This study established the ability of alendronate to inhibit the osteoclastic-mediated osteolysis around joint implants.

Use of an absorbable membrane to position biologically inductive materials in the periprosthetic space of cemented joints.

PubMed

DiResta, Gene R; Brown, Holly; Aiken, Sean; Doty, Steven; Schneider, Robert; Wright, Timothy; Healey, John H

2006-01-01

A device is presented that positions ultrahigh molecular weight polyethylene (UHMWPE) debris against periprosthetic bone surfaces. This can facilitate the study of aseptic loosening associated with cemented joint prostheses by speeding the appearance of this debris within the periprosthetic space. The device, composed of a 100 microm thick bioabsorbable membrane impregnated with 1.4 x 10(9) sub-micron particles of UHMWPE debris, is positioned on the endosteum of the bone prior to the insertion of the cemented orthopedic implant. An in vitro pullout study and an in vivo canine pilot study were performed to investigate its potential to accelerate "time to aseptic loosening" of cemented prosthetic joints. Pullout studies characterized the influence of the membrane on initial implant fixation. The tensile stresses (mean+/-std.dev.) required to withdraw a prosthesis cemented into canine femurs with and without the membrane were 1.15+/-0.3 and 1.54+/-0.01 MPa, respectively; these findings were not significantly different (p > 0.4). The in vivo pilot study, involving five dogs, was performed to evaluate the efficacy of the debris to accelerate loosening in a canine cemented hip arthroplasty. Aseptic loosening and lameness occurred within 12 months, quicker than the 30 months reported in a retrospective clinical review of canine hip arthroplasty.

Periprosthetic Joint Infection of Shoulder Arthroplasties: Diagnostic and Treatment Options

PubMed Central

Sevelda, Florian

2017-01-01

Periprosthetic joint infection (PJI) is one of the most frequent reasons for painful shoulder arthroplasties and revision surgery of shoulder arthroplasties. Cutibacterium acnes (Propionibacterium acnes) is one of the microorganisms that most often causes the infection. However, this slow growing microorganism is difficult to detect. This paper presents an overview of different diagnostic test to detect a periprosthetic shoulder infection. This includes nonspecific diagnostic tests and specific tests (with identifying the responsible microorganism). The aspiration can combine different specific and nonspecific tests. In dry aspiration and suspected joint infection, we recommend a biopsy. Several therapeutic options exist for the treatment of PJI of shoulder arthroplasties. In acute infections, the options include leaving the implant in place with open debridement, septic irrigation with antibacterial fluids like octenidine or polyhexanide solution, and exchange of all removable components. In late infections (more than four weeks after implantation) the therapeutic options are a permanent spacer, single-stage revision, and two-stage revision with a temporary spacer. The functional results are best after single-stage revisions with a success rate similar to two-stage revisions. For single-stage revisions, the microorganism should be known preoperatively so that specific antibiotics can be mixed into the cement for implantation of the new prosthesis and specific systemic antibiotic therapy can be applied to support the surgery. PMID:29423407

On the interfacial fracture resistance of resin-bonded zirconia and glass-infiltrated graded zirconia

PubMed Central

Chai, Herzl; Kaizer, Marina; Chughtai, Asima; Tong, Hui; Tanaka, Carina; Zhang, Yu

2015-01-01

Objective A major limiting factor for the widespread use of zirconia in prosthetic dentistry is its poor resin-cement bonding capabilities. We show that this deficiency can be overcome by infiltrating the zirconia cementation surface with glass. Current methods for assessing the fracture resistance of resin-ceramic bonds are marred by uneven stress distribution at the interface, which may result in erroneous interfacial fracture resistance values. We have applied a wedge-loaded double-cantilever-beam testing approach to accurately measure the interfacial fracture resistance of adhesively bonded zirconia-based restorative materials. Methods The interfacial fracture energy GC was determined for adhesively bonded zirconia, graded zirconia and feldspathic ceramic bars. The bonding surfaces were subjected to sandblasting or acid etching treatments. Baseline GC was measured for bonded specimens subjected to 7 days hydration at 37 °C. Long-term GC was determined for specimens exposed to 20,000 thermal cycles between 5 and 55 °C followed by 2-month aging at 37 °C in water. The test data were interpreted with the aid of a 2D finite element fracture analysis. Results The baseline and long-term GC for graded zirconia was 2–3 and 8 times that for zirconia, respectively. More significantly, both the baseline and long-term GC of graded zirconia were similar to those for feldspathic ceramic. Significance The interfacial fracture energy of feldspathic ceramic and graded zirconia was controlled by the fracture energy of the resin cement while that of zirconia by the interface. GC for the graded zirconia was as large as for feldspathic ceramic, making it an attractive material for use in dentistry. PMID:26365987

Potential seal bypass and caprock storage produced by deformation-band-to-opening-mode-fracture transition at the reservoir/caprock interface

DOE PAGES

Raduha, S.; Butler, D.; Mozley, P. S.; ...

2016-06-18

Here, we examined the potential impact on CO 2 transport of zones of deformation bands in reservoir rock that transition to opening-mode fractures within overlying caprock. Sedimentological and petrophysical measurements were collected along an approximately 5 m × 5 m outcrop of the Slick Rock and Earthy Members of the Entrada Sandstone on the eastern flank of the San Rafael Swell, Utah, USA. Measured deformation band permeability (2 mD) within the reservoir facies is about three orders of magnitude lower than the host sandstone. Average permeability of the caprock facies (0.0005 mD) is about seven orders of magnitude lower thanmore » the host sandstone. Aperture-based permeability estimates of the opening-mode caprock fractures are high (3.3 × 10 7 mD). High-resolution CO 2–H 2O transport models incorporate these permeability data at the millimeter scale. We then varied fault properties at the reservoir/caprock interface between open fractures and deformation bands as part of a sensitivity study. Numerical modeling results suggest that zones of deformation bands within the reservoir strongly compartmentalize reservoir pressures largely blocking lateral, cross-fault flow of supercritical CO 2. Significant vertical CO 2 transport into the caprock occurred in some scenarios along opening-mode fractures. The magnitude of this vertical CO 2 transport depends on the small-scale geometry of the contact between the opening-mode fracture and the zone of deformation bands, as well as the degree to which fractures penetrate caprock. Finally, the presence of relatively permeable units within the caprock allows storage of significant volumes of CO 2, particularly when the fracture network does not extend all the way through the caprock.« less

Engineering Interfaces in Metal Matrix Composites (Volume 3)

DTIC Science & Technology

1988-06-10

Howard S. Landis and James A. Cornie Interfaces with Controlled Toughness as Mechanical Fuses to Isolate Fibers from Damage -Vijay Gupta, All S. Argon and...protect the re- inforcing fiber from damage resulting from fracture of surrounding fibers or from misfitting reaction products between the matrix and...properties to govern the decoupling of the fiber from its damaging surroundings, while maintaining full wetting contact along the interface between

[Are There any Differences in Quality or Complication Rate in Total Knee Arthroplasty after Establishing a Centre for Endoprosthesis?

PubMed

Düzgünoglu, Muzaffer; Hönle, Wolfgang; Scheller, Alexander; Schuh, Alexander

2018-05-18

The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ). We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital. The following parameters were documented which are necessary to establish an EPZ: existence of X-rays before and after operation. Existence of full length weight bearing X-ray before operation or using a navigation device. Existence of preoperative planning, duration of TKA below 100 minutes. The following complications were documented: Periprosthetic infections, occurrence of periprosthetic fissures/fractures, thrombembolism, neurologic complications, patients' satisfaction rate with the hospital stay and mortality rate. Additionally femorotibial angle, femoral angle, tibial angle and tibial slope were measured. Statistical analysis was performed with SPSS 22.0. using the Kolmogorov-Smirnov test, the Qui-Square test and the Mann-Whitney U test. There were no statistical differences in local or systemic complications. The mean duration of operation was 82.9 min in group I (min.: 55, max.: 141) und 81.5 min in group II (min.: 57, max.: 129; p > 0.05). In group I, there were 20/100 cases (20%) with operation time longer than 100 minutes, in group II 13/100 cases (13%; p < 0.001). Analysis of anatomical femorotibial angle, femur angle, tibial angle and tibial slope showed no significant differences. The rate of documented survey of patients' satisfaction rate improved from 62% in group I to 98% in group II (p < 0.001). By establishing an EPZ, we achieved a significant improvement in the parameters operation time > 100 minutes and documented survey of patients' satisfaction rate, but not in complication rate. Georg Thieme Verlag KG Stuttgart · New York.

Interleukin-6 in serum and in synovial fluid enhances the differentiation between periprosthetic joint infection and aseptic loosening.

PubMed

Randau, Thomas M; Friedrich, Max J; Wimmer, Matthias D; Reichert, Ben; Kuberra, Dominik; Stoffel-Wagner, Birgit; Limmer, Andreas; Wirtz, Dieter C; Gravius, Sascha

2014-01-01

The preoperative differentiation between septic and aseptic loosening after total hip or knee arthroplasty is essential for successful therapy and relies in part on biomarkers. The objective of this study was to assess synovial and serum levels of inflammatory proteins as diagnostic tool for periprosthetic joint infection and compare their accuracy with standard tests. 120 patients presenting with a painful knee or hip endoprosthesis for surgical revision were included in this prospective trial. Blood samples and samples of intraoperatively acquired joint fluid aspirate were collected. White blood cell count, C-reactive protein, procalcitonin and interleukin-6 were determined. The joint aspirate was analyzed for total leukocyte count and IL-6. The definite diagnosis of PJI was determined on the basis of purulent synovial fluid, histopathology and microbiology. IL-6 in serum showed significantly higher values in the PJI group as compared to aseptic loosening and control, with specificity at 58.3% and a sensitivity of 79.5% at a cut-off value of 2.6 pg/ml. With a cut-off >6.6 pg/ml, the specificity increased to 88.3%. IL-6 in joint aspirate had, at a cut-off of >2100 pg/ml, a specificity of 85.7% and sensitivity of 59.4%. At levels >9000 pg/ml, specificity was almost at 100% with sensitivity just below 50%, so PJI could be considered proven with IL-6 levels above this threshold. Our data supports the published results on IL-6 as a biomarker in PJI. In our large prospective cohort of revision arthroplasty patients, the use of IL-6 in synovial fluid appears to be a more accurate marker than either the white blood cell count or the C-reactive protein level in serum for the detection of periprosthetic joint infection. On the basis of the results we recommend the use of the synovial fluid biomarker IL-6 for the diagnosis of periprosthetic joint infection following total hip and knee arthroplasty.

CD15 focus score: Infection diagnosis and stratification into low-virulence and high-virulence microbial pathogens in periprosthetic joint infection.

PubMed

Krenn, V T; Liebisch, M; Kölbel, B; Renz, N; Gehrke, T; Huber, M; Krukemeyer, M G; Trampuz, A; Resch, H; Krenn, V

2017-05-01

The aim of the work was to validate the CD15 focus score for the infection pathology of periprosthetic joint infection in a large group and to clarify whether a stratification into low-virulence and high-virulence microbial pathogens is possible by means of the CD15 focus score (quantification of CD15 positive granulocytes). The histopathology of 275 synovial tissue samples taken intraoperatively during revision operations (n=127 hip, n=141 knee, n=2 shoulder, n=5 ankle) was evaluated according to the SLIM consensus classification (SLIM=synovial-like interface membrane). Neutrophilic granulocytes (NG) were quantified by the CD15 focus score on the basis of the principle of focal maximum infiltration (focus) with evaluation of one field of vision (about 0.3mm 2 ). The quantification values were compared with the microbiological diagnoses taking into consideration the virulence groups of low-virulence and high-virulence microbial pathogens and mixed infection. The patients with positive microbiological findings (n=160) had significantly (p<0.001, Mann-Whitney U test) higher CD15 focus score values than patients with negative microbiological findings (n=115), the cut-off value being 39 cells per high power field (HPF). The CD15 focus score values of low-virulence microbial pathogens (n=94) were significantly lower (p<0.001, Mann-Whitney U test) than the values of high-virulence microbial pathogens (n=55), the cut-off value being 106 cells per HPF. Based on the microbiological diagnosis the sensitivity with respect to a microbial infection is 0.91, the specificity 0.92 (PPV=0.94; NPV=0.88; accuracy: 0.92; AUC=0.95). Based on the differentiation of the CD15 focus score values between low-virulence and high-virulence microbes the sensitivity is 0.70 and the specificity 0.77 (PPV=0.63; NPV=0.81; accuracy=0.74; AUC=0.74). As a result of the high sensitivity and specificity, the easy to use CD15 focus score is a diagnostically valid score for microbial periprosthetic infection. A differentiation between low-virulence and high-virulence microorganism of sufficiently high diagnostic quality is additionally possible as a result of the defined quantification of CD15 positive granulocytes (the CD15 focus score) histopathological diagnosis of microbial infections is possible, which on the one hand supports the microbiological diagnosis and on the other hand by the stratification into low-virulence and high-virulence microbial pathogens could represent an additional basis for a pathogen-specific antibiotic treatment in the event of unclear constellations of findings. Copyright © 2017 Elsevier GmbH. All rights reserved.

Identification of delamination failure of boride layer on common Cr-based steels

NASA Astrophysics Data System (ADS)

Taktak, Sukru; Tasgetiren, Suleyman

2006-10-01

Adhesion is an important aspect in the reliability of coated components. With low-adhesion of interfaces, different crack paths may develop depending on the local stress field at the interface and the fracture toughness of the coating, substrate, and interface. In the current study, an attempt has been made to identify the delamination failure of coated Cr-based steels by boronizing. For this reason, two commonly used steels (AISI H13, AISI 304) are considered. The steels contain 5.3 and 18.3 wt.% Cr, respectively. Boriding treatment is carried out in a slurry salt bath consisting of borax, boric acid, and ferrosilicon at a temperature range of 800 950 °C for 3, 5, and 7 h. The general properties of the boron coating are obtained by mechanical and metallographic characterization tests. For identification of coating layer failure, some fracture toughness tests and the Daimler-Benz Rockwell-C adhesion test are used.

Tensile overpressure compartments on low-angle thrust faults

NASA Astrophysics Data System (ADS)

Sibson, Richard H.

2017-08-01

Hydrothermal extension veins form by hydraulic fracturing under triaxial stress (principal compressive stresses, σ 1 > σ 2 > σ 3) when the pore-fluid pressure, P f, exceeds the least compressive stress by the rock's tensile strength. Such veins form perpendicular to σ 3, their incremental precipitation from hydrothermal fluid often reflected in `crack-seal' textures, demonstrating that the tensile overpressure state, σ 3' = ( σ 3 - P f) < 0, was repeatedly met. Systematic arrays of extension veins develop locally in both sub-metamorphic and metamorphic assemblages defining tensile overpressure compartments where at some time P f > σ 3. In compressional regimes ( σ v = σ 3), subhorizontal extension veins may develop over vertical intervals <1 km or so below low-permeability sealing horizons with tensile strengths 10 < T o < 20 MPa. This is borne out by natural vein arrays. For a low-angle thrust, the vertical interval where the tensile overpressure state obtains may continue down-dip over distances of several kilometres in some instances. The overpressure condition for hydraulic fracturing is comparable to that needed for frictional reshear of a thrust fault lying close to the maximum compression, σ 1. Under these circumstances, especially where the shear zone material has varying competence (tensile strength), affecting the failure mode, dilatant fault-fracture mesh structures may develop throughout a tabular rock volume. Evidence for the existence of fault-fracture meshes around low-angle thrusts comes from exhumed ancient structures and from active structures. In the case of megathrust ruptures along subduction interfaces, force balance analyses, lack of evidence for shear heating, and evidence of total shear stress release during earthquakes suggest the interfaces are extremely weak ( τ < 40 MPa), consistent with weakening by near-lithostatically overpressured fluids. Portions of the subduction interface, especially towards the down-dip termination of the seismogenic megathrust, are prone to episodes of slow-slip, non-volcanic tremor, low-frequency earthquakes, very-low-frequency earthquakes, etc., attributable to the activation of tabular fault-fracture meshes at low σ 3' around the thrust interface. Containment of near-lithostatic overpressures in such settings is precarious, fluid loss curtailing mesh activity.[Figure not available: see fulltext.

Primary drainage in geological fractures: Effects of aperture variability and wettability

NASA Astrophysics Data System (ADS)

Yang, Z.; Méheust, Y.; Neuweiler, I.

2017-12-01

Understanding and controlling fluid-fluid displacement in porous and fractured media is a key asset for many practical applications, such as the geological storage of CO2, hydrocarbon recovery, groundwater remediation, etc. We numerically investigate fluid-fluid displacement in rough-walled fractures with a focus on the combined effect of wettability, the viscous contrast between the two fluids, and fracture surface topography on drainage patterns and interface growth. A model has been developed to simulate the dynamic displacement of one fluid by another immiscible one in a rough geological fracture; the model takes both capillary and viscous forces into account. Capillary pressures at the fluid-fluid interface are calculated based on the Young-Laplace equation using the two principal curvatures (aperture-induced curvature and in-plane curvature) [1], while viscous forces are calculated by continuously solving the fluid pressure field in the fracture. The aperture field of a fracture is represented by a spatially correlated random field, with a power spectral density of the fracture wall topographies scaling as a power law, and a cutoff wave-length above which the Fourier modes of the two walls are identical [2]. We consider flow scenarios with both rectangular and radial configurations. Results show that the model is able to produce displacement patterns of compact displacement, capillary fingering, and viscous fingering, as well as the transitions between them. Both reducing the aperture variability and increasing the contact angle (from drainage to weak imbibition) can stabilize the displacement due to the influence of the in-plane curvature, an effect analogous to that of the cooperative pore filling in porous media. These results suggest that for geometries typical of geological fractures we can extend the phase diagram in the parameter space of capillary number and mobility ratio by another dimension to take into account the combined effect of wettability and fracture aperture topography. References: [1] Yang, Z. et al. (2012), A generalized approach for estimation of in-plane curvature in invasion percolation models for drainage in fractures. Wat. Resour. Res., 48(9), W09507. [2] Yang, Z. et al. (2016), Fluid trapping during capillary displacement in fractures. Adv. Water Resour., 95, 264-275.

Fracture toughness of ultrashort pulse-bonded fused silica

NASA Astrophysics Data System (ADS)

Richter, S.; Naumann, F.; Zimmermann, F.; Tünnermann, A.; Nolte, S.

2016-02-01

We determined the bond interface strength of ultrashort pulse laser-welded fused silica for different processing parameters. To this end, we used a high repetition rate ultrashort pulse laser system to inscribe parallel welding lines with a specific V-shaped design into optically contacted fused silica samples. Afterward, we applied a micro-chevron test to measure the fracture toughness and surface energy of the laser-inscribed welding seams. We analyzed the influence of different processing parameters such as laser repetition rate and line separation on the fracture toughness and fracture surface energy. Welding the entire surface a fracture toughness of 0.71 {MPa} {m}^{1/2}, about 90 % of the pristine bulk material ({≈ } 0.8 {MPa} {m}^{1/2}), is obtained.

Dentin-Composite Bond Strength Measurement Using the Brazilian Disk Test

PubMed Central

Carrera, Carola A.; Chen, Yung-Chung; Li, Yuping; Rudney, Joel; Aparicio, Conrado; Fok, Alex

2016-01-01

Objectives This study presents a variant of the Brazilian disk test (BDT) for assessing the bond strength between composite resins and dentin. Methods Dentin-composite disks (φ 5 mm × 2 mm) were prepared using either Z100 or Z250 (3M ESPE) in combination with one of three adhesives, Adper Easy Bond (EB), Adper Scotchbond Multi-Purpose (MP) and Adper Single Bond (SB), and tested under diametral compression. Acoustic emission (AE) and digital image correlation (DIC) were used to monitor debonding of the composite from the dentin ring. A finite element (FE) model was created to calculate the bond strengths using the failure loads. Fracture modes were examined by scanning electron microscopy (SEM). Results Most specimens fractured along the dentin-resin composite interface. DIC and AE confirmed interfacial debonding immediately before fracture of the dentin ring. Results showed that the mean bond strength with EB (14.9±1.9 MPa) was significantly higher than with MP (13.2±2.4 MPa) or SB (12.9±3.0 MPa) (p<0.05); no significant difference was found between MP and SB (p>0.05). Z100 (14.5±2.3 MPa) showed higher bond strength than Z250 (12.7±2.5 MPa) (p<0.05). Majority of specimens (91.3%) showed an adhesive failure mode. EB failed mostly at the dentin-adhesive interface, whereas MP at the composite-adhesive interface; specimens with SB failed at the composite-adhesive interface and cohesively in the adhesive. Conclusions The BDT variant showed to be a suitable alternative for measuring the bond strength between dentin and composite, with zero premature failure, reduced variability in the measurements, and consistent failure at the dentin-composite interface. PMID:27395367

Morphology and fracture of enamel.

PubMed

Myoung, Sangwon; Lee, James; Constantino, Paul; Lucas, Peter; Chai, Herzl; Lawn, Brian

2009-08-25

This study examines the inter-relation between enamel morphology and crack resistance by sectioning extracted human molars after loading to fracture. Cracks appear to initiate from tufts, hypocalcified defects at the enamel-dentin junction, and grow longitudinally around the enamel coat to produce failure. Microindentation corner cracks placed next to the tufts in the sections deflect along the tuft interfaces and occasionally penetrate into the adjacent enamel. Although they constitute weak interfaces, the tufts are nevertheless filled with organic matter, and appear to be stabilized against easy extension by self-healing, as well as by mutual stress-shielding and decussation, accounting at least in part for the capacity of tooth enamel to survive high functional forces.

Adhesion at the interface in cured graphite fiber epoxy-amine resin composites

NASA Technical Reports Server (NTRS)

Needles, Howard L.; Alger, Kenneth W.; Okamoto, Robert

1987-01-01

The effect of high temperature curing on the interface between unsized or epoxy-sized graphite fiber tow and epoxy-amine resin was examined by scanning electron microscopy of compression and freeze fractured specimens. Little or no adhesion was found between the unsized graphite fiber tows and the epoxy-amine resin on curing at 165 C for 17 hrs. Epoxy-sized graphite fibers showed a similar lack of adhesion between the fiber tows and the epoxy-amine resin at 3 and 17 hr cures, although good penetration of the resin into the sized fiber tows had occurred. Interfacial bond strengths for the composites could not be effectively measured by compression fracture of specimens.

Shear bond strength comparison between conventional porcelain fused to metal and new functionally graded dental restorations after thermal-mechanical cycling.

PubMed

Henriques, B; Gonçalves, S; Soares, D; Silva, F S

2012-09-01

The aim of this study was to evaluate the effect of thermo-mechanical cycling on the metal-ceramic bond strength of conventional porcelain fused to metal restorations (PFM) and new functionally graded metal-ceramic dental restorations (FGMR). Two types of specimens were produced: PFM and FGMR specimens. PFM specimens were produced by conventional PFM technique. FGMR specimens were hot pressed and prepared with a metal/ceramic composite interlayer (50 M, vol%) at the metal-ceramic interface. They were manufactured and standardized in cylindrical format and then submitted to thermal (3000, 6000 and 12,000 cycles; between 5 °C and 60 °C; dwell time: 30s) and mechanical (25,000, 50,000 and 100,000 cycles under a load of 50 N; 1.6 Hz) cycling. The shear bond strength tests were performed in a universal testing machine (crosshead speed: 0.5mm/min), using a special device to concentrate the tension at the metal-ceramic interface and the load was applied until fracture. The metal-ceramic interfaces were examined with SEM/EDS prior to and after shear tests. The Young's modulus and hardness were measured across the interfaces of both types of specimens using nanoindentation tests. Data was analyzed with Shapiro-Wilk test to test the assumption of normality. The 2-way ANOVA was used to compare shear bond strength results (p<0.05). FGMR specimens showed significantly (p<0.001) higher shear bond strength results than PFM specimens, irrespective of fatigue conditions. Fatigue conditions significantly (p<0.05) affected the shear bond strength results. The analysis of surface fracture revealed adhesive fracture type for PFM specimens and mixed fracture type for FGMR specimens. Nanoindentation tests showed differences in mechanical properties measured across the metal-ceramic interface for the two types of specimens, namely Young's Modulus and hardness. This study showed significantly better performance of the new functionally graded restorations relative to conventional PFM restorations, under fatigue testing conditions and for the materials tested. Copyright © 2012 Elsevier Ltd. All rights reserved.

Failure mechanism of resistance-spot-welded specimens impacted on base material by bullets

NASA Astrophysics Data System (ADS)

Fan, Chunlei; Ma, Bohan; Chen, Danian; Wang, Huanran; Ma, Dongfang

2018-01-01

The tests of bullet impact on the base material (BM) of a simple specimen with a single resistance-spot-welded (RSW) nugget of TRIP800 steel are performed to investigate the response of the RSW specimen to the ballistic debris impact on the RSW specimen. A one-stage gas gun is used to fire the bullets while a laser velocity interferometer system for any reflector (VISAR) is used to measure the velocity histories of the free surfaces of the RSW specimen. The recovered RSW specimens are examined with the three-dimensional super depth digital microscope (SDDM) and the scanning electro microscope (SEM). For the tests of small multiple-bullet impact, it is revealed that the wave train of the VISAR measured results and the detachment of the base material interfaces in the recovered RSW specimens are directly related to the reflection and refraction of the curved stress waves incoming to the interfaces and the free surfaces in the RSW specimens. The detachment of BM interfaces can lead to the impact failure of the RSW joints for the larger multiple-bullet impact at higher velocity, the mechanism of which is different from the case for normal incidence (spalling). For the tests of single large bullet impact, it is brought to light experimentally that the plastic strain concentration at the "notch tip" spurs either the crack near the RSW joint or the split of the nugget. The numerical simulation shows up the process of splitting the nugget: a crack initiates at the "notch tip", propagates across the nugget interface and splits the nugget into two parts. It is indicated that the interaction between the stress waves and many interfaces/free surfaces in the RSW specimen under ballistic impact causes variable local stress triaxialities and stress Lode angles, which affects the deformation and fracture mechanism of the RSW specimen including stretching and shearing failure. It is shown that the impact failure of the RSW joints is a mixture of brittle fracture and ductile fracture while the fracture or perforation of the BM is ductile.

Microstructure and mechanical behavior of Zr substrates coated with FeCrAl and Mo by cold-spraying

NASA Astrophysics Data System (ADS)

Park, Dong Jun; Kim, Hyun Gil; Jung, Yang Il; Park, Jung Hwan; Yang, Jae Ho; Koo, Yang Hyun

2018-06-01

FeCrAl and Mo layers were cold-sprayed onto a Zr surface, with the Mo layer introduced between the FeCrAl coating and the Zr matrix preventing high-temperature interdiffusion. Microstructural characterization of the first-deposited Mo layer and the Zr matrix immediately below the Mo/Zr interface was performed using transmission electron microscopy, and near-interface elemental distributions were obtained using energy-dispersive X-ray spectroscopy. The deformation of the coated Mo powder induced the formation of microbands and mechanically interlocked nanoscale structures. The mechanical behavior of Zr with a coating layer was compared with those characteristic of conventional Zr samples. The coated sample showed smaller strength reduction in the test conducted at elevated temperature. The hardness and fracture morphology of the Zr matrix near the interface region were investigated to determine the effect of impacting Mo particles on the matrix microstructure. The enhanced hardness and cleavage fracture morphology of the Zr matrix immediately below the Mo/Zr interface indicated the occurrence of localized deformation owing to Mo particle impact.

Fan-head shear rupture mechanism as a source of off-fault tensile cracking

NASA Astrophysics Data System (ADS)

Tarasov, Boris

2016-04-01

This presentation discusses the role of a recently identified fan-head shear rupture mechanism [1] in the creation of off-fault tensile cracks observed in earthquake laboratory experiments conducted on brittle photoelastic specimens [2,3]. According to the fan-mechanism the shear rupture propagation is associated with consecutive creation of small slabs in the fracture tip which, due to rotation caused by shear displacement of the fracture interfaces, form a fan-structure representing the fracture head. The fan-head combines such unique features as: extremely low shear resistance (below the frictional strength) and self-sustaining tensile stress intensification along one side of the interface. The variation of tensile stress within the fan-head zone is like this: it increases with distance from the fracture tip up to a maximum value and then decreases. For the initial formation of the fan-head high local stresses corresponding to the fracture strength should be applied in a small area, however after completions of the fan-head it can propagate dynamically through the material at low shear stresses (even below the frictional strength). The fan-mechanism allows explaining all unique features associated with the off-fault cracking process observed in photoelastic experiments [2,3]. In these experiments spontaneous shear ruptures were nucleated in a bonded, precut, inclined and pre-stressed interface by producing a local pressure pulse in a small area. Isochromatic fringe patterns around a shear rupture propagating along bonded interface indicate the following features of the off-fault tensile crack development: tensile cracks nucleate and grow periodically along one side of the interface at a roughly constant angle (about 80 degrees) relative to the shear rupture interface; the tensile crack nucleation takes place some distance behind the rupture tip; with distance from the point of nucleation tensile cracks grow up to a certain length within the rupture head zone; behind this zone static microcracks are left in the wake of the propagating rupture. Unfortunately, the modern technology used in these experiments is not able to identify the shear rupture mechanism itself operated within the narrow rupture interface. However, a special analysis of side effects accompanying the shear rupture propagation (including the off-fault tensile cracking) allows supposing that the failure process was governed by the fan-mechanism. 1. Tarasov, B.G. 2014. Hitherto unknown shear rupture mechanism as a source of instability in intact hard rocks at highly confined compression. Tectonophysics, 621, 69-84. 2. Griffith, W.A., Rosakis, A., Pollard, D.D. and Ko, C.W., 2009. Dynamic rupture experiments elucidate tensile crack development during propagating earthquake ruptures, Geology, pp 795-798. 3. Ngo, D., Huang, Y., Rosakis, A., Griffith, W.A., Pollard D. 2012. Off-fault tensile cracks: A link between geological fault observations, lab experiments, and dynamic rupture models. Journal of Geophysical Research, vol. 117, B01307, doi: 10.1029/2011JB008577 (2012).

Anisotropic and heterogeneous mechanical properties of a stratified shale/limestone sequence at Nash Point, South Wales: A case study for hydraulic fracture propagation through a layered medium

NASA Astrophysics Data System (ADS)

Forbes Inskip, Nathaniel; Meredith, Philip; Gudmundsson, Agust

2016-04-01

While considerable effort has been expended on the study of fracture propagation in rocks in recent years, our understanding of how fractures propagate through layered sedimentary rocks with different mechanical and elastic properties remains poorly constrained. Yet this is a key issue controlling the propagation of both natural and anthropogenic hydraulic fractures in layered sequences. Here we report measurements of the contrasting mechanical and elastic properties of the Lower Lias at Nash Point, South Wales, which comprises an interbedded sequence of shale and limestone layers, and how those properties may influence fracture propagation. Elastic properties of both materials have been characterised via ultrasonic wave velocity measurements as a function of azimuth on samples cored both normal and parallel to bedding. The shale is highly anisotropic, with P-wave velocities varying from 2231 to 3890 m s-1, giving an anisotropy of ~55%. By contrast, the limestone is essentially isotropic, with a mean P-wave velocity of 5828 m s-1 and an anisotropy of ~2%. The dynamic Young's modulus of the shale, calculated from P- and S-wave velocity data, is also anisotropic with a value of 36 GPa parallel to bedding and 12 GPa normal to bedding. The modulus of the limestone is again isotropic with a value of 80 GPa. It follows that for a vertical fracture propagating (i.e. normal to bedding) the modulus contrast is 6.6. This is important because the contrast in elastic properties is a key factor in controlling whether fractures arrest, deflect, or propagate across interfaces between layers in a sequence. There are three principal mechanisms by which a fracture may deflect across or along an interface, namely: Cook-Gordon debonding, stress barrier, and elastic mismatch. Preliminary numerical modelling results (using a Finite Element Modelling software) of induced fractures at Nash Point suggest that all three are important. The results demonstrate a rotation of the maximum principal compressive stress across an interface but also a confinement of tensile stress within the host layer. Mechanical properties have been characterised by indirect measurement of the tensile strength using the Brazil-Disk technique. Measurements were made in the three principal orientations relative to bedding, Arrester, Divider, and Short-Transverse, and also at 15° intervals between these planes. Values for the shale again showed a high degree of anisotropy; with similar values in the Arrester and Divider orientations, but with much lower values in the Short-Transverse (bedding parallel) orientation. The tensile strength of the limestone is considerably higher than that of the shale and exhibits no significant anisotropy. Current work is underway to characterise the fracture propagation properties by measuring the fracture toughness and fracture ductility of both rocks using a combination of the Semi-Circular Bend and Short-Rod techniques.

Laser-Arc Hybrid Welding of Dissimilar Titanium Alloy and Stainless Steel Using Copper Wire

NASA Astrophysics Data System (ADS)

Gao, Ming; Chen, Cong; Wang, Lei; Wang, Zemin; Zeng, Xiaoyan

2015-05-01

Laser-arc hybrid welding with Cu3Si filler wire was employed to join dissimilar Ti6Al4V titanium alloy and AISI316 stainless steel (316SS). The effects of welding parameters on bead shape, microstructure, mechanical properties, and fracture behavior were investigated in detail. The results show that cross-weld tensile strength of the joints is up to 212 MPa. In the joint, obvious nonuniformity of the microstructure is found in the fusion zone (FZ) and at the interfaces from the top to the bottom, which could be improved by increasing heat input. For the homogeneous joint, the FZ is characterized by Fe67- x Si x Ti33 dendrites spreading on α-Cu matrix, and the two interfaces of 316SS/FZ and FZ/Ti6Al4V are characterized by a bamboo-like 316SS layer and a CuTi2 layer, respectively. All the tensile samples fractured in the hardest CuTi2 layer at Ti6Al4V side of the joints. The fracture surface is characterized by river pattern revealing brittle cleavage fracture. The bead formation mechanisms were discussed according to the melt flow and the thermodynamic calculation.

Laser Brazing Characteristics of Al to Brass with Zn-Based Filler

NASA Astrophysics Data System (ADS)

Tan, Caiwang; Liu, Fuyun; Sun, Yiming; Chen, Bo; Song, Xiaoguo; Li, Liqun; Zhao, Hongyun; Feng, Jicai

2018-05-01

Laser brazing of Al to brass in lap configuration with Zn-based filler was performed in this work. The process parameters including laser power, defocused distance were found to have a significant influence on appearance, microstructure and mechanical properties. The process parameters were optimized to be laser power of 2700 W and defocusing distance of + 40 mm from brass surface. In addition, preheating exerted great influence on wetting and spreading ability of Zn filler on brass surface. The microstructure observation showed the thickness of reaction layer (CuZn phase) at the interface of the brass side would grow with the increase in laser power and the decrease in the laser defocusing distance. Moreover, preheating could increase the spreading area of the filler metal and induced the growth of the reaction layer. The highest tensile-shear load of the joint could reach 2100 N, which was 80% of that of Al alloy base metal. All the joints fractured along the CuZn reaction layer and brass interface. The fracture morphology displayed the characteristics of the cleavage fracture when without preheating before welding, while it displayed the characteristics of the quasi-cleavage fracture with preheating before welding.

Histological Evidence of the Osseointegration of Fractured Direct Metal Laser Sintering Implants Retrieved after 5 Years of Function.

PubMed

Mangano, Francesco; Mangano, Carlo; Piattelli, Adriano; Iezzi, Giovanna

2017-01-01

Direct metal laser sintering (DMLS) is an additive manufacturing technique that allows the fabrication of dental implants layer by layer through the laser fusion of titanium microparticles. The surface of DMLS implants is characterized by a high open porosity with interconnected pores of different sizes; therefore, it has the potential to enhance and accelerate bone healing. To date, however, there are no histologic/histomorphometric studies in the literature evaluating the interface between bone and DMLS implants in the long-term. To evaluate the interface between bone and DMLS implants retrieved after 5 years of functional loading. Two fractured DMLS implants were retrieved from the human jaws, using a 5 mm trephine bur. Both the implants were clinically stable and functioned regularly before fracture. The specimens were processed for histologic/histomorphometric evaluation; the bone-to-implant contact (BIC%) was calculated. Compact, mature lamellar bone was found over most of the DMLS implants in close contact with the implant surface; the histomorphometric evaluation showed a mean BIC% of 66.1% (±4.5%). The present histologic/histomorphometric study showed that DMLS implants were well integrated in bone, after 5 years of loading, with the peri-implant bone undergoing continuous remodeling at the interface.

Histological Evidence of the Osseointegration of Fractured Direct Metal Laser Sintering Implants Retrieved after 5 Years of Function

PubMed Central

Piattelli, Adriano

2017-01-01

Background Direct metal laser sintering (DMLS) is an additive manufacturing technique that allows the fabrication of dental implants layer by layer through the laser fusion of titanium microparticles. The surface of DMLS implants is characterized by a high open porosity with interconnected pores of different sizes; therefore, it has the potential to enhance and accelerate bone healing. To date, however, there are no histologic/histomorphometric studies in the literature evaluating the interface between bone and DMLS implants in the long-term. Purpose To evaluate the interface between bone and DMLS implants retrieved after 5 years of functional loading. Methods Two fractured DMLS implants were retrieved from the human jaws, using a 5 mm trephine bur. Both the implants were clinically stable and functioned regularly before fracture. The specimens were processed for histologic/histomorphometric evaluation; the bone-to-implant contact (BIC%) was calculated. Results Compact, mature lamellar bone was found over most of the DMLS implants in close contact with the implant surface; the histomorphometric evaluation showed a mean BIC% of 66.1% (±4.5%). Conclusions The present histologic/histomorphometric study showed that DMLS implants were well integrated in bone, after 5 years of loading, with the peri-implant bone undergoing continuous remodeling at the interface. PMID:28929117

Comminution of solids caused by kinetic energy of high shear strain rate, with implications for impact, shock, and shale fracturing.

PubMed

Bazant, Zdenek P; Caner, Ferhun C

2013-11-26

Although there exists a vast literature on the dynamic comminution or fragmentation of rocks, concrete, metals, and ceramics, none of the known models suffices for macroscopic dynamic finite element analysis. This paper outlines the basic idea of the macroscopic model. Unlike static fracture, in which the driving force is the release of strain energy, here the essential idea is that the driving force of comminution under high-rate compression is the release of the local kinetic energy of shear strain rate. The density of this energy at strain rates >1,000/s is found to exceed the maximum possible strain energy density by orders of magnitude, making the strain energy irrelevant. It is shown that particle size is proportional to the -2/3 power of the shear strain rate and the 2/3 power of the interface fracture energy or interface shear stress, and that the comminution process is macroscopically equivalent to an apparent shear viscosity that is proportional (at constant interface stress) to the -1/3 power of this rate. A dimensionless indicator of the comminution intensity is formulated. The theory was inspired by noting that the local kinetic energy of shear strain rate plays a role analogous to the local kinetic energy of eddies in turbulent flow.

In Situ SEM Observations of Fracture Behavior of Laser Welded-Brazed Al/Steel Dissimilar Joint

NASA Astrophysics Data System (ADS)

Xia, Hongbo; Tan, Caiwang; Li, Liqun; Ma, Ninshu

2018-03-01

Laser welding-brazing of 6061-T6 aluminum alloy to DP590 dual-phase steel with Al-Si12 flux-cored filler wire was performed. The microstructure at the brazing interface was characterized. Fracture behavior was observed and analyzed by in situ scanning electron microscope. The microstructure of the brazing interface showed that inhomogeneous intermetallic compounds formed along the thickness direction, which had a great influence on the crack initiation and propagation. In the top region, the reaction layer at the interface consisted of scattered needle-like Fe(Al,Si)3 and serration-shaped Fe1.8Al7.2Si. In the middle region, the compound at the interface was only serration-shaped Fe1.8Al7.2Si. In the bottom region, the interface was composed of lamellar-shaped Fe1.8Al7.2Si. The cracks were first detected in the bottom region and propagated from bottom to top along the interface. At the bottom region, the crack initiated and propagated along the Fe1.8Al7.2Si/weld seam interface during the in situ tensile test. When the crack propagated into the middle region, a deflection of crack propagation appeared. The crack first propagated along the steel/Fe1.8Al7.2Si interface and then moved along the weld seam until the failure of the joint. The tensile strength of the joint was 146.5 MPa. Some micro-cracks were detected at Fe(Al,Si)3 and the interface between the steel substrate and Fe(Al,Si)3 in the top region while the interface was still connected.

Self-Healing of Unentangled Polymer Networks with Reversible Bonds

PubMed Central

Stukalin, Evgeny B.; Cai, Li-Heng; Kumar, N. Arun; Leibler, Ludwik; Rubinstein, Michael

2013-01-01

Self-healing polymeric materials are systems that after damage can revert to their original state with full or partial recovery of mechanical strength. Using scaling theory we study a simple model of autonomic self-healing of unentangled polymer networks. In this model one of the two end monomers of each polymer chain is fixed in space mimicking dangling chains attachment to a polymer network, while the sticky monomer at the other end of each chain can form pairwise reversible bond with the sticky end of another chain. We study the reaction kinetics of reversible bonds in this simple model and analyze the different stages in the self-repair process. The formation of bridges and the recovery of the material strength across the fractured interface during the healing period occur appreciably faster after shorter waiting time, during which the fractured surfaces are kept apart. We observe the slowest formation of bridges for self-adhesion after bringing into contact two bare surfaces with equilibrium (very low) density of open stickers in comparison with self-healing. The primary role of anomalous diffusion in material self-repair for short waiting times is established, while at long waiting times the recovery of bonds across fractured interface is due to hopping diffusion of stickers between different bonded partners. Acceleration in bridge formation for self-healing compared to self-adhesion is due to excess non-equilibrium concentration of open stickers. Full recovery of reversible bonds across fractured interface (formation of bridges) occurs after appreciably longer time than the equilibration time of the concentration of reversible bonds in the bulk. PMID:24347684

Air and groundwater flow at the interface between fractured host rock and a bentonite buffer

NASA Astrophysics Data System (ADS)

Dessirier, B.; Jarsjo, J.; Frampton, A.

2014-12-01

Designs of deep geological repositories for spent nuclear fuel include several levels of confinement. The Swedish and Finnish concept KBS-3 targets for example sparsely fractured crystalline bedrock as host formation and would have the waste canisters embedded in an engineered buffer of compacted MX-80 bentonite. The host rock is a highly heterogeneous dual porosity material containing fractures and a rock matrix. Bentonite is a complex expansive porous material. Its water content and mechanical properties are interdependent. Beyond the specific physics of unsaturated flow and transport in each medium, the interface between them is critical. Detailed knowledge of the transitory two-phase flow regime, induced by the insertion of the unsaturated buffer in a saturated rock environment, is necessary to assess the performance of planned KBS-3 deposition holes. A set of numerical simulations based on the equations of two-phase flow for water and air in porous media were conducted to investigate the dynamics of air and groundwater flow near the rock/bentonite interface in the period following installation of the unsaturated bentonite buffer. We assume state of the two-phase flow parameter values for bentonite from laboratory water uptake tests and typical fracture and rock properties from the Äspö Hard rock laboratory (Sweden) gathered under several field characterization campaigns. The results point to desaturation of the rock domain as far as 10 cm away from the interface into matrix-dominated regions for up to 160 days. Similar observations were made during the Bentonite Rock Interaction Experiment (BRIE) at the Äspö HRL, with a desaturation sustained for even longer times. More than the mere time to mechanical and hydraulic equilibrium, the occurrence of sustained unsaturated conditions opens the possibility for biogeochemical processes that could be critical in the safety assessment of the planned repository.

Trochantoplasty for Total Hip Arthroplasty in Patients With Coxa Vara Deformity.

PubMed

Yoo, Jun-Il; Parvizi, Javad; Song, Ji-Ung; Ha, Yong-Chan; Lee, Young-Kyun; Koo, Kyung-Hoi

2017-07-01

In total hip arthroplasty (THA) of hips with coxa vara, the femoral stems might be inserted in a varus alignment. To avoid varus insertion, we designed a technique, which we termed "trochantoplasty." In this procedure, the medial half of the greater trochanter was removed during THA. We evaluated 30 patients (31 hips) who had coxa vara deformity and underwent THA using trochantoplasty at the mean follow-up of 5 years (range, 3-9 years). All stems were inserted in the neutral position. One Vancouver type 1 periprosthetic femoral fracture occurred after a fall at postoperative 2 months. At the latest follow-up, the mean power of abductor was 4.3 (range, 3-5). Four patients had moderate limp whereas 26 patients had slight limp. The abduction at 90° flexion ranged from 15° to 45° (mean, 35°). There was no revision. All prostheses had bone-ingrown stability without any detectable wear or osteolysis. The mean Harris hip score was improved from 66.9 to 89.4 points. Trochantoplasty can be used to avoid varus insertion of the femoral stem while performing THA in patients with coxa vara deformity without compromising the abductor mechanism. Copyright © 2017 Elsevier Inc. All rights reserved.

Transfemoral implantation of the Wagner SL stem. The abolition of subsidence and enhancement of osteotomy union rate using Dall-Miles cables.

PubMed

Warren, P J; Thompson, P; Fletcher, M D A

2002-12-01

The Wagner SL uncemented revision stem has been utilised successfully for revision hip surgery where marked loss of proximal bone stock co-exists or where there is a periprosthetic fracture. Implanted via the transfemoral approach, one significant difficulty appears to be a tendency for implant subsidence, which in some cases has been troublesome enough to necessitate early revision (usually to a larger prosthesis). A change in our operative practice allowed us to review the effects of using either wire cerclages or 2.0 mm Dall-Miles cables for prophylactic wiring of the distal femur. Seventeen Wagner SL stems, inserted via the transfemoral approach, were studied in 16 patients. We found those patients prophylactically wired with Dall-Miles cables demonstrated no subsidence in comparison with those in whom heavy wire cerclage had been utilised (mean subsidence 6 mm; p=0.001). In addition, we found that closure of the proximal osteotomy with wires conferred a more reliable rate of union in comparison with those closed with heavy sutures. We recommend the use of Dall-Miles cables for distal cerclage and osteotomy closure for the Wagner prosthesis.

Fractography of the interlaminar fracture of carbon-fibre epoxy composites

NASA Technical Reports Server (NTRS)

Bascom, W. D.; Boll, D. J.; Fuller, B.; Phillips, P. J.

1985-01-01

The failed surfaces of interlaminar fracture (mode I) specimens of AS4/3501-6 were examined using scanning electron microscopy. The principal fracture features were fiber pull-out (bundles and single fibers), hackle markings, and regions of smooth resin fracture. Considerable (30 to 50 percent) relaxation of the deformed resin occurred when the specimens were heated above the matrix glass transition temperature. This relaxation was taken as evidence of extensive shear yielding of the resin during the fracture process. Some of the fractography features are discussed in terms of transverse tensile stresses and peeling stresses acting on the fibers. In some instances these localized stresses focus failure close to the resin-fiber interface, which can be mistakenly interpreted as interfacial failure and low fiber-resin adhesion.

[Tumor prostheses : Important in modern revision arthroplasty].

PubMed

Hillmann, A; Ipach, I

2015-05-01

Due to demographic aging, an increasing number of revision arthroplasty procedures is expected during upcoming years. While the use of a megaprosthesis for bone reconstruction after tumor resection is gold standard, this type of prosthesis still meets with reservation in the field of revision arthroplasty because of numerous risk factors. The purpose of this article is to present the importance of modular megaprostheses in revision arthroplasty, taking into consideration the risks of periprosthetic infection, aseptic loosening, material failure, and hip dislocation. Because of improvements in the field of megaprostheses during the last 30 years, the risks after implantation of this type of prosthesis have significantly decreased. The risk of periprosthetic infection has been reduced about 1/3 by the use of silver surface coating. Improvements in stem design, cement technique, and the additional use of locking screws have minimized the risk of aseptic loosening. Improvements in material composition have reduced the risk of material failure. The risk of hip dislocation could also be minimized by careful tissue preparation and appropriate suture technique. There is no need for the conservative use of megaprostheses in revision arthroplasty. There are many benefits in the use of megaprostheses in multimorbid patients (i.e., reduced operating time, the possibility of early full weight bearing, and a reduced risk of periprosthetic infection by the use of silver surface coating) instead of complex bone reconstruction during revision arthroplasty.

Wear particles and ions from cemented and uncemented titanium-based hip prostheses—A histological and chemical analysis of retrieval material

PubMed Central

Grosse, Susann; Haugland, Hans Kristian; Lilleng, Peer; Ellison, Peter; Hallan, Geir; Høl, Paul Johan

2015-01-01

Wear debris-induced inflammation is considered to be the main cause for periprosthetic osteolysis in total hip replacements (THR). The objective of this retrieval study was to examine the tissue reactions and exposure to metal ions and wear particles in periprosthetic tissues and blood samples from patients with titanium (Ti)-based hip prostheses that were revised due to wear, osteolysis, and/or aseptic loosening. Semiquantitative, histological tissue evaluations in 30 THR-patients revealed numerous wear debris-loaded macrophages, inflammatory cells, and necrosis in both groups. Particle load was highest in tissues adjacent to loosened cemented Ti stems that contained mainly submicron zirconium (Zr) dioxide particles. Particles containing pure Ti and Ti alloy elements were most abundant in tissues near retrieved uncemented cups. Polyethylene particles were also detected, but accounted only for a small portion of the total particle number. The blood concentrations of Ti and Zr were highly elevated in cases with high abrasive wear and osteolysis. Our findings indicate that wear particles of different chemical composition induced similar inflammatory responses, which suggests that particle size and load might be more important than the wear particle composition in periprosthetic inflammation and osteolysis. © 2014 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 103B:709–717, 2015. PMID:25051953

3D micro-crack propagation simulation at enamel/adhesive interface using FE submodeling and element death techniques.

PubMed

Liu, Heng-Liang; Lin, Chun-Li; Sun, Ming-Tsung; Chang, Yen-Hsiang

2010-06-01

This study investigates micro-crack propagation at the enamel/adhesive interface using finite element (FE) submodeling and element death techniques. A three-dimensional (3D) FE macro-model of the enamel/adhesive/ceramic subjected to shear bond testing was generated and analyzed. A 3D micro-model with interfacial bonding structure was constructed at the upper enamel/adhesive interface where the stress concentration was found from the macro-model results. The morphology of this interfacial bonding structure (i.e., resin tag) was assigned based on resin tag geometry and enamel rod arrangement from a scanning electron microscopy micrograph. The boundary conditions for the micro-model were determined from the macro-model results. A custom iterative code combined with the element death technique was used to calculate the micro-crack propagation. Parallel experiments were performed to validate this FE simulation. The stress concentration within the adhesive occurred mainly at the upper corner near the enamel/adhesive interface and the resin tag base. A simulated fracture path was found at the resin tag base along the enamel/adhesive interface. A morphological observation of the fracture patterns obtained from in vitro testing corresponded with the simulation results. This study shows that the FE submodeling and element death techniques could be used to simulate the 3D micro-stress pattern and the crack propagation noted at the enamel/adhesive interface.

Fluctuations of global energy release and crackling in nominally brittle heterogeneous fracture.

PubMed

Barés, J; Hattali, M L; Dalmas, D; Bonamy, D

2014-12-31

The temporal evolution of mechanical energy and spatially averaged crack speed are both monitored in slowly fracturing artificial rocks. Both signals display an irregular burstlike dynamics, with power-law distributed fluctuations spanning a broad range of scales. Yet, the elastic power released at each time step is proportional to the global velocity all along the process, which enables defining a material-constant fracture energy. We characterize the intermittent dynamics by computing the burst statistics. This latter displays the scale-free features signature of crackling dynamics, in qualitative but not quantitative agreement with the depinning interface models derived for fracture problems. The possible sources of discrepancies are pointed out and discussed.

[Preliminary analysis about influence of porcelain thickness on interfacial crack of PFM].

PubMed

Zhu, Ziyuan; Zhang, Baowei; Zhang, Xiuyin; Xu, Kan; Fang, Ruhua; Wang, Dongmei

2002-01-01

This study was about the influence of porcelain thickness on crack at interface. The effect of porcelain thickness on the flaw at the interface between porcelain and metal was studied in three groups with porcelain thickness of 0.5 mm, 1.5 mm and 2.5 mm (metal thickness of 0.5 mm) by means of moire interferometre and interfacial fracture mechanics. The parameter Jc was compared among the three groups and the growing of the flaw was observed. Jc and the extreme strength of group with porcelain thickness of 0.5 mm (2.813 N/m and 9.979 N) were lower than those of the groups with porcelain thickness of 1.5 mm and 2.5 mm (5.395 N/m, 19.134 N and 5.429 N/m, 19.256 N). Flaws extend along the interface in the groups with porcelain thickness of 1.5 mm and 0.5 mm. (1) Fracture resistance of the interface in the groups with porcelain thickness of 1.5 mm and 2.5 mm is similar and it decreases in the group with 0.5 mm thick porcelain. (2) When porcelain is 1.5 mm or 0.5 mm thick, flaws will extend along the interface. When porcelain is 2.5 mm thick, flaws will extend into the porcelain layer.

Fracture and Failure in Micro- and Nano-Scale

NASA Astrophysics Data System (ADS)

Charitidis, Costas A.

Indentation and scratch in micro- and nano-scale are the most commonly used techniques for quantifying thin film and systems properties. Among them are different failure modes such as deformation, friction, fracture toughness, fatigue. Failure modes can be activated either by a cycle of indentation or by scratching of the samples to provide an estimation of the fracture toughness and interfacial fracture energies. In the present study, we report on the failure and fracture modes in two cases of engineering materials; that is transparent SiOx thin films onto poly(ethylene terephthalate) (PET) membranes and glass-ceramic materials. The SiOx/PET system meets the demands regarding scratch-resistance, wettability, biocompatibility, gas transmission, or friction, while maintaining the bulk characteristics of PET (such as easy processing, good mechanical properties, reasonably low permeability to oxygen and carbon dioxide gases (barrier properties), and good chemical coupling with antibacterial coatings). Glass-ceramic materials, since their first accidental production in the mid fifties by S.D. Stookey, have been used in a vast area of applications, from household cooktops and stoves, to missile nose cones and mirror mounts of orbital telescopes and from decorative wall coverings to medical applications. The fracture modes, namely transgranular and intergranular modes in glass-ceramic materials have paid less attention in literature comparing with ceramic materials. In the former case the crack paves its way irrespectively of the direction of the grain boundaries, i.e., the interfaces between the different phases. In the latter case the crack preferentially follows them, i.e., debonds the interfaces.

[Classification of prosthetic loosening and determination of wear particles].

PubMed

Otto, M

2008-11-01

Nowaday, loosening of orthopaedic implants implies important medical and socioeconomic problems. Implant loosening is caused by implant infections as well as aseptic loosening, due to particle disease and mechanical alterations. Clinically we divide the implant infection into early and late infections. Morphologically it is possible to reliably detect the infection by quantification of neutrophil granulocytes. Additionally molecular methods are suitable to detect micro-organisms which are responsible for the prosthetic joint infection including their resistance to antibiotics. Particle disease may be reproducibly classified by the detection of different types of wear particles, particularly polyethylene, metal, ceramic and cement. The aetiology of the indeterminate type of the periprosthetic membrane is obscure, but may be associated with osteopathies. This classification of the periprosthetic membrane morphology provides clinically significant information concerning clinical management of implant loosening.

Fracturing of doleritic intrusions and associated contact zones: Implications for fluid flow in volcanic basins

NASA Astrophysics Data System (ADS)

Senger, Kim; Buckley, Simon J.; Chevallier, Luc; Fagereng, Åke; Galland, Olivier; Kurz, Tobias H.; Ogata, Kei; Planke, Sverre; Tveranger, Jan

2015-02-01

Igneous intrusions act as both carriers and barriers to subsurface fluid flow and are therefore expected to significantly influence the distribution and migration of groundwater and hydrocarbons in volcanic basins. Given the low matrix permeability of igneous rocks, the effective permeability in- and around intrusions is intimately linked to the characteristics of their associated fracture networks. Natural fracturing is caused by numerous processes including magma cooling, thermal contraction, magma emplacement and mechanical disturbance of the host rock. Fracturing may be locally enhanced along intrusion-host rock interfaces, at dyke-sill junctions, or at the base of curving sills, thereby potentially enhancing permeability associated with these features. In order to improve our understanding of fractures associated with intrusive bodies emplaced in sedimentary host rocks, we have investigated a series of outcrops from the Karoo Basin of the Eastern Cape province of South Africa, where the siliciclastic Burgersdorp Formation has been intruded by various intrusions (thin dykes, mid-sized sheet intrusions and thick sills) belonging to the Karoo dolerite. We present a quantified analysis of fracturing in- and around these igneous intrusions based on five outcrops at three individual study sites, utilizing a combination of field data, high-resolution lidar virtual outcrop models and image processing. Our results show a significant difference between the three sites in terms of fracture orientation. The observed differences can be attributed to contrasting intrusion geometries, outcrop geometry (for lidar data) and tectonic setting. Two main fracture sets were identified in the dolerite at two of the sites, oriented parallel and perpendicular to the contact respectively. Fracture spacing was consistent between the three sites, and exhibits a higher degree of variation in the dolerites compared to the host rock. At one of the study sites, fracture frequency in the surrounding host rock increases slightly toward the intrusion at approximately 3 m from the contact. We conclude by presenting a conceptual fluid flow model, showing permeability enhancement and a high potential for fluid flow-channeling along the intrusion-host rock interfaces.

Direct-soldering 6061 aluminum alloys with ultrasonic coating.

PubMed

Ding, Min; Zhang, Pei-lei; Zhang, Zhen-yu; Yao, Shun

2010-02-01

In this study, the authors applied furnace soldering with ultrasonic coating method to solder 6061 aluminum alloy and investigated the effects of both coating time and soldering temperature on its properties. The following results were obtained: firstly, the solder region mainly composed of four kinds of microstructure zones: rich Sn zone, rich-Pb zone, Sn-Pb eutectic phase and rich Al zone. Meanwhile, the microanalysis identified a continuous reaction product at the alumina-solder interface as a rich-Pb zone. Therefore, the joint strength changed with soldering time and soldering temperature. Secondly, the tensile data had significantly greater variability, with values ranging from 13.99MPa to 24.74MPa. The highest value was obtained for the samples coated with Sn-Pb-Zn alloy for 45s. Fractures occurred along the solder-alumina interface for the 6061 aluminum alloy with its surface including hybrid tough fracture of dimple and tear ridge. The interface could initially strip at the rich Bi zone with the effect of shear stress.

Plastic damage induced fracture behaviors of dental ceramic layer structures subjected to monotonic load.

PubMed

Wang, Raorao; Lu, Chenglin; Arola, Dwayne; Zhang, Dongsheng

2013-08-01

The aim of this study was to compare failure modes and fracture strength of ceramic structures using a combination of experimental and numerical methods. Twelve specimens with flat layer structures were fabricated from two types of ceramic systems (IPS e.max ceram/e.max press-CP and Vita VM9/Lava zirconia-VZ) and subjected to monotonic load to fracture with a tungsten carbide sphere. Digital image correlation (DIC) and fractography technology were used to analyze fracture behaviors of specimens. Numerical simulation was also applied to analyze the stress distribution in these two types of dental ceramics. Quasi-plastic damage occurred beneath the indenter in porcelain in all cases. In general, the fracture strength of VZ specimens was greater than that of CP specimens. The crack initiation loads of VZ and CP were determined as 958 ± 50 N and 724 ± 36 N, respectively. Cracks were induced by plastic damage and were subsequently driven by tensile stress at the elastic/plastic boundary and extended downward toward to the veneer/core interface from the observation of DIC at the specimen surface. Cracks penetrated into e.max press core, which led to a serious bulk fracture in CP crowns, while in VZ specimens, cracks were deflected and extended along the porcelain/zirconia core interface without penetration into the zirconia core. The rupture loads for VZ and CP ceramics were determined as 1150 ± 170 N and 857 ± 66 N, respectively. Quasi-plastic deformation (damage) is responsible for crack initiation within porcelain in both types of crowns. Due to the intrinsic mechanical properties, the fracture behaviors of these two types of ceramics are different. The zirconia core with high strength and high elastic modulus has better resistance to fracture than the e.max core. © 2013 by the American College of Prosthodontists.

GRIZZLY/FAVOR Interface Project Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dickson, Terry L; Williams, Paul T; Yin, Shengjun

As part of the Light Water Reactor Sustainability (LWRS) Program, the objective of the GRIZZLY/FAVOR Interface project is to create the capability to apply GRIZZLY 3-D finite element (thermal and stress) analysis results as input to FAVOR probabilistic fracture mechanics (PFM) analyses. The one benefit of FAVOR to Grizzly is the PROBABILISTIC capability. This document describes the implementation of the GRIZZLY/FAVOR Interface, the preliminary verification and tests results and a user guide that provides detailed step-by-step instructions to run the program.

All-Polyethylene Tibial Components: An Analysis of Long-Term Outcomes and Infection.

PubMed

Houdek, Matthew T; Wagner, Eric R; Wyles, Cody C; Watts, Chad D; Cass, Joseph R; Trousdale, Robert T

2016-07-01

There is debate regarding tibial component modularity and composition in total knee arthroplasty (TKA). Biomechanical studies have suggested improved stress distribution in metal-backed tibias; however, these results have not translated clinically. The purpose of this study was to analyze the outcomes of all-polyethylene components and to compare the results to those with metal-backed components. We reviewed 31,939 patients undergoing a primary TKA over a 43-year period (1970-2013). There were 28,224 (88%) metal-backed and 3715 (12%) all-polyethylene tibial components. The metal-backed and all-polyethylene groups had comparable demographics with respect to gender, age and body mass index (BMI). Mean follow-up was 7 years. The mean survival for all primary TKAs at the 5-, 10-, 20- and 30-year time points was 95%, 89%, 73%, and 57%, respectively. All-polyethylene tibial components were found to have a significantly improved (P < .0001) survivorship when compared with their metal-backed counterparts. All-polyethylene tibial components were also found to have a significantly lower rate of infection, instability, tibial component loosening, and periprosthetic fracture. The all-polyethylene group had improved survival rates in all age groups, except in patients 85 years old or greater, where there was no significant difference. All-polyethylene tibial components had improved survival for all BMI groups except in the morbidly obese (BMI ≥ 40) where there was no significant difference. All-polyethylene tibial components had significantly improved implant survival, reduced rates of postoperative infection, fracture, and tibial component loosening. All polyethylene should be considered for most of the patients, regardless of age and BMI. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical Outcomes and Complications during the Learning Curve for Reverse Total Shoulder Arthroplasty: An Analysis of the First 40 Cases

PubMed Central

Song, Kwang-Soon; Koo, Tae-Won

2017-01-01

Background The purpose of this study was to investigate the results and complications during the learning curve of reverse total shoulder arthroplasty (RTSA) for rotator cuff deficiency. Methods We retrospectively reviewed the first 40 cases of RTSA performed by a single surgeon. The mean age of patients was 72.7 years (range, 63 to 81 years) and mean follow-up period was 26.7 months (range, 9 to 57 months). Clinical outcomes were evaluated using a visual analog scale (VAS) for pain, the University of California at Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeon (ASES) score, subjective shoulder value (SSV), and active range of motion (ROM). Intraoperative and postoperative complications were also evaluated. Results The average VAS pain score, UCLA score, ASES score, and SSV improved from 6.9%, 12.8%, 29.0%, and 29.0% before surgery to 1.6%, 27.0%, 73.3%, and 71.5% after surgery, respectively (p < 0.001). The mean forward flexion, abduction, and external rotation improved from 68.0°, 56.9°, and 28.0° before surgery to 131.0°, 112.3°, and 38.8° after surgery, respectively (p < 0.001, p < 0.001, and p = 0.021). However, the mean internal rotation did not improve after surgery (p = 0.889). Scapular notching was observed in 33 patients (51.5%). Eight shoulders (20%) had complications, including 2 major (1 deep infection and 1 glenoid fixation failure) and 6 minor complications (3 brachial plexus injuries, 2 acromial fractures, and 1 intraoperative periprosthetic fracture). Conclusions The first 40 cases of RTSA performed by a single surgeon during the learning curve period showed satisfactory short-term follow-up results with an acceptable complication rate. PMID:28567225

[Treatment of metaphyseal fractures of shin bones by the method of blocking osteosynthesis].

PubMed

Neverov, V A; Khromov, A A; Cherniaev, S N; Egorov, K S; Shebarshov, A L

2008-01-01

The proposed method of reposition and polyaxial stabilization of fragments for intramedullary meallosynthesis of fractures of long tubular bones allows blocking osteosynthesis to be successfully used in treatment of complex metaphyseal fractures of shin bones. It results in strong fixation of the fragments, makes it possible to successfully eliminate residual deformities after introduction of the nail and to avoid the development of them in future under the influence of loading. The method provides early functioning of the interfacing joints, early axial loading, shorter period of disability, the absence of external immobilization.

[The Economic Challenge of Centralised Treatment of Patients with Periprosthetic Infections].

PubMed

Müller, Michael; Trampuz, Andrej; Winkler, Tobias; Perka, Carsten

2018-02-07

Periprosthetic infection (PJI) is one of the most severe complications in joint arthroplasty. Correct diagnosis and adequate therapy represent an enormous interdisciplinary challenge. The necessary interdisciplinarity and complexity of treatment require therapy in centres. However, the high costs have not yet been analysed or discussed and are problematic. The aim of this work is therefore to compare the costs within a year of treatment in a department specialised in the treatment of periprosthetic infections. A retrospective evaluation of the patients who were hospitalised in our Centre for Septic Surgery in 2015 was carried out using data from the hospital information system and medical controlling. Demographic data, diagnoses, the length of hospital stay, the number of surgical interventions and the pathogen spectrum were recorded and the costs of treatment were determined. These were compared to the DRG revenues. A total of 281 patients were treated in 2015 due to an infection of the musculoskeletal system, 144 of these with a periprosthetic infection of the knee or hip joint (ratio 1.5 : 1). The mean duration of treatment was 16 days; the mean treatment costs per day and patient were approximately 820 €. The total cost of the 281 treatments was 3.3 million €, of which only 2.7 million were covered by DRG revenues (underfill of approx. - 20%). This corresponded to a deficit of 633,000 €, with a mean deficit per treatment case of 2300 €. The deficit for infected THA was 8585 € on average and was five times greater than for infected TKA - with 1638 €. The main reasons for the high treatment costs were the length of hospital stay, multiple surgical interventions and the isolation treatment. The increasing number of PJI requires interdisciplinary treatment in centres. However, the costs not covered by the DRG system prevent such highly specialised treatment in centres, implying a loss of quality in treatment. There is an urgent need for social discussion and resolution. Georg Thieme Verlag KG Stuttgart · New York.

Thermal Fatigue and Fracture Behavior of Ceramic Thermal Barrier Coatings

NASA Technical Reports Server (NTRS)

Zhu, Dong-Ming; Choi, Sung R.; Miller, Robert A.

2001-01-01

Thermal fatigue and fracture behavior of plasma-sprayed ceramic thermal barrier coatings has been investigated under high heat flux and thermal cyclic conditions. The coating crack propagation is studied under laser heat flux cyclic thermal loading, and is correlated with dynamic fatigue and strength test results. The coating stress response and inelasticity, fatigue and creep interactions, and interface damage mechanisms during dynamic thermal fatigue processes are emphasized.

How microfracture roughness can be used to distinguish between exhumed cracks and in-situ flow paths in shales

NASA Astrophysics Data System (ADS)

Pluymakers, Anne; Kobchenko, Maya; Renard, François

2017-01-01

Flow through fractures in shales is of importance to many geoengineering purposes. Shales are not only caprocks to hydrocarbon reservoirs and nuclear waste or CO2 storage sites, but also potential source and reservoir rocks for hydrocarbons. The presence of microfractures in shales controls their permeability and transport properties. Using X-ray micro-tomography and white light interferometry we scanned borehole samples obtained from 4 km depth in the Pomeranian shales in Poland. These samples contain open exhumation/drying cracks as well as intact vein-rock interfaces plus one striated slip surface. At micron resolution and above tensile drying cracks exhibit a power-law roughness with a scaling exponent, called the Hurst exponent H, of 0.3. At sub-micron resolution we capture the properties of the clay interface only, with H = 0.6. In contrast, the in-situ formed veins and slip surface exhibit H = 0.4-0.5, which is deemed representative for in-situ fractures. These results are discussed in relation to the shale microstructure and linear elastic fracture mechanics theory. The data imply that the Hurst roughness exponent can be used as a microstructural criterion to distinguish between exhumation and in-situ fractures, providing a step forward towards the characterization of potential flow paths at depth in shales.

Laser Welding-Brazing of Immiscible AZ31B Mg and Ti-6Al-4V Alloys Using an Electrodeposited Cu Interlayer

NASA Astrophysics Data System (ADS)

Zhang, Zequn; Tan, Caiwang; Wang, Gang; Chen, Bo; Song, Xiaoguo; Zhao, Hongyun; Li, Liqun; Feng, Jicai

2018-03-01

Metallurgical bonding between immiscible system AZ31B magnesium (Mg) and Ti-6Al-4V titanium (Ti) was achieved by adding Cu interlayer using laser welding-brazing process. Effect of the laser power on microstructure evolution and mechanical properties of Mg/Cu-coated Ti joints was studied. Visually acceptable joints were obtained at the range of 1300 to 1500 W. The brazed interface was divided into three parts due to temperature gradient: direct irradiation zone, intermediate zone and seam head zone. Ti3Al phase was produced along the interface at the direct irradiation zone. Ti-Al reaction layer grew slightly with the increase in laser power. A small amount of Ti2(Cu,Al) interfacial compounds formed at the intermediate zone and the ( α-Mg + Mg2Cu) eutectic structure dispersed in the fusion zone instead of gathering when increasing the laser power at this zone. At the seam head zone, Mg-Cu eutectic structure was produced in large quantities under all cases. Joint strength first increased and then decreased with the variation of the laser power. The maximum fracture load of Mg/Cu-coated Ti joint reached 2314 N at the laser power of 1300 W, representing 85.7% joint efficiency when compared with Mg base metal. All specimens fractured at the interface. The feature of fracture surface at the laser power of 1100 W was characterized by overall smooth surface. Obvious tear ridge and Ti3Al particles were observed at the fracture surface with increase in laser power. It suggested atomic diffusion was accelerated with more heat input giving rise to the enhanced interfacial reaction and metallurgical bonding in direct irradiation zone, which determined the mechanical properties of the joint.

Experimental study of interfacial fracture toughness in a SiN(x)/PMMA barrier film.

PubMed

Kim, Yongjin; Bulusu, Anuradha; Giordano, Anthony J; Marder, Seth R; Dauskardt, Reinhold; Graham, Samuel

2012-12-01

Organic/inorganic multilayer barrier films play an important role in the semihermetic packaging of organic electronic devices. With the rise in use of flexible organic electronics, there exists the potential for mechanical failure due to the loss of adhesion/cohesion when exposed to harsh environmental operating conditions. Although barrier performance has been the predominant metric for evaluating these encapsulation films, interfacial adhesion between the organic/inorganic barrier films and factors that influence their mechanical strength and reliability has received little attention. In this work, we present the interfacial fracture toughness of a model organic/inorganic multilayer barrier (SiN(x)-PMMA). Data from four point bending (FPB) tests showed that adhesive failure occurred between the SiN(x) and PMMA, and that the adhesion increased from 4.8 to 10 J/m(2) by using a variety of chemical treatments to vary the surface energy at the interface. Moreover, the adhesion strength increased to 28 J/m(2) by creating strong covalent bonds at the interface. Overall, three factors were found to have the greatest impact on the interfacial fracture toughness which were (a) increasing the polar component of the surface energy, (b) creating strong covalent bonds at the organic/inorganic interface, and (c) by increasing the plastic zone size at the crack tip by increasing the thickness of the PMMA layer.

Comminution of solids caused by kinetic energy of high shear strain rate, with implications for impact, shock, and shale fracturing

PubMed Central

Bažant, Zdeněk P.; Caner, Ferhun C.

2013-01-01

Although there exists a vast literature on the dynamic comminution or fragmentation of rocks, concrete, metals, and ceramics, none of the known models suffices for macroscopic dynamic finite element analysis. This paper outlines the basic idea of the macroscopic model. Unlike static fracture, in which the driving force is the release of strain energy, here the essential idea is that the driving force of comminution under high-rate compression is the release of the local kinetic energy of shear strain rate. The density of this energy at strain rates >1,000/s is found to exceed the maximum possible strain energy density by orders of magnitude, making the strain energy irrelevant. It is shown that particle size is proportional to the −2/3 power of the shear strain rate and the 2/3 power of the interface fracture energy or interface shear stress, and that the comminution process is macroscopically equivalent to an apparent shear viscosity that is proportional (at constant interface stress) to the −1/3 power of this rate. A dimensionless indicator of the comminution intensity is formulated. The theory was inspired by noting that the local kinetic energy of shear strain rate plays a role analogous to the local kinetic energy of eddies in turbulent flow. PMID:24218624

Phase field model of fluid-driven fracture in elastic media: Immersed-fracture formulation and validation with analytical solutions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santillán, David; Juanes, Ruben; Cueto-Felgueroso, Luis

Propagation of fluid-driven fractures plays an important role in natural and engineering processes, including transport of magma in the lithosphere, geologic sequestration of carbon dioxide, and oil and gas recovery from low-permeability formations, among many others. The simulation of fracture propagation poses a computational challenge as a result of the complex physics of fracture and the need to capture disparate length scales. Phase field models represent fractures as a diffuse interface and enjoy the advantage that fracture nucleation, propagation, branching, or twisting can be simulated without ad hoc computational strategies like remeshing or local enrichment of the solution space. Heremore » we propose a new quasi-static phase field formulation for modeling fluid-driven fracturing in elastic media at small strains. The approach fully couples the fluid flow in the fracture (described via the Reynolds lubrication approximation) and the deformation of the surrounding medium. The flow is solved on a lower dimensionality mesh immersed in the elastic medium. This approach leads to accurate coupling of both physics. We assessed the performance of the model extensively by comparing results for the evolution of fracture length, aperture, and fracture fluid pressure against analytical solutions under different fracture propagation regimes. Thus, the excellent performance of the numerical model in all regimes builds confidence in the applicability of phase field approaches to simulate fluid-driven fracture.« less

Phase field model of fluid-driven fracture in elastic media: Immersed-fracture formulation and validation with analytical solutions

DOE PAGES

Santillán, David; Juanes, Ruben; Cueto-Felgueroso, Luis

2017-04-20

Propagation of fluid-driven fractures plays an important role in natural and engineering processes, including transport of magma in the lithosphere, geologic sequestration of carbon dioxide, and oil and gas recovery from low-permeability formations, among many others. The simulation of fracture propagation poses a computational challenge as a result of the complex physics of fracture and the need to capture disparate length scales. Phase field models represent fractures as a diffuse interface and enjoy the advantage that fracture nucleation, propagation, branching, or twisting can be simulated without ad hoc computational strategies like remeshing or local enrichment of the solution space. Heremore » we propose a new quasi-static phase field formulation for modeling fluid-driven fracturing in elastic media at small strains. The approach fully couples the fluid flow in the fracture (described via the Reynolds lubrication approximation) and the deformation of the surrounding medium. The flow is solved on a lower dimensionality mesh immersed in the elastic medium. This approach leads to accurate coupling of both physics. We assessed the performance of the model extensively by comparing results for the evolution of fracture length, aperture, and fracture fluid pressure against analytical solutions under different fracture propagation regimes. Thus, the excellent performance of the numerical model in all regimes builds confidence in the applicability of phase field approaches to simulate fluid-driven fracture.« less

Fracture behavior of 20% Nb particulate reinforced alumina composite

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lane, S.; Biner, S.B.; Buck, O.

1993-11-01

The composites consist of alumina matrix with 0.05 wt % MgO and 20 Vol % Nb with an average particle size of 30 to 100 microns produced by dry mixing and sintering to near their theoretical densities. Fracture toughness tests were carried out in three point bending on chevron notched samples. Results indicate that R-curve of the composites exhibited more than 300% increase in crack growth resistance compared to crack growth resistance of alumina produced with the identical procedures. Crack growth resistance curve of the composites increased with increasing Nb particle size. Metallorgraph indicated that failure of Nb particles inmore » crack path ranges from full interface separation without any significant deformation of Nb particles to cleavage failure without any evidence of interface separation.« less

The Inhibition of Escherichia coli Biofilm Formation by Gallium Nitrate-Modified Titanium.

PubMed

Zhu, Yuanyuan; Qiu, Yan; Chen, Ruiqi; Liao, Lianming

2015-08-01

Periprosthetic infections are notoriously difficult to treat due to biofilm formation. Previously, we reported that gallium-EDTA attached to PVC (polyvinyl chloride) surface could prevent bacterial colonization. Herein we examined the effect of this gallium-EDTA complex on Escherichia coli biofilm formation on titanium. It was clearly demonstrated that gallium nitrate significantly inhibited the growth and auto-aggregation of Escherichia coli. Furthermore, titanium with gallium-EDTA coating resisted bacterial colonization as indicated by crystal violet staining. When the chips were immersed in human serum and incubated at 37 °C, they demonstrated significant antimicrobial activity after more than 28 days of incubation. These findings indicate that gallium-EDTA coating of implants can result in a surface that can resist bacterial colonization. This technology holds great promise for the prevention and treatment of periprosthetic infections.

Intraoperative Considerations for Treatment/Prevention of Prosthetic Joint Infection.

PubMed

Suleiman, Linda I; Mesko, Daniel R; Nam, Denis

2018-06-23

Innovative measures have recently been proposed to prevent periprosthetic joint infection following total hip and knee arthroplasty. We sought to review these recent innovations to determine the reported reduction in periprosthetic joint infection. The most recent literature demonstrates promising results in regard to hydrofiber dressings as an independent risk factor for primary prosthetic joint infection reduction, which in turn is also linked with cost savings. As our understanding of safe yet effective concentrations of antiseptic solutions develops, dilute betadine in particular has demonstrated encouraging efficacy which warrants continued investigation through controlled trials. In summary, we found that the application of a hydrofiber dressing may prove beneficial in decreasing the risk of prosthetic joint infection following primary total hip and knee arthroplasty. The gold standard for an infection prevention protocol continues to be explored and optimized.

Environmental consequences of shale gas exploitation and the crucial role of rock microfracturing

NASA Astrophysics Data System (ADS)

Renard, Francois

2015-04-01

The growing exploitation of unconventional gas and oil resources has dramatically changed the international market of hydrocarbons in the past ten years. However, several environmental concerns have also been identified such as the increased microseismicity, the leakage of gas into freshwater aquifers, and the enhanced water-rock interactions inducing the release of heavy metals and other toxic elements in the produced water. In all these processes, fluids are transported into a network of fracture, ranging from nanoscale microcracks at the interface between minerals and the kerogen of the source rock, to well-developed fractures at the meter scale. Characterizing the fracture network and the mechanisms of its formation remains a crucial goal. A major difficulty when analyzing fractures from core samples drilled at depth is that some of them are produced by the coring process, while some other are produced naturally at depth by the coupling between geochemical and mechanical forces. Here, I present new results of high resolution synchrotron 3D X-ray microtomography imaging of shale samples, at different resolutions, to characterize their microfractures and their mechanisms of formation. The heterogeneities of rock microstructure are also imaged, as they create local stress concentrations where cracks may nucleate or along which they propagate. The main results are that microcracks form preferentially along kerogen-mineral interfaces and propagate along initial heterogeneities according to the local stress direction, connecting to increase the total volume of fractured rock. Their lifetime is also an important parameter because they may seal by fluid circulation, fluid-rock interactions, and precipitation of a cement. Understanding the multi-scale processes of fracture network development in shales and the coupling with fluid circulation represents a key challenge for future research directions.

Fracture and crack growth in orthotropic laminates

NASA Technical Reports Server (NTRS)

Goree, James G.; Kaw, Autar K.

1985-01-01

A mathematical model based on the classical shear-lag assumptions is used to study the residual strength and fracture behavior of composite laminates with symmetrically placed buffer strips. The laminate is loaded by a uniform remote longitudinal tensile strain and has initial damage in the form of a transverse crack in the parent laminate between buffer strips. The crack growth behavior as a function of material properties, number of buffer-strip plies, spacing, width of buffer strips, longitudinal matrix splitting, and debonding at the interface is studied. Buffer-strip laminates are shown to arrest fracture and increase the residual strengths significantly over those of one material laminates, with S-glass being a more effective buffer strip material than Kevlar in increasing the damage tolerance of graphite/epoxy panels. For a typical graphite/epoxy laminate with S-glass buffer-strips, the residual strength is about 2.4 times the residual strength of an all graphite/epoxy panel with the same crack length. Approximately 50% of this increase is due to the S-glass/epoxy buffer-strips, 40% due to longitudinal splitting of the buffer strip interface and 10% due to bonding.

Effects of H content on the tensile properties and fracture behavior of SA508-III steel

NASA Astrophysics Data System (ADS)

Liu, Jia-hua; Wang, Lei; Liu, Yang; Song, Xiu; Luo, Jiong; Yuan, Dan

2015-08-01

SA508-III steel was charged with different hydrogen (H) contents using a high-pressure thermal charging method to study the effects of H content on the tensile properties and evaluate the H embrittlement behavior of the steel. The results indicate that the ultimate tensile strength remains nearly unchanged with the addition of H. In contrast, the yielding strength slightly increases, and the elongation significantly decreases with increasing H content, especially at concentrations exceeding 5.6 × 10-6. On the basis of fractographic analysis, it is clear that the addition of H changes the fracture mode from microvoid coalescence to a mixture of river patterns and dimples. Carbides are strong traps for H; thus, the H atoms easily migrate in the form of Cottrell atmosphere toward the carbides following moving dislocations during tensile deformation. In addition, stress-induced H atoms accumulate at the interface between carbides and the matrix after necking under three-dimensional stress, which weakens the interfacial bonding force. Consequently, when the local H concentration reaches a critical value, microcracks occur at the interface, resulting in fracture.

DOE Office of Scientific and Technical Information (OSTI.GOV)

J. Zhou; H. Huang; M. Deo

Log and seismic data indicate that most shale formations have strong heterogeneity. Conventional analytical and semi-analytical fracture models are not enough to simulate the complex fracture propagation in these highly heterogeneous formation. Without considering the intrinsic heterogeneity, predicted morphology of hydraulic fracture may be biased and misleading in optimizing the completion strategy. In this paper, a fully coupling fluid flow and geomechanics hydraulic fracture simulator based on dual-lattice Discrete Element Method (DEM) is used to predict the hydraulic fracture propagation in heterogeneous reservoir. The heterogeneity of rock is simulated by assigning different material force constant and critical strain to differentmore » particles and is adjusted by conditioning to the measured data and observed geological features. Based on proposed model, the effects of heterogeneity at different scale on micromechanical behavior and induced macroscopic fractures are examined. From the numerical results, the microcrack will be more inclined to form at the grain weaker interface. The conventional simulator with homogeneous assumption is not applicable for highly heterogeneous shale formation.« less

TRITIUM AND DECAY HELIUM EFFECTS ON THE FRACTURE TOUGHNESS PROPERTIES OF STAINLESS STEEL WELDMENTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morgan, M; Scott West, S; Michael Tosten, M

2007-08-31

J-Integral fracture toughness tests were conducted on tritium-exposed-and-aged Types 304L and 21-6-9 stainless steel weldments in order to measure the combined effects of tritium and its decay product, helium-3 on the fracture toughness properties. Initially, weldments have fracture toughness values about three times higher than base-metal values. Delta-ferrite phase in the weld microstructure improved toughness provided no tritium was present in the microstructure. After a tritium-exposure-and-aging treatment that resulted in {approx}1400 atomic parts per million (appm) dissolved tritium, both weldments and base metals had their fracture toughness values reduced to about the same level. The tritium effect was greater inmore » weldments (67 % reduction vs. 37% reduction) largely because the ductile discontinuous delta-ferrite interfaces were embrittled by tritium and decay helium. Fracture toughness values decreased for both base metals and weldments with increasing decay helium content in the range tested (50-200 appm).« less

An interface finite element model can be used to predict healing outcome of bone fractures.

PubMed

Alierta, J A; Pérez, M A; García-Aznar, J M

2014-01-01

After fractures, bone can experience different potential outcomes: successful bone consolidation, non-union and bone failure. Although, there are a lot of factors that influence fracture healing, experimental studies have shown that the interfragmentary movement (IFM) is one of the main regulators for the course of bone healing. In this sense, computational models may help to improve the development of mechanical-based treatments for bone fracture healing. Hence, based on this fact, we propose a combined repair-failure mechanistic computational model to describe bone fracture healing. Despite being a simple model, it is able to correctly estimate the time course evolution of the IFM compared to in vivo measurements under different mechanical conditions. Therefore, this mathematical approach is especially suitable for modeling the healing response of bone to fractures treated with different mechanical fixators, simulating realistic clinical conditions. This model will be a useful tool to identify factors and define targets for patient specific therapeutics interventions. © 2013 Published by Elsevier Ltd.

Interfacial Studies of Chemical Vapor Infiltrated (CVI) Ceramic Matrix Composites

DTIC Science & Technology

1988-10-01

carbon layer exists at the fiber/matrix interface. From Fig. 6, it can also be seen that a small amount of Cl exists at the interface and in the CVD SiC...matrix interface, most of which stayed on the fiber surface upon fracture. A small amount of oxygen (3-5 at*/) was found to be present in the CVI SiC. The... small amount of oxygen (1-2%). The results of MTS precursor coatings applied to Nextel 440 and Nicalon fibers preceded by an argon flush of the reactor

Interfacial Microstructure and Mechanical Strength of 93W/Ta Diffusion-Bonded Joints with Ni Interlayer

NASA Astrophysics Data System (ADS)

Luo, Guoqiang; Zhang, Jian; Li, Meijuan; Wei, Qinqin; Shen, Qiang; Zhang, Lianmeng

2013-02-01

93W alloy and Ta metal were successfully diffusion bonded using a Ni interlayer. Ni4W was found at the W-Ni interface, and Ni3Ta and Ni2Ta were formed at the Ni-Ta interface. The shear strength of the joints increases with increasing holding time, reaching a value of 202 MPa for a joint prepared using a 90-minute holding time at 1103 K (830 °C) and 20 MPa. The fracture of this joint occurred within the Ni/Ta interface.

Establishing Multiscale Models for Simulating Whole Limb Estimates of Electric Fields for Osseointegrated Implants

PubMed Central

Isaacson, Brad M.; Stinstra, Jeroen G.; Bloebaum, Roy D.; Pasquina, COL Paul F.; MacLeod, Rob S.

2011-01-01

Although the survival rates of warfighters in recent conflicts are among the highest in military history, those who have sustained proximal limb amputations, may pose additional rehabilitation concerns. In some of these cases, traditional prosthetic limbs may not provide adequate function for returning to an active lifestyle. Osseointegration has emerged as a potential prosthetic alternative for those with limited residual limb length. Using this technology, direct skeletal attachment occurs between a transcutaneous osseointegrated implant (TOI) and the host bone, thereby eliminating the need for a socket. While reports from the first 100 patients with a TOI have been promising, some rehabilitation regimens require 12–18 months of restricted weight bearing to prevent overloading at the bone implant-interface. Electrically induced osseointegration has been proposed as an option for expediting periprosthetic fixation and preliminary studies have demonstrated the feasibility of adapting the TOI into a functional cathode. To assure safe and effective electrical fields that are conducive for osseoinduction and osseointegration, we have developed multiscale modeling approaches to simulate the expected electric metrics at the bone-implant interface. We have used computed tomography scans and volume segmentation tools to create anatomically accurate models that clearly distinguish tissue parameters and serve as the basis for finite element analysis. This translational computational biological process has supported biomedical electrode design, implant placement, and experiments to date have demonstrated the clinical feasibility of electrically induced osseointegration. PMID:21712151

Development of a new software for analyzing 3-D fracture network

NASA Astrophysics Data System (ADS)

Um, Jeong-Gi; Noh, Young-Hwan; Choi, Yosoon

2014-05-01

A new software is presented to analyze fracture network in 3-D. Recently, we completed the software package based on information given in EGU2013. The software consists of several modules that play roles in management of borehole data, stochastic modelling of fracture network, construction of analysis domain, visualization of fracture geometry in 3-D, calculation of equivalent pipes and production of cross-section diagrams. Intel Parallel Studio XE 2013, Visual Studio.NET 2010 and the open source VTK library were utilized as development tools to efficiently implement the modules and the graphical user interface of the software. A case study was performed to analyze 3-D fracture network system at the Upper Devonian Grosmont Formation in Alberta, Canada. The results have suggested that the developed software is effective in modelling and visualizing 3-D fracture network system, and can provide useful information to tackle the geomechanical problems related to strength, deformability and hydraulic behaviours of the fractured rock masses. This presentation describes the concept and details of the development and implementation of the software.

Dissolution-precipitation reactions and permeability evolution from reactions of CO2-rich aqueous solutions with fractured basalt

NASA Astrophysics Data System (ADS)

Wells, R. K.; Xiong, W.; Bae, Y.; Sesti, E.; Skemer, P. A.; Giammar, D.; Conradi, M.; Ellis, B. R.; Hayes, S. E.

2015-12-01

The injection of CO2 into fractured basalts is one of several possible solutions to mitigate global climate change; however, research on carbonation in natural basalts in relation to carbon sequestration is limited, which impedes our understanding of the processes that may influence the viability of this strategy. We are conducting bench-scale experiments to characterize the mineral dissolution and precipitation and the evolution of permeability in synthetic and natural basalts exposed to CO2-rich fluids. Analytical methods include optical and electron microscopy, electron microprobe, Raman spectroscopy, nuclear magnetic resonance (NMR), and micro X-ray computed tomography (μCT) with variable flow rates. Reactive rock and mineral samples consist of 1) packed powders of olivine or natural basalt, and 2) sintered cores of olivine or a synthetic basalt mixture. Each sample was reacted in a batch reactor at 100 °C, and 100 bars CO2. Magnesite is detected within one day in olivine packed beds, and within 15 days in olivine sintered cores. Forsterite and synthetic basalt sinters were also reacted in an NMR apparatus at 102 °C and 65 bars CO2. Carbonate signatures are observed within 72 days of reaction. Longer reaction times are needed for carbonate precipitation in natural basalt samples. Cores from the Columbia River flood basalt flows that contain Mg-rich olivine and a serpentinized basalt from Colorado were cut lengthwise, the interface mechanically roughened or milled, and edges sealed with epoxy to simulate a fractured interface. The cores were reacted in a batch reactor at 50-150 °C and 100 bars CO2. At lower temperatures, calcite precipitation is rare within the fracture after 4 weeks. At higher temperatures, numerous calcite and aragonite crystals are observed within 1 mm of the fracture entrance along the roughened fracture surface. In flow-through experiments, permeability decreased along the fracture paths within a few hours to several days of flow.

Investigation on fracture behavior and mechanisms of DGEBF toughened by CTBN

NASA Astrophysics Data System (ADS)

Wang, Lulu; Tan, Yefa; Wang, Haitao; Gao, Li; Xiao, Chufan

2018-05-01

Carboxyl-terminated butadiene-co-acrylonitrile (CTBN) was used as the toughener to improve the mechanical performance and fracture toughness of diglycidyl ether of bisphenol F (DGEBF) by prereacted approach. The results show that the chemical bonding interface was formed between DGEBF and CTBN particles in the prepolymerization reaction process, which remarkably enhances the fracture toughness of the composites. Based on the qualitative and quantitative analyses, it shows the main toughening mechanisms are the plastic shear banding effect resulted from the plastic deformation of the EP matrix and the plastic void expansion because of the debonding of CTBN particles from the EP matrix.

Kinetics of bed fracturing around mine workings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veksler, Yu.A.

1988-03-01

A failure of the bed near the walls of the workings of a mine away from the face occurs gradually over time and in this paper the authors take a kinetic approach to evaluating its development. The influence of certain mine engineering factors on the pattern of bed fracturing is discussed. The effect of the depth of mining is shown. Cracking occurs in the portion of the seam at the face near the ground at some distance from it on the interface between soft and hard coal. The density of the fractured rocks and their response affect the bed fracturingmore » near the stope face.« less

Experimental and numerical study on the strength of all-ceramic crowns

NASA Astrophysics Data System (ADS)

Lu, Chenglin; Zhang, Xiuyin; Zhang, Dongsheng

2008-11-01

Two types of sectioned tooth-like ceramic crowns (IPS Empress 2) were prepared along lingual-facial direction and the fracture process of crowns under contact load was directly monitored with the use of imaging system. The displacement filed resulted from digital image correlation indicate that the fracture mode of real crown is more complicated while the flat crown has the same rupture mode as described by other investigators. Meanwhile numerical simulation was also carried out to support the experiments. Stress distributions in individual layer and interface were presented. Results indicate that the presented experimental and numerical methods are efficient in studying the fracture mechanism of all-ceramic crowns.

Anisotropic Tribological Properties of Silicon Carbide

NASA Technical Reports Server (NTRS)

Miyoshi, K.; Buckley, D. H.

1980-01-01

The anisotropic friction, deformation and fracture behavior of single crystal silicon carbide surfaces were investigated in two categories. The categories were called adhesive and abrasive wear processes, respectively. In the adhesive wear process, the adhesion, friction and wear of silicon carbide were markedly dependent on crystallographic orientation. The force to reestablish the shearing fracture of adhesive bond at the interface between silicon carbide and metal was the lowest in the preferred orientation of silicon carbide slip system. The fracturing of silicon carbide occurred near the adhesive bond to metal and it was due to primary cleavages of both prismatic (10(-1)0) and basal (0001) planes.

Fracture propagation through a layered shale and limestone sequence at Nash Point, South Wales: Implications on the development of fracture networks in layered sequences

NASA Astrophysics Data System (ADS)

Forbes Inskip, N.; Meredith, P. G.; Gudmundsson, A.

2017-12-01

While considerable effort has been expended on the study of fracture propagation in rocks in recent years, our understanding of how fractures propagate through sedimentary rocks composed of layers with different mechanical and elastic properties remains poor. Yet the mechanical layering is a key parameter controlling the propagation of fractures in sedimentary sequences. Here we report measurements of the contrasting properties of the Lower Lias at Nash Point, South Wales, which comprises a sequence of interbedded shale and limestone layers, and how those properties influence fracture propagation. The static Young's modulus (Estat) of both rock types has been measured parallel and normal to bedding. The shale is highly anisotropic, with Estat varying from 2.4 GPa, in the bedding-normal orientation, to 7.9 GPa, in the bedding-parallel orientation, yielding an anisotropy of 107%. By contrast the limestone has a very low anisotropy of 8%, with Estat values varying from 28.5 GPa, in the bedding-normal orientation, to 26.3 GPa in the bedding-parallel orientation. It follows that for a vertical fracture propagating in this sequence the modulus contrast is by a factor of about 12. This is important because the contrast in elastic properties is a key factor in controlling whether fractures arrest, deflect, or propagate across interfaces between layers in a sequence. Preliminary numerical modelling results (using a finite element modelling software) of induced fractures at Nash Point demonstrate a rotation of the maximum principal compressive stress across interfaces but also the concentration of tensile stress within the more competent (high Estat) limestone layers. The tensile strength (σT), using the Brazil-disk technique, and fracture toughness (KIc), using the semi-circular bend methodology, of both rock types have been measured. Measurements were made in the three principal orientations relative to bedding, Arrester, Divider, and Short-Transverse, and also at 15° intervals between these planes. Again, values for the shale show a high degree of anisotropy; with similar values in the Arrester and Divider orientations, but much lower values in the Short-Transverse orientation. σT and KIc values for the limestone are considerably higher than those for the shale and exhibit no significant anisotropy.

Compositional Reservoir Simulation of Highly Heterogeneous and Anisotropic Fractured Media in 2D and 3D Unstructured Gridding

NASA Astrophysics Data System (ADS)

Zidane, A.; Firoozabadi, A.

2017-12-01

We present an efficient and accurate numerical model for multicomponent compressible single-phase flow in 2D and 3D fractured media based on higher-order discretization. The numerical model accounts for heterogeneity and anisotropy in unstructured gridding with low mesh dependency. The efficiency of our model is demonstrated by having comparable CPU time between fractured and unfractured media. The fracture cross-flow equilibrium approach (FCFE) is applied on triangular finite elements (FE) in 2D. This allows simulating fractured reservoirs with all possible orientations of fractures as opposed to rectangular FE. In 3D we apply the FCFE approach on the prism FE. The prism FE with FCFE allows simulating realistic fractured domains compared to hexahedron FE. In addition, when using FCFE on triangular and prism FE there is no limitation on the number of intersecting fractures, whereas in rectangular and hexahedron FE the number is limited to 2 in 2D and 3 in 3D. To generate domains with complicated boundaries, we have developed a computer-aided design (CAD) interface in our model. The advances introduced in this work are demonstrated through various examples.

Electrohydrodynamic controlled assembly and fracturing of thin colloidal particle films confined at drop interfaces

NASA Astrophysics Data System (ADS)

Rozynek, Z.; Dommersnes, P.; Mikkelsen, A.; Michels, L.; Fossum, J. O.

2014-09-01

Particles can adsorb strongly at liquid interfaces due to capillary forces, which in practice can confine the particles to the interface. Here we investigate the electrohydrodynamic flow driven packing and deformation of colloidal particle layers confined at the surface of liquid drops. The electrohydrodynamic flow has a stagnation point at the drop equator, leading to assembly of particles in a ribbon shaped film. The flow is entirely controlled by the electric field, and we demonstrate that AC fields can be used to induce hydrodynamic "shaking" of the colloidal particle film. We find that the mechanical properties of the film is highly dependent on the particles: monodisperse polystyrene beads form packed granular monolayers which "liquefies" upon shaking, whereas clay mineral particles form cohesive films that fracture upon shaking. The results are expected to be relevant for understanding the mechanics and rheology of particle stabilized emulsions. Supplementary material in the form of a pdf file available from the Journal web page at http://dx.doi.org/10.1140/epjst/e2014-02231-x

Evaluation of Encapsulant Adhesion to Surface Metallization of Photovoltaic Cells: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tracy, Jared; Dauskardt, Reinhold; Bosco, Nick

Delamination of encapsulant materials from PV cell surfaces often appears to originate at regions with metallization. Using a fracture mechanics based metrology, the adhesion of EVA encapsulant to screen printed silver metallization was evaluated. At room temperature, the fracture energy, Gc [J/m2], of the EVA/silver interface (952 J/m2) was ~70% lower than that of the EVA/AR coating (>2900 J/m2) and ~60% lower than that of the EVA to the surface of cell (2265 J/m2). After only 300 hours of damp heat aging, the adhesion energy of the silver interface dropped to and plateaued at ~50-60 J/m2, while that of themore » EVA/AR coating and EVA/cell remained mostly unchanged. Elemental surface analysis showed that the EVA separates from the silver in a purely adhesive manner, indicating that bonds at the interface were likely displaced in the presence of humidity and elevated temperature, and may explain the propensity for delamination to occur at metallized surfaces in the field.« less

Encapsulant Adhesion to Surface Metallization on Photovoltaic Cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tracy, Jared; Bosco, Nick; Dauskardt, Reinhold

Delamination of encapsulant materials from PV cell surfaces often appears to originate at regions with metallization. Using a fracture mechanics based metrology, the adhesion of ethylene vinyl acetate (EVA) encapsulant to screen-printed silver metallization was evaluated. At room temperature, the fracture energy Gc [J/m2] of the EVA/silver interface (952 J/m2) was ~70% lower than that of the EVA/antireflective (AR) coating (>2900 J/m2) and ~60% lower than that of the EVA to the surface of cell (2265 J/m2). After only 300 h of damp heat aging, the adhesion energy of the silver interface dropped to and plateaued at ~50-60 J/m2 whilemore » that of the EVA/AR coating and EVA/cell remained mostly unchanged. Elemental surface analysis showed that the EVA separates from the silver in a purely adhesive manner, indicating that bonds at the interface were likely displaced in the presence of humidity and chemical byproducts at elevated temperature, which in part accounts for the propensity of metalized surfaces to delaminate in the field.« less

Fracture Mechanics Analyses for Interface Crack Problems - A Review

NASA Technical Reports Server (NTRS)

Krueger, Ronald; Shivakumar, Kunigal; Raju, Ivatury S.

2013-01-01

Recent developments in fracture mechanics analyses of the interfacial crack problem are reviewed. The intent of the review is to renew the awareness of the oscillatory singularity at the crack tip of a bimaterial interface and the problems that occur when calculating mode mixity using numerical methods such as the finite element method in conjunction with the virtual crack closure technique. Established approaches to overcome the nonconvergence issue of the individual mode strain energy release rates are reviewed. In the recent literature many attempts to overcome the nonconvergence issue have been developed. Among the many approaches found only a few methods hold the promise of providing practical solutions. These are the resin interlayer method, the method that chooses the crack tip element size greater than the oscillation zone, the crack tip element method that is based on plate theory and the crack surface displacement extrapolation method. Each of the methods is validated on a very limited set of simple interface crack problems. However, their utility for a wide range of interfacial crack problems is yet to be established.

Fracture and Failure at and Near Interfaces Under Pressure

DTIC Science & Technology

1998-06-18

realistic data for comparison with improved analytical results, and to 2) initiate a new computational approach for stress analysis of cracks at and near...new computational approach for stress analysis of cracks in solid propellants at and near interfaces, which analysis can draw on the ever expanding...tactical and strategic missile systems. The most important and most difficult component of the system analysis has been the predictability or

[The use of structural proximal tibial allografts coated with human albumin in treating extensive periprosthetic knee-joint bone deficiency and averting late complications. Case report].

PubMed

Klára, Tamás; Csönge, Lajos; Janositz, Gábor; Pap, Károly; Lacza, Zsombor

2015-01-11

The authors report the history of a 74-year-old patient who underwent surgical treatment for segmental knee-joint periprosthetic bone loss using structural proximal tibial allografts coated with serum albumin. Successful treatment of late complications which occurred in the postoperative period is also described. The authors emphasize that bone replacement with allografts is a physiological process that enables the stable positioning of the implant and the reconstruction of the soft tissues, the replacement of extensive bone loss, and also it is a less expensive operation. It has been already confirmed that treatment of lyophilised allografts with albumin improves the ability of bone marrow-derived mesenchymal stem cells to adhere and proliferate the surface of the allografts, penetrate the pores and reach deeper layers of the graft. Earlier studies have shown osteoblast activity on the surface and interior of the graft.

Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

PubMed

Bosco, Joseph; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett

2016-01-01

Infection is a rare, serious complication after total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research.

Forced-Air Warming Discontinued: Periprosthetic Joint Infection Rates Drop.

PubMed

Augustine, Scott D

2017-06-23

Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals. Surgical and antibiotic protocols were held constant. The pooled multicenter data showed a decreased PJI rate of 78% following the discontinuation of FAW and a switch to air-free CFW (n=2034; P=0.002). The 78% reduction in joint implant infections observed when FAW was discontinued suggests that there is a link between the waste FAW heat and PJIs.

Forced-Air Warming Discontinued: Periprosthetic Joint Infection Rates Drop

PubMed Central

Augustine, Scott D.

2017-01-01

Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals. Surgical and antibiotic protocols were held constant. The pooled multicenter data showed a decreased PJI rate of 78% following the discontinuation of FAW and a switch to air-free CFW (n=2034; P=0.002). The 78% reduction in joint implant infections observed when FAW was discontinued suggests that there is a link between the waste FAW heat and PJIs. PMID:28713524

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection.

PubMed

Levack, Ashley E; Cyphert, Erika L; Bostrom, Mathias P; Hernandez, Christopher J; von Recum, Horst A; Carli, Alberto V

2018-04-30

Infection in the setting of total joint arthroplasty, referred to as periprosthetic joint infection (PJI), is a devastating complication requiring prolonged and costly treatment. The unique environment around an artificial joint and ability of surrounding tissues to sequester bacteria collectively make prevention, diagnosis, and treatment of this condition challenging. In light of the unique pathogenesis of PJI, this review explores the limitations of contemporary treatments and discusses novel treatment options. Recent advancements in local antibiotic delivery platforms for preventing and treating PJI include titanium nanotube arrays, synthetic polymers, resorbable hydrogels, and cyclodextrin-based drug delivery options. In particular, cyclodextrins have facilitated great advancements in other clinical disorders and have demonstrated early promise as a future option in the arena of PJI. Novel treatment modalities for PJI optimize the implant surfaces to prevent bacterial biofilm formation or provide prolonged intra-articular antibiotic dosing to eradicate bacteria.

Morphological characterization of dental prostheses interfaces using optical coherence tomography

NASA Astrophysics Data System (ADS)

Sinescu, Cosmin; Negrutiu, Meda L.; Ionita, Ciprian; Marsavina, Liviu; Negru, Radu; Caplescu, Cristiana; Bradu, Adrian; Topala, Florin; Rominu, Roxana O.; Petrescu, Emanuela; Leretter, Marius; Rominu, Mihai; Podoleanu, Adrian G.

2010-03-01

Fixed partial prostheses as integral ceramic, polymers, metal-ceramic or metal-polymers bridges are mainly used in the frontal part of the dental arch (especially the integral bridges). They have to satisfy high stress as well as esthetic requirements. The masticatory stress may induce fractures of the bridges. These may be triggered by initial materials defects or by alterations of the technological process. The fractures of these bridges lead to functional, esthetic and phonetic disturbances which finally render the prosthetic treatment inefficient. Dental interfaces represent one of the most significant aspects in the strength of the dental prostheses under the masticatory load. The purpose of this study is to evaluate the capability of optical coherence tomography (OCT) to characterize the dental prostheses interfaces. The materials used were several fixed partial prostheses integral ceramic, polymers, metal-ceramic and metal-polymers bridges. It is important to produce both C-scans and B-scans of the defects in order to differentiate morphological aspects of the bridge infrastructures. The material defects observed with OCT were investigated with micro-CT in order to prove their existence and positions. In conclusion, it is important to have a non invasive method to investigate dental prostheses interfaces before the insertion of prostheses in the oral cavity.

Dynamic fracture and hot-spot modeling in energetic composites

NASA Astrophysics Data System (ADS)

Grilli, Nicolò; Duarte, Camilo A.; Koslowski, Marisol

2018-02-01

Defects such as cracks, pores, and particle-matrix interface debonding affect the sensitivity of energetic materials by reducing the time-to-ignition and the threshold pressure to initiate an explosion. Frictional sliding of preexisting cracks is considered to be one of the most important causes of localized heating. Therefore, understanding the dynamic fracture of crystalline energetic materials is of extreme importance to assess the reliability and safety of polymer-bonded explosives. Phase field damage model simulations, based on the regularization of the crack surface as a diffuse delta function, are used to describe crack propagation in cyclotetramethylene-tetranitramine crystals embedded in a Sylgard matrix. A thermal transport model that includes heat generation by friction at crack interfaces is coupled to the solution of crack propagation. 2D and 3D dynamic compression simulations are performed with different boundary velocities and initial distributions of cracks and interface defects to understand their effect on crack propagation and heat generation. It is found that, at an impact velocity of 400 m/s, localized damage at the particle-binder interface is of key importance and that the sample reaches temperatures high enough to create a hot-spot that will lead to ignition. At an impact velocity of 10 m/s, preexisting cracks advanced inside the particle, but the increase of temperature will not cause ignition.

HIV and Bone Metabolism

PubMed Central

Ofotokun, Ighovwerha; Weitzmann, M. Neale

2013-01-01

The skeleton is an organ whose integrity is maintained by constant lifelong renewal involving coordinated removal of worn bone by osteoclasts and resynthesis of new bone by osteoblasts. In young adult humans and animals this process is homeostatic with no net gain or loss of bone mass. With natural aging and exacerbated by numerous pathological conditions, bone removal exceeds bone formation, disrupting homeostasis and resulting in bone loss. Over time, skeletal decline reaches clinical significance with development of osteopenia and eventually osteoporosis, conditions that dramatically increase bone fragility and the risk of fracture. Bone fractures can be devastating with significant morbidity and mortality. Over the last decade, it has become clear that skeletal renewal is strongly influenced by the immune system, a consequence of deep integration and centralization of common cell types and cytokine mediators, which we have termed the “immuno-skeletal interface.” Consequently, dysregulated skeletal renewal and bone loss is a common feature of inflammatory conditions associated with immune activation. Interestingly, bone loss is also associated with conditions of immunodeficiency, including infection by the human immunodeficiency virus (HIV) that leads to acquired immunodeficiency syndrome (AIDS). Disruptions to the immuno-skeletal interface drive skeletal deterioration contributing to a high rate of bone fracture in HIV infection. This review examines current knowledge concerning the prevalence and etiology of skeletal complications in HIV infection, the effect of antiretroviral therapies (ART) on the skeleton, and how disruption of the immuno-skeletal interface may underlie bone loss in HIV infection and ART. PMID:21616037

Performance Evaluation and Durability Studies of Adhesive Bonds

NASA Astrophysics Data System (ADS)

Ranade, Shantanu Rajendra

In this thesis, four test approaches were developed to characterize the adhesion performance and durability of adhesive bonds for specific applications in areas spanning from structural adhesive joints to popular confectionaries such as chewing gum. In the first chapter, a double cantilever beam (DCB) specimen geometry is proposed for combinatorial fracture studies of structural adhesive bonds. This specimen geometry enabled the characterization of fracture energy vs. bondline thickness trends through fewer tests than those required during a conventional "one at a time" characterization approach, potentially offering a significant reduction in characterization times. The second chapter investigates the adhesive fracture resistance and crack path selection in adhesive joints containing patterns of discreet localized weak interfaces created using physical vapor deposition of copper. In a DCB specimen tested under mode-I conditions, fracture energy within the patterned regions scaled according to a simple rule of mixture, while reverse R-curve and R-curve type trends were observed in the regions surrounding weak interface patterns. Under mixed mode conditions such that bonding surface with patterns is subjected to axial tension, fracture energy did not show R-curve type trends while it was observed that a crack could be made to avoid exceptionally weak interfaces when loaded such that bonding surface with defects is subjected to axial compression. In the third chapter, an adaptation of the probe tack test is proposed to characterize the adhesion behavior of gum cuds. This test method allowed the introduction of substrates with well-defined surface energies and topologies to study their effects on gum cud adhesion. This approach and reported insights could potentially be useful in developing chewing gum formulations that facilitate easy removal of improperly discarded gum cuds from adhering surfaces. In the fourth chapter we highlight a procedure to obtain insights into the long-term performance of silicone sealants designed for load-bearing applications such as solar panel support sealants. Using small strain constitutive tests and time-temperature-superposition principle, thermal shift factors were obtained and successfully used to characterize the creep rupture master curves for specific joint configurations, leading to insights into delayed failures corresponding to three years through experiments carried out in one month.

The minimal invasive direct anterior approach in combination with large heads in total hip arthroplasty - is dislocation still a major issue? a case control study.

PubMed

Hoell, Steffen; Sander, Marius; Gosheger, Georg; Ahrens, Helmut; Dieckmann, Ralf; Hauschild, Gregor

2014-03-12

There have been increasing numbers of publications in recent years on minimally invasive surgery (MIS) for total hip arthroplasty (THA), reporting results with the use of different head sizes, tribologic and functional outcomes. This study presents the results and early complication rates after THA using the direct anterior approach (DAA) in combination with head sizes ≥ 36 mm. A total of 113 patients with THA were included in the study. The Harris Hip Score (HHS) was determined, a radiographic evaluation was carried out, and complications were recorded. The minimum follow-up period was 2 years (means 35 ± 7 months). The HHS improved from 43.6 (± 12) to 88.2 (± 14; P < 0.01). One early infection occurred, one periprosthetic fracture, and three cases of aseptic stem loosening. No incorrect positioning of the implants was observed, and there were no dislocations. THA with the minimally invasive DAA in combination with large heads is associated with good to very good functional results in the majority of cases. The complication rates are not increased. The rate of dislocation mainly as an complication of the first two years can be markedly reduced in particular.

Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT.

PubMed

Pessis, Eric; Campagna, Raphaël; Sverzut, Jean-Michel; Bach, Fabienne; Rodallec, Mathieu; Guerini, Henri; Feydy, Antoine; Drapé, Jean-Luc

2013-01-01

With arthroplasty being increasingly used to relieve joint pain, imaging of patients with metal implants can represent a significant part of the clinical work load in the radiologist's daily practice. Computed tomography (CT) plays an important role in the postoperative evaluation of patients who are suspected of having metal prosthesis-related problems such as aseptic loosening, bone resorption or osteolysis, infection, dislocation, metal hardware failure, or periprosthetic bone fracture. Despite advances in detector technology and computer software, artifacts from metal implants can seriously degrade the quality of CT images, sometimes to the point of making them diagnostically unusable. Several factors may help reduce the number and severity of artifacts at multidetector CT, including decreasing the detector collimation and pitch, increasing the kilovolt peak and tube charge, and using appropriate reconstruction algorithms and section thickness. More recently, dual-energy CT has been proposed as a means of reducing beam-hardening artifacts. The use of dual-energy CT scanners allows the synthesis of virtual monochromatic spectral (VMS) images. Monochromatic images depict how the imaged object would look if the x-ray source produced x-ray photons at only a single energy level. For this reason, VMS imaging is expected to provide improved image quality by reducing beam-hardening artifacts.

Lattice Boltzmann simulation of CO2 reactive transport in network fractured media

NASA Astrophysics Data System (ADS)

Tian, Zhiwei; Wang, Junye

2017-08-01

Carbon dioxide (CO2) geological sequestration plays an important role in mitigating CO2 emissions for climate change. Understanding interactions of the injected CO2 with network fractures and hydrocarbons is key for optimizing and controlling CO2 geological sequestration and evaluating its risks to ground water. However, there is a well-known, difficult process in simulating the dynamic interaction of fracture-matrix, such as dynamic change of matrix porosity, unsaturated processes in rock matrix, and effect of rock mineral properties. In this paper, we develop an explicit model of the fracture-matrix interactions using multilayer bounce-back treatment as a first attempt to simulate CO2 reactive transport in network fractured media through coupling the Dardis's LBM porous model for a new interface treatment. Two kinds of typical fracture networks in porous media are simulated: straight cross network fractures and interleaving network fractures. The reaction rate and porosity distribution are illustrated and well-matched patterns are found. The species concentration distribution and evolution with time steps are also analyzed and compared with different transport properties. The results demonstrate the capability of this model to investigate the complex processes of CO2 geological injection and reactive transport in network fractured media, such as dynamic change of matrix porosity.

Numerical Simulation of Permeability Change in Wellbore Cement Fractures after Geomechanical Stress and Geochemical Reactions Using X-ray Computed Tomography Imaging.

PubMed

Kabilan, Senthil; Jung, Hun Bok; Kuprat, Andrew P; Beck, Anthon N; Varga, Tamas; Fernandez, Carlos A; Um, Wooyong

2016-06-21

X-ray microtomography (XMT) imaging combined with three-dimensional (3D) computational fluid dynamics (CFD) modeling technique was used to study the effect of geochemical and geomechanical processes on fracture permeability in composite Portland cement-basalt caprock core samples. The effect of fluid density and viscosity and two different pressure gradient conditions on fracture permeability was numerically studied by using fluids with varying density and viscosity and simulating two different pressure gradient conditions. After the application of geomechanical stress but before CO2-reaction, CFD revealed fluid flow increase, which resulted in increased fracture permeability. After CO2-reaction, XMT images displayed preferential precipitation of calcium carbonate within the fractures in the cement matrix and less precipitation in fractures located at the cement-basalt interface. CFD estimated changes in flow profile and differences in absolute values of flow velocity due to different pressure gradients. CFD was able to highlight the profound effect of fluid viscosity on velocity profile and fracture permeability. This study demonstrates the applicability of XMT imaging and CFD as powerful tools for characterizing the hydraulic properties of fractures in a number of applications like geologic carbon sequestration and storage, hydraulic fracturing for shale gas production, and enhanced geothermal systems.

Numerical Simulation of Permeability Change in Wellbore Cement Fractures after Geomechanical Stress and Geochemical Reactions Using X-ray Computed Tomography Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kabilan, Senthil; Jung, Hun Bok; Kuprat, Andrew P.

X-ray microtomography (XMT) imaging combined with a three-dimensional (3D) computational fluid dynamics (CFD) modeling technique was used to study the effect of geochemical and geomechanical processes on fracture properties in composite Portland cement–basalt caprock core samples. The effect of fluid properties and flow conditions on fracture permeability was numerically studied by using fluids with varying physical properties and simulating different pressure conditions. CFD revealed that the application of geomechanical stress led to increased fluid flow, which resulted in increased fracture permeability. After CO2-reaction, XMT images displayed preferential precipitation of calcium carbonate within the fractures in the cement matrix and lessmore » precipitation in fractures located at the cement–basalt interface. CFD predicted changes in flow characteristics and differences in absolute values of flow properties due to different pressure gradients. CFD was able to highlight the profound effect of fluid properties on flow characteristics and hydraulic properties of fractures. This study demonstrates the applicability of XMT imaging and CFD as powerful tools for characterizing the hydraulic properties of fractures in a number of applications like geologic carbon sequestration and storage, hydraulic fracturing for shale gas production, and enhanced geothermal systems.« less

Study of fracture and stress-induced morphological instabilities in polymeric materials

NASA Astrophysics Data System (ADS)

Sabouri-Ghomi, Mohsen

We study the phenomena of fracture in polymers at the molecular and continuum level. At a molecular level, we study the failure of polymer/polymer interfaces. Our main focus is on a specific mode of failure known as chain pull-out fracture, which is common to weak adhesive junctions, and polymer blends and mixtures. In the case of the interface between incompatible polymers, reinforcement is achieved by adding a block copolymer to the interface. We introduce a microscopic model based on Brownian dynamics to investigate the effect of the polymerization index N, of the block connector chain, on fracture toughness of such reinforced polymeric junctions. We consider the mushroom regime, where connector chains are grafted with low surface density, for the case of large pulling velocity. We find that for short chains the interface fracture toughness depends linearly on the polymerization index N of the connector chains, while for longer chains the dependence becomes N 3/2. We propose a scaling argument, based on the geometry of the initial configuration, that accounts for both short and long chains and the crossover between them. At the continuum level, we study the pattern selection mechanism of finger-like crack growth phenomena in gradient driven growth problems in general, and the structure of stress-induced morphological instabilities in crazing of polymer glasses in particular. We simulate solidification in a narrow channel through the use of a phase-field model with an adaptive grid. By tuning a dimensionless parameter, the Peclet number, we show a continuous crossover from a free dendrite at high Peclet numbers to anisotropic viscous fingering at low Peclet numbers. At low Peclet numbers we find good agreement between our results, theoretical predictions, and experiment, providing the first quantitative test of solvability theory for anisotropic viscous fingers. For high undercoolings, we find new phenomena, a solid forger which satisfies stability and thermodynamic criterion. We further provide an analytical form for the shape of these fingers, based on local models of solidification, which fits our numerical results from simulation. Later we study the growth of crazes in polymer glasses by deriving the equations of motion of plastic flow at the craze tip, and the steady-state velocity profile of this flow. By developing a phenomenological model, we solve the full time-dependent equations of motion of this highly non-linear phenomena. Our simulation produces the steady-state cellular pattern observed in experiments. We further show that polymer glasses with lower yield stress produce cellular patterns with sharper tips and more cells, indicating instabilities with smaller wavelengths.

Periprosthetic Tissue Loss in Patients With Idiopathic Vitreous Inflammation After the Boston Keratoprosthesis.

PubMed

Grassi, Christina M; Cruzat, Andrea; Taniguchi, Elise V; Crnej, Alja; Colby, Kathryn A; Dohlman, Claes H; Chodosh, James

2015-11-01

Idiopathic vitritis is a poorly understood complication after Boston keratoprosthesis surgery with unclear etiology. We sought to determine whether an association exists between periprosthetic corneal tissue loss and the development of idiopathic vitritis in keratoprosthesis recipients. Thirteen Boston type I keratoprosthesis recipient eyes with a history of idiopathic vitritis and 34 type I keratoprosthesis recipient eyes with no history of idiopathic vitritis underwent anterior segment optical coherence tomography (AS-OCT) at a median time postoperatively of 2.4 years versus 1.9 years (range, 0.5-14.2 vs. 0.1-13.6 years), respectively. Areas of corneal graft tissue loss ("gaps") around the keratoprosthesis stem were identified and analyzed by 2 masked observers. The difference in the presence, number, and size of gaps was compared between cases and controls. A periprosthetic gap was identified more commonly in idiopathic vitritis cases than in controls on AS-OCT (11/13, 86% vs. 11/34, 33.3%, P < 0.001). The number of gaps between cases and controls was also significantly different (2.6 ± 1.6 vs. 0.5 ± 0.8, P < 0.001), but not the estimated gap area (0.056 ± 0.049 mm² vs. 0.039 ± 0.025 mm², P = 0.22). A significantly higher proportion of keratoprosthesis recipient eyes with idiopathic vitritis had corneal tissue loss around the keratoprosthesis stem than did controls. Tissue loss could serve as an entry point for debris or bacterial components, triggering idiopathic vitritis. Our study underscores the utility of AS-OCT imaging in the postoperative management of keratoprosthesis patients.

Particulate wear debris activates protein tyrosine kinases and nuclear factor kappaB, which down-regulates type I collagen synthesis in human osteoblasts.

PubMed

Vermes, C; Roebuck, K A; Chandrasekaran, R; Dobai, J G; Jacobs, J J; Glant, T T

2000-09-01

Particulate wear debris generated mechanically from prosthetic materials is phagocytosed by a variety of cell types within the periprosthetic space including osteoblasts, which cells with an altered function may contribute to periprosthetic osteolysis. Exposure of osteoblast-like osteosarcoma cells or bone marrow-derived primary osteoblasts to either metallic or polymeric particles of phagocytosable sizes resulted in a marked decrease in the steady-state messenger RNA (mRNA) levels of procollagen alpha1[I] and procollagen alpha1[III]. In contrast, no significant effect was observed for the osteoblast-specific genes, such as osteonectin and osteocalcin (OC). In kinetic studies, particles once phagocytosed, maintained a significant suppressive effect on collagen gene expression and type I collagen synthesis for up to five passages. Large particles of a size that cannot be phagocytosed also down-regulated collagen gene expression suggesting that an initial contact between cells and particles can generate gene responsive signals independently of the phagocytosis process. Concerning such signaling, titanium particles rapidly increased protein tyrosine phosphorylation and nuclear transcription factor kappaB (NF-kappaB) binding activity before the phagocytosis of particles. Protein tyrosine kinase (PTK) inhibitors such as genistein and the NF-kappaB inhibitor pyrrolidine dithiocarbamate (PDTC) significantly reduced the suppressive effect of titanium on collagen gene expression suggesting particles suppress collagen gene expression through the NF-kappaB signaling pathway. These results provide a mechanism by which particulate wear debris can antagonize the transcription of the procollagen alpha1[I] gene in osteoblasts, which may contribute to reduced bone formation and progressive periprosthetic osteolysis.

Knee arthrodesis with a long intramedullary nail as limb salvage for complex periprosthetic infections.

PubMed

Razii, Nima; Abbas, Ammar M I; Kakar, Rahul; Agarwal, Sanjeev; Morgan-Jones, Rhidian

2016-12-01

Periprosthetic infection following total knee arthroplasty is a devastating complication, which is not always satisfactorily resolved by revision surgery. Arthrodesis is a salvage alternative to above-knee amputation or permanent resection arthroplasty. Fixation options include internal compression plating, external fixation, and intramedullary nails. We retrospectively reviewed twelve consecutive cases (9 males, 3 females; mean age, 67 years) of knee arthrodesis with a long intramedullary nail, performed at a single institution between 2003 and 2014. Desired outcomes were the ability to mobilize without pain, solid radiographic fusion, and the eradication of infection. Mean follow-up was 48.5 months (range, 9-120 months). Eleven patients (92 %) demonstrated stable fusion, ten patients (83 %) were ambulatory without pain, and ten patients (83 %) remained without infection at most recent follow-up. Eight patients (67 %) achieved union at an average of 12 months; three required repeat procedures, achieving union at an average of 9 months. There was a significant difference (P < 0.01) between the numbers of previous operations amongst the eight patients who initially achieved union (mean, 3.25) and three who subsequently required repeat procedures (mean, 8.33). In contrast to similar studies, we performed a single-stage exchange where possible, while comparable ambulatory and fusion rates were observed. Numerous previous attempts at revision arthroplasty, co-morbidities, and infections with highly resistant organisms have been associated with further complications. Although technically challenging, knee arthrodesis with a long intramedullary nail offers an acceptable limb salvage procedure for carefully selected patients with complex periprosthetic infections.

Periprosthetic pathology in 'at risk' ceramic-on-polyethylene total hip arthroplasty: a clinical study using MARS-MRI in 50 patients.

PubMed

Das, Dirk H; van der Weegen, Walter; Wullems, Jorgen A; Brakel, Koen; Sijbesma, Thea; Nelissen, Rob G

2016-05-16

Recent studies of metal-on-metal (MoM) total hip arthroplasty (THA) using metal-artefact-reducing-sequence software for magnetic resonance Imaging (MARS-MRI) have revealed remarkable soft tissue pathology around the hip, usually referred to as pseudotumours. Case reports describe identical pathology in non-MoM THA, but descriptive overviews of MRI abnormalities in patients with non-MoM prosthesis are scarce. A clinical study in a cohort of 50 ceramic-on-polyethylene (CoP) THA selected for high risk of peri-prosthetic pathology including 2 subgroups: (i) 40 patients with a high polyethylene (PE) wear rate (>0.2 mm per year) and 5-12 years follow-up; (ii) 10 patients with a 2 to 5 years follow-up and a documented history of persistent complaints. All patients were clinically evaluated, MARS-MRIs were completed and chrome and cobalt serum samples were taken. 17 scans were normal (34%). Periprosthetic fluid collections were seen as a bursae iliopsoas (n = 12, 24%), in the trochanter bursae (n = 4, 8%) and in the surgical tract (n = 9, 18%). 1 case demonstrated a cyst on MARS-MRI resembling a pseudotumour as seen with MoM THA (2%). Intraosseous acetabular cysts were seen in 12 cases (24%), intraosseous trochanteric cysts in 10 cases (20%). Soft tissue abnormalities after non-MoM THA are common in selected patients and can be clearly visualised with MARS-MRI. Pseudotumours as seen on MARS-MRI do occur in non-MoM hip arthroplasty but with low prevalence.

Particle Disease: A Current Review of the Biological Mechanisms in Periprosthetic Osteolysis After Hip Arthroplasty

PubMed Central

Sukur, Erhan; Akman, Yunus Emre; Ozturkmen, Yusuf; Kucukdurmaz, Fatih

2016-01-01

Background: Inflammatory responses to wear debris cause osteolysis that leads to aseptic prosthesis loosening and hip arthroplasty failure. Although osteolysis is usually associated with aseptic loosening, it is rarely seen around stable implants. Aseptic implant loosening is a simple radiologic phenomenon, but a complex immunological process. Particulate debris produced by implants most commonly causes osteolysis, and this is called particle-associated periprosthetic osteolysis (PPO). Objective: The objective of this review is to outline the features of particle-associated periprosthetic osteolysis to allow the physician to recognise this condition and commence early treatment, thereby optimizing patient outcome. Methods: A thorough literature search was performed using available databases, including Pubmed, to cover important research published covering particle-associated PPO. Results: Although osteolysis causes bone resorption, clinical, animal, and in vitro studies of particle bioreactivity suggest that particle-associated PPO represents the culmination of several biological reactions of many cell types, rather than being caused solely by the osteoclasts. The biological activity is highly dependent on the characteristics and quantity of the wear particles. Conclusion: Despite advances in total hip arthroplasty (THA), particle-associated PPO and aseptic loosening continue to be major factors that affect prosthetic joint longevity. Biomarkers could be exploited as easy and objective diagnostic and prognostic targets that would enable testing for osteolysis after THA. Further research is needed to identify new biomarkers in PPO. A comprehensive understanding of the underlying biological mechanisms is crucial for developing new therapeutic interventions to reverse or suppress biological responses to wear particles. PMID:27499822

The Effect of Antiseptics in the Prophylaxis of Infection in Orthopaedic Surgery.

PubMed

Lüdemann, Martin; Munoz, Pablo; Wagner, Martin; Malzahn, Uwe; Horas, Konstantin; Heuschmann, Peter; Rudert, Maximilian

2018-06-14

Over the past decade, the incidence of revision arthroplasty has increased substantially. One of the main reasons for revision arthroplasty is periprosthetic joint infection, often resulting in multiple surgical interventions with variable success and poor clinical outcome. Intraoperative wound irrigation has been proposed to reduce bacterial contamination and thus the risk of periprosthetic infection. However, there is currently no widely accepted recommendation for the use of topical antiseptics within the operative setting for primary implantation. We performed a systematic review of studies pertaining to the use of intraoperative topical antiseptics and their effectiveness in preventing infection of orthopaedic implants. A comprehensive literature search including MEDLINE (PubMed), Cochrane Library, and Current Contents Medicine (CCMED-Medpilot) was performed according to a standardised protocol. Overall, 1905 articles were initially assessed. Four studies met the inclusion criteria and remained for further analysis, comprising two prospective cohort studies using retrospective control groups (evidence level II - III) and two randomised controlled trials (evidence level I). 0.35% Povidone-iodine (PVP-I) was used in three of these studies and a solution of 6.25% PVP-I and 6.25%-hydrogen peroxide (H 2 O 2 ) in one study for intraoperative wound irrigation. There was a clear trend in all studies suggesting that intraoperative topical antiseptics are effective in preventing periprosthetic infection. Although no clear regimen can be recommended, the available literature indicates that the use of intraoperative topical antiseptics is of clinical relevance in preventing infection of orthopaedic implants. Further randomised controlled trials are recommended. Georg Thieme Verlag KG Stuttgart · New York.

The Diagnosis of Periprosthetic Infection

PubMed Central

del Arco, Alfonso; Bertrand, María Luisa

2013-01-01

Periprosthetic infection (PJI) is the most serious joint replacement complication, occurring in 0.8-1.9% of knee arthroplasties and 0.3-1.7% of hip arthroplasties. A definition of PJI was proposed in the November 2011 issue of the journal Clinical Orthopedics and Related Research. The presence of a fistula or of local inflammatory signs is indicative of PJI, but in many cases local pain is the only symptom. In the absence of underlying inflammatory conditions, C-reactive protein measurement is the most useful preoperative blood test for detecting infection associated with a prosthetic joint. The most useful preoperative diagnostic test is the aspiration of synovial joint fluid to obtain a total and differential cell count and culture. Intraoperative frozen sections of periprosthetic tissues produce excellent accuracy in predicting a diagnosis of PJI but only moderate accuracy in ruling out the diagnosis. In this process, obtaining a quality sample is the first step, and determines the quality of microbiological results. Specimens for culture should be obtained prior to the initiation of antibiotic treatment. Sonication of a removed implant may increase the culture yield. Plain radiography has low sensitivity and low specificity for detecting infection associated with a prosthetic joint. Computed tomography and magnetic resonance imaging may be useful in the evaluation of complex cases, but metal inserts interfere with these tests, and abnormalities may be non-specific. Labelled-leucocyte imaging (e.g., leucocytes labelled with indium-111) combined with bone marrow imaging with the use of technetium-99m–labelled sulphur colloid is considered the imaging test of choice when imaging is necessary. PMID:23898349

Synovial Fluid α-Defensin as a Biomarker for Peri-Prosthetic Joint Infection: A Systematic Review and Meta-Analysis.

PubMed

Li, Bin; Chen, Fei; Liu, Yi; Xu, Guokang

Total joint arthroplasty (TJA) has been one of the most beneficial interventions for treating patients suffering from joint disorders. However, peri-prosthetic joint infection (PJI) is a serious complication that often accompanies TJA and the diagnosis of PJI is remains difficult. Questions remain regarding whether certain biomarkers can be valuable in the diagnosis of PJI. We conducted our systematic review by searching PubMed, Embase, Web of Science, the Cochrane Library, and Science Direct with the key words "periprosthetic joint infection," "synovial fluid," and "α-defensin." Studies that provided sufficient data to construct 2 × 2 contingency tables were chosen based on inclusion and exclusion criteria. The quality of included studies was assessed according to the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated for the included studies. The summary receiver operating characteristic (SROC) curve and the area under the summary receiver operating characteristic (AUSROC) were used to evaluate the overall diagnostic performance. Eight studies were included in this systematic review. Among them four articles were included in meta-analysis. A total of 421 participants were studied in the meta-analysis. The pooled sensitivity, specificity, and DOR were 0.98 (95% confidence interval [CI]: 0.94-1.00), 0.97 (95% CI: 0.95-0.99), and 1095.49 (95% CI: 283.68.58-4230.45), respectively. The AUSROC was 0.9949 (standard error [SE] 0.0095). Synovial fluid α-defensin is a biomarker of high sensitivity and specificity for the diagnosis of PJI.

Requirements of frictional debonding at fiber/matrix interfaces for tough ceramic composites

NASA Astrophysics Data System (ADS)

Hsueh, Chun-Hway

1992-11-01

Optimum toughening of fiber-reinforced ceramic composites requires debonding at fiber/matrix interfaces and subsequent frictional sliding between the fibers and the matrix as the main crack extends through the composite. Criteria of both interfacial debonding vs fiber fracture, and frictional debonding vs frictionless debonding, are illustrated. To achieve interfacial debonding, the ratio of the fiber strength to the interfacial shear strength must exceed a critical value; to achieve a frictional interface after interfacial debonding, the ratio of the interfacial residual clamping stress to the interfacial shear strength must also exceed a critical value. While interfacial debonding is not sensitive to Poisson's effect, the frictional interface is sensitive to Poisson's effect.

Vancomycin-Loaded Polymethylmethacrylate Spacers Fail to Eradicate Periprosthetic Joint Infection in a Clinically Representative Mouse Model.

PubMed

Carli, Alberto V; Bhimani, Samrath; Yang, Xu; de Mesy Bentley, Karen L; Ross, F Patrick; Bostrom, Mathias P G

2018-06-06

Periprosthetic joint infection (PJI) remains a devastating complication following total joint arthroplasty. Current animal models of PJI do not effectively recreate the clinical condition and thus provide limited help in understanding why treatments fail. We developed a mouse model of the first-stage surgery of a 2-stage revision for PJI involving a 3-dimensionally printed Ti-6Al-4V implant and a mouse-sized cement spacer that elutes vancomycin. Vancomycin was mixed with polymethylmethacrylate (PMMA) cement and inserted into custom-made mouse-sized spacer molds. Twenty C57BL/6 mice received a proximal tibial implant and an intra-articular injection of 3 × 10 colony-forming units of Staphylococcus aureus Xen36. At 2 weeks, 9 mice underwent irrigation and debridement of the leg with revision of the implant to an articulating vancomycin-loaded PMMA spacer. Postoperatively, mice underwent radiography and serum inflammatory-marker measurements. Following euthanasia of the mice at 6 weeks, bone and soft tissues were homogenized to quantify bacteria within periprosthetic tissues. Implants and articulating spacers were either sonicated to quantify adherent bacteria or examined under scanning electron microscopy (SEM) to characterize the biofilm. Vancomycin-loaded PMMA spacers eluted vancomycin for ≤144 hours and retained antimicrobial activity. Control mice had elevated levels of inflammatory markers, radiographic evidence of septic loosening of the implant, and osseous destruction. Mice treated with a vancomycin-loaded PMMA spacer had significantly lower levels of inflammatory markers (p < 0.01), preserved tibial bone, and no intra-articular purulence. Retrieved vancomycin-loaded spacers exhibited significantly lower bacterial counts compared with implants (p < 0.001). However, bacterial counts in periprosthetic tissue did not significantly differ between the groups. SEM identified S. aureus encased within biofilm on control implants, while vancomycin-loaded spacers contained no bacteria. This animal model is a clinically representative model of PJI treatment. The results suggest that the antimicrobial effects of PMMA spacers are tightly confined to the articular space and must be utilized in conjunction with thorough tissue debridement and systemic antibiotics. These data provide what we believe to be the first insight into the effect of antibiotic-loaded cement spacers in a clinically relevant animal model and justify the adjunctive use of intravenous antibiotics when performing a 2-stage revision for PJI.

Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial.

PubMed

Huang, Tsan-Wen; Wang, Chao-Jan; Shih, Hsin-Nung; Chang, Yuhan; Huang, Kuo-Chin; Peng, Kuo-Ti; Lee, Mel S

2017-05-22

Although the loss of bone mineral density (BMD) after total hip arthroplasty (THA) is a known problem, it remains unresolved. This study prospectively examined the effect of zoledronic acid (ZA) on bone turnover and BMD after cementless THA. Between January 2010 and August 2011, 60 patients who underwent cementless THA were randomly assigned to receive either ZA infusion or placebo (0.9% normal saline only) postoperatively. ZA was administered at 2 day and 1 year postoperatively. Periprosthetic BMD in seven Gruen zones was assessed preoperatively and at given time points for 2 years. Serum markers of bone turnover, functional scales, and adverse events were recorded. Each group contained 27 patients for the final analysis. The loss of BMD across all Gruen zones (significantly in zones 1 and 7) up to 2 years postoperatively was noted in the placebo group. BMD was significantly higher in the ZA group than in the placebo group in Gruen zones 1, 2, 6, and 7 at 1 year and in Gruen zones 1, 6, and 7 at 2 years (p < 0.05). Compared with baseline measures of BMD, the ZA group had increased BMD in zones 1, 2, 4, 5, 6, and 7 at 1 year and in zones 1, 4, 6, and 7 at 2 years (p < 0.05). Serum bone-specific alkaline phosphatase and N-telopeptide of procollagen I levels were significantly increased at 6 weeks in the placebo group and decreased after 3 months in the ZA group. A transient decrease in osteocalcin level was found at 6 months in the ZA group. Functional scales and adverse events were not different between the two groups. The loss of periprosthetic BMD, especially in the proximal femur (zones 1 and 7), after cementless THA could be effectively reverted using ZA. In addition, bone turnover markers were suppressed until 2 years postoperatively following ZA administration. Chang Gung Memorial Hospital Protocol Record 98-1150A3, Prevention of Periprosthetic Bone Loss After Total Hip Replacement by Annual Bisphosphonate Therapy, has been reviewed and will be made public on ClinicalTrials.gov. NCT02838121 . Registered on 19 July, 2016.

Spiral interface: A reinforcing mechanism for laminated composite materials learned from nature

NASA Astrophysics Data System (ADS)

Gao, Yang; Guo, Zhenbin; Song, Zhaoqiang; Yao, Haimin

2017-12-01

Helical structures are ubiquitous in nature at length scales of a wide range. In this paper, we studied a helical architecture called microscopic screw dislocation (μ-SD), which is prevalently present in biological laminated composites such as shells of mollusks P. placenta and nacre of abalone. Mechanical characterization indicated that μ-SDs can greatly enhance resistance to scratching. To shed light on the underlying reinforcing mechanisms, we systematically investigated the mechanical behaviors of μ-SD using theoretical modeling in combination with finite element simulation. Our analysis on an individual μ-SD showed that the failure of a μ-SD under tension involves the delamination of the prolonged spiral interface, giving rise to much higher toughness compared to those of the planar counterpart. The corporation of multiple μ-SDs was further investigated by analyzing the effect of μ-SD density on the mechanical reinforcement. It was found that higher areal density of μ-SD would lead to more improvement in toughness. However, the operation of such reinforcing mechanism of μ-SD requires proclivity of cracking along the spiral interface, which is not spontaneous but conditional. Fracture mechanics-based modeling indicated that the proclivity of crack propagation along the spiral interface can be ensured if the fracture toughness of the interface is less than 60% of that of the lamina material. These findings not only uncover the reinforcing mechanisms of μ-SDs in biological materials but imply a great promise of applying μ-SDs in reinforcing synthetic laminated composites.

Tensile Fracture Behavior and Failure Mechanism of Additively-Manufactured AISI 4140 Low Alloy Steel by Laser Engineered Net Shaping

PubMed Central

Kim, Hoyeol; Liu, Zhichao; Cong, Weilong; Zhang, Hong-Chao

2017-01-01

AISI 4140 powder was directly deposited on AISI 4140 wrought substrate using laser engineered net shaping (LENS) to investigate the compatibility of a LENS-deposited part with the substrate. Tensile testing at room temperature was performed to evaluate the interface bond performance and fracture behavior of the test specimens. All the samples failed within the as-deposited zone, indicating that the interfacial bond is stronger than the interlayer bond inside the deposit. The fracture surfaces were analyzed using scanning electron microscopy (SEM) and energy disperse X-ray spectrometry (EDS). Results show that the tensile fracture failure of the as-deposited part is primarily affected by lack-of-fusion defects, carbide precipitation, and oxide particles inclusions, which causes premature failure of the deposit by deteriorating the mechanical properties and structural integrity. PMID:29120374

Bonding measurement -Strength and fracture mechanics approaches.

PubMed

Anunmana, Chuchai; Wansom, Wiroj

2017-07-26

This study investigated the effect of cross-sectional areas on interfacial fracture toughness and bond strength of bilayered dental ceramics. Zirconia core ceramics were veneered and cut to produce specimens with three different cross-sectional areas. Additionally, monolithic specimens of glass veneer were also prepared. The specimens were tested in tension until fracture at the interface and reported as bond strength. Fracture surfaces were observed, and the apparent interfacial toughness was determined from critical crack size and failure stress. The results showed that cross-sectional area had no effect on the interfacial toughness whereas such factor had a significant effect on interfacial bond strength. The study revealed that cross-sectional area had no effect on the interfacial toughness, but had a significant effect on interfacial bond strength. The interfacial toughness may be a more reliable indicator for interfacial bond quality than interfacial bond strength.

Tensile Fracture Behavior and Failure Mechanism of Additively-Manufactured AISI 4140 Low Alloy Steel by Laser Engineered Net Shaping.

PubMed

Kim, Hoyeol; Liu, Zhichao; Cong, Weilong; Zhang, Hong-Chao

2017-11-09

AISI 4140 powder was directly deposited on AISI 4140 wrought substrate using laser engineered net shaping (LENS) to investigate the compatibility of a LENS-deposited part with the substrate. Tensile testing at room temperature was performed to evaluate the interface bond performance and fracture behavior of the test specimens. All the samples failed within the as-deposited zone, indicating that the interfacial bond is stronger than the interlayer bond inside the deposit. The fracture surfaces were analyzed using scanning electron microscopy (SEM) and energy disperse X-ray spectrometry (EDS). Results show that the tensile fracture failure of the as-deposited part is primarily affected by lack-of-fusion defects, carbide precipitation, and oxide particles inclusions, which causes premature failure of the deposit by deteriorating the mechanical properties and structural integrity.

Multiscale Modeling of Grain-Boundary Fracture: Cohesive Zone Models Parameterized From Atomistic Simulations

NASA Technical Reports Server (NTRS)

Glaessgen, Edward H.; Saether, Erik; Phillips, Dawn R.; Yamakov, Vesselin

2006-01-01

A multiscale modeling strategy is developed to study grain boundary fracture in polycrystalline aluminum. Atomistic simulation is used to model fundamental nanoscale deformation and fracture mechanisms and to develop a constitutive relationship for separation along a grain boundary interface. The nanoscale constitutive relationship is then parameterized within a cohesive zone model to represent variations in grain boundary properties. These variations arise from the presence of vacancies, intersticies, and other defects in addition to deviations in grain boundary angle from the baseline configuration considered in the molecular dynamics simulation. The parameterized cohesive zone models are then used to model grain boundaries within finite element analyses of aluminum polycrystals.

Solid Oxide Fuel Cell Seal Glass - BN Nanotubes Composites

NASA Technical Reports Server (NTRS)

Bansal, Narottam P.; Choi, Sung R.; Hurst, Janet B.; Garg, Anita

2005-01-01

Solid oxide fuel cell seal glass G18 composites reinforced with approx.4 weight percent of BN nanotubes were fabricated via hot pressing. Room temperature strength and fracture toughness of the composite were determined by four-point flexure and single edge V-notch beam methods, respectively. The strength and fracture toughness of the composite were higher by as much as 90% and 35%, respectively, than those of the glass G18. Microscopic examination of the composite fracture surfaces using SEM and TEM showed pullout of the BN nanotubes, similar in feature to fiber-reinforced ceramic matrix composites with weak interfaces. Other mechanical and physical properties of the composite will also be presented.

Fiber Laser Welding-Brazing Characteristics of Dissimilar Metals AZ31B Mg Alloys to Copper with Mg-Based Filler

NASA Astrophysics Data System (ADS)

Zhao, Xiaoye; Tan, Caiwang; Meng, Shenghao; Chen, Bo; Song, Xiaoguo; Li, Liqun; Feng, Jicai

2018-03-01

Fiber laser welding-brazing of 1-mm-thick AZ31B Mg alloys to 1.5-mm-thick copper (T2) with Mg-based filler was performed in a lap configuration. The weld appearance, interfacial microstructure and mechanical properties were investigated with different heat inputs. The results indicated that processing windows for optimizing appropriate welding parameters were relatively narrow in this case. Visually acceptable joints with certain strength were achieved at appropriate welding parameters. The maximum tensile-shear fracture load of laser-welded-brazed Mg/Cu joint could reach 1730 N at the laser power of 1200 W, representing 64.1% joint efficiency relative to AZ31Mg base metal. The eutectic structure (α-Mg + Mg2Cu) and Mg-Cu intermetallic compound was observed at the Mg/Cu interface, and Mg-Al-Cu ternary intermetallic compound were identified between intermetallics and eutectic structure at high heat input. All the joints fractured at the Mg-Cu interface. However, the fracture mode was found to differ. For laser power of 1200 W, the surface was characterized by tearing edge, while that with poor joint strength was almost dominated by smooth surface or flat tear pattern.

Impact Delamination and Fracture in Aluminum/Acrylic Sandwich Plates

NASA Technical Reports Server (NTRS)

Liaw, Benjamin; Zeichner, Glenn; Liu, Yanxiong; Bowles, Kenneth J. (Technical Monitor)

2000-01-01

Impact-induced delamination and fracture in 6061-T6 aluminum/cast acrylic sandwich plates adhered by epoxy were generated in an instrumented drop-weight impact machine. Although only a small dent was produced on the aluminum side when a hemispherical penetrator tup was dropped onto it from a couple of inches, a large ring of delamination at the interface was observed. The delamination damage was often accompanied by severe shattering in the acrylic substratum. Damage patterns in the acrylic layer include radial and ring cracks and, together with delamination at the interface, may cause peeling-off of acrylic material from the sandwich plate. Theory of stress-wave propagation can be used to explain these damage patterns. The impact tests were conducted at various temperatures. The results also show clearly that temperature effect is very important in impact damage. For pure cast acrylic nil-ductile transition (NDT) occurs between 185-195 F. Excessive impact energy was dissipated into fracture energy when tested at temperature below this range or through plastic deformation when tested at temperature above the NDT temperature. Results from this study will be used as baseline data for studying fiber-metal laminates, such as GLARE and ARALL for advanced aeronautical and astronautical applications.

Auger analysis of a fiber/matrix interface in a ceramic matrix composite

NASA Technical Reports Server (NTRS)

Honecy, Frank S.; Pepper, Stephen V.

1988-01-01

Auger electron spectroscopy (AES) depth profiling was used to characterize the fiber/matrix interface of an SiC fiber, reaction bonded Si3N4 matrix composite. Depth profiles of the as received double coated fiber revealed concentration oscillations which disappeared after annealing the fiber in the environment used to fabricate the composite. After the composite was fractured, the Auger depth profiles showed that failure occurred in neither the Beta-SiC fiber body nor in the Si3N4 matrix but, concurrently, at the fiber coating/matrix interface and within the fiber coating itself.

Comparison of Rooting Strategies to Explore Rock Fractures for Shallow Soil-Adapted Tree Species with Contrasting Aboveground Growth Rates: A Greenhouse Microcosm Experiment.

PubMed

Nie, Yunpeng; Chen, Hongsong; Ding, Yali; Yang, Jing; Wang, Kelin

2017-01-01

For tree species adapted to shallow soil environments, rooting strategies that efficiently explore rock fractures are important because soil water depletion occurs frequently. However, two questions: (a) to what extent shallow soil-adapted species rely on exploring rock fractures and (b) what outcomes result from drought stress, have rarely been tested. Therefore, based on the expectation that early development of roots into deep soil layers is at the cost of aboveground growth, seedlings of three tree species ( Cyclobalanopsis glauca, Delavaya toxocarpa , and Acer cinnamomifolium ) with distinct aboveground growth rates were selected from a typical shallow soil region. In a greenhouse experiment that mimics the basic features of shallow soil environments, 1-year-old seedlings were transplanted into simulated microcosms of shallow soil overlaying fractured bedrock. Root biomass allocation and leaf physiological activities, as well as leaf δ 13 C values were investigated and compared for two treatments: regular irrigation and repeated cycles of drought stress. Our results show that the three species differed in their rooting strategies in the context of encountering rock fractures, however, these strategies were not closely related to the aboveground growth rate. For the slowest-growing seedling, C. glauca , percentages of root mass in the fractures, as well as in the soil layer between soil and bedrock increased significantly under both treatments, indicating a specialized rooting strategy that facilitated the exploration of rock fractures. Early investment in deep root growth was likely critical to the establishment of this drought-vulnerable species. For the intermediate-growing, A. cinnamomifolium , percentages of root mass in the bedrock and interface soil layers were relatively low and exhibited no obvious change under either treatment. This limited need to explore rock fractures was compensated by a conservative water use strategy. For the fast-growing, D. toxocarpa , percentages of root mass in the bedrock and interface layers increased simultaneously under drought conditions, but not under irrigated conditions. This drought-induced rooting plasticity was associated with drought avoidance by this species. Although, root development might have been affected by the simulated microcosm, contrasting results among the three species indicated that efficient use of rock fractures is not a necessary or specialized strategy of shallow-soil adapted species. The establishment and persistence of these species relied on the mutual complementation between their species-specific rooting strategies and drought adaptations.

Non-uniform breaking of molecular bonds, peripheral morphology and releasable adhesion by elastic anisotropy in bio-adhesive contacts

PubMed Central

Liu, Yan; Gao, Yanfei

2015-01-01

Biological adhesive contacts are usually of hierarchical structures, such as the clustering of hundreds of sub-micrometre spatulae on keratinous hairs of gecko feet, or the clustering of molecular bonds into focal contacts in cell adhesion. When separating these interfaces, releasable adhesion can be accomplished by asymmetric alignment of the lowest scale discrete bonds (such as the inclined spatula that leads to different peeling force when loading in different directions) or by elastic anisotropy. However, only two-dimensional contact has been analysed for the latter method (Chen & Gao 2007 J. Mech. Phys. Solids 55, 1001–1015 (doi:10.1016/j.jmps.2006.10.008)). Important questions such as the three-dimensional contact morphology, the maximum to minimum pull-off force ratio and the tunability of releasable adhesion cannot be answered. In this work, we developed a three-dimensional cohesive interface model with fictitious viscosity that is capable of simulating the de-adhesion instability and the peripheral morphology before and after the onset of instability. The two-dimensional prediction is found to significantly overestimate the maximum to minimum pull-off force ratio. Based on an interface fracture mechanics analysis, we conclude that (i) the maximum and minimum pull-off forces correspond to the largest and smallest contact stiffness, i.e. ‘stiff-adhere and compliant-release’, (ii) the fracture toughness is sensitive to the crack morphology and the initial contact shape can be designed to attain a significantly higher maximum-to-minimum pull-off force ratio than a circular contact, and (iii) since the adhesion is accomplished by clustering of discrete bonds or called bridged crack in terms of fracture mechanics terminology, the above conclusions can only be achieved when the bridging zone is significantly smaller than the contact size. This adhesion-fracture analogy study leads to mechanistic predictions that can be readily used to design biomimetics and releasable adhesives. PMID:25392403

Correlation between mechanical behavior of protein films at the air/water interface and intrinsic stability of protein molecules.

PubMed

Martin, Anneke H; Cohen Stuart, Martien A; Bos, Martin A; van Vliet, Ton

2005-04-26

The relation between mechanical film properties of various adsorbed protein layers at the air/water interface and intrinsic stability of the corresponding proteins is discussed. Mechanical film properties were determined by surface deformation in shear and dilation. In shear, fracture stress, sigma(f), and fracture strain, gamma(f), were determined, as well as the relaxation behavior after macroscopic fracture. The dilatational measurements were performed in a Langmuir trough equipped with an infra-red reflection absorption spectroscopy (IRRAS) accessory. During compression and relaxation of the surface, the surface pressure, Pi, and adsorbed amount, Gamma (determined from the IRRAS spectra), were determined simultaneously. In addition, IRRAS spectra revealed information on conformational changes in terms of secondary structure. Possible correlations between macroscopic film properties and intrinsic stability of the proteins were determined and discussed in terms of molecular dimensions of single proteins and interfacial protein films. Molecular properties involved the area per protein molecule at Pi approximately 0 mN/m (A(0)), A(0)/M (M = molecular weight) and the maximum slope of the Pi-Gamma curves (dPi/dGamma). The differences observed in mechanical properties and relaxation behavior indicate that the behavior of a protein film subjected to large deformation may vary widely from predominantly viscous (yielding) to more elastic (fracture). This transition is also observed in gradual changes in A(0)/M. It appeared that in general protein layers with high A(0)/M have a high gamma(f) and behave more fluidlike, whereas solidlike behavior is characterized by low A(0)/M and low gamma(f). Additionally, proteins with a low A(0)/M value have a low adaptability in changing their conformation upon adsorption at the air/water interface. Both results support the conclusion that the hardness (internal cohesion) of protein molecules determines predominantly the mechanical behavior of adsorbed protein layers.

Orientation-dependent tensile deformation and damage of a T700 carbon fiber/epoxy composite: A synchrotron-based study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bie, B. X.; Huang, J. Y.; Fan, D.

Uniaxial tensile experiments are conducted on a T700 carbon fiber/epoxy composite along various offaxis angles. Stressestrain curves are measured along with strain fields mapped via synchrotron x-ray digital image correlation, as well as computerized tomography. Elastic modulus and tensile strength decrease with increasing off-axis angles, while fracture strain exhibits a nonmonotonic trend as a combined result of tensile strength decrease and fracture mode transition. At high off-axis angles, strain field mapping demonstrates distinct tensile and shear strain localizations and deformation bands approximately along the fiber directions, while deformation is mainly achieved via continuous growth of tensile strain at low off-axismore » angles. Roughness of fracture planes decreases exponentially as the off-axis angle increases. The stressestrain curves, strain fields, tomography and fractographs show consistent features, and reveal a fracture mode transition from mainly tension (fiber fracture) to in-plane shear (interface debonding).« less

Mesoscale simulation of concrete spall failure

NASA Astrophysics Data System (ADS)

Knell, S.; Sauer, M.; Millon, O.; Riedel, W.

2012-05-01

Although intensively studied, it is still being debated which physical mechanisms are responsible for the increase of dynamic strength and fracture energy of concrete observed at high loading rates, and to what extent structural inertia forces on different scales contribute to the observation. We present a new approach for the three dimensional mesoscale modelling of dynamic damage and cracking in concrete. Concrete is approximated as a composite of spherical elastic aggregates of mm to cm size embedded in an elastic cement stone matrix. Cracking within the matrix and at aggregate interfaces in the μm range are modelled with adaptively inserted—initially rigid—cohesive interface elements. The model is applied to analyse the dynamic tensile failure observed in Hopkinson-Bar spallation experiments with strain rates up to 100/s. The influence of the key mesoscale failure parameters of strength, fracture energy and relative weakening of the ITZ on macromechanic strength, momentum and energy conservation is numerically investigated.

A Case-Based Study with Radiologists Performing Diagnosis Tasks in Virtual Reality.

PubMed

Venson, José Eduardo; Albiero Berni, Jean Carlo; Edmilson da Silva Maia, Carlos; Marques da Silva, Ana Maria; Cordeiro d'Ornellas, Marcos; Maciel, Anderson

2017-01-01

In radiology diagnosis, medical images are most often visualized slice by slice. At the same time, the visualization based on 3D volumetric rendering of the data is considered useful and has increased its field of application. In this work, we present a case-based study with 16 medical specialists to assess the diagnostic effectiveness of a Virtual Reality interface in fracture identification over 3D volumetric reconstructions. We developed a VR volume viewer compatible with both the Oculus Rift and handheld-based head mounted displays (HMDs). We then performed user experiments to validate the approach in a diagnosis environment. In addition, we assessed the subjects' perception of the 3D reconstruction quality, ease of interaction and ergonomics, and also the users opinion on how VR applications can be useful in healthcare. Among other results, we have found a high level of effectiveness of the VR interface in identifying superficial fractures on head CTs.

Discrete fracture modeling of multiphase flow and hydrocarbon production in fractured shale or low permeability reservoirs

NASA Astrophysics Data System (ADS)

Hao, Y.; Settgast, R. R.; Fu, P.; Tompson, A. F. B.; Morris, J.; Ryerson, F. J.

2016-12-01

It has long been recognized that multiphase flow and transport in fractured porous media is very important for various subsurface applications. Hydrocarbon fluid flow and production from hydraulically fractured shale reservoirs is an important and complicated example of multiphase flow in fractured formations. The combination of horizontal drilling and hydraulic fracturing is able to create extensive fracture networks in low permeability shale rocks, leading to increased formation permeability and enhanced hydrocarbon production. However, unconventional wells experience a much faster production decline than conventional hydrocarbon recovery. Maintaining sustainable and economically viable shale gas/oil production requires additional wells and re-fracturing. Excessive fracturing fluid loss during hydraulic fracturing operations may also drive up operation costs and raise potential environmental concerns. Understanding and modeling processes that contribute to decreasing productivity and fracturing fluid loss represent a critical component for unconventional hydrocarbon recovery analysis. Towards this effort we develop a discrete fracture model (DFM) in GEOS (LLNL multi-physics computational code) to simulate multiphase flow and transfer in hydraulically fractured reservoirs. The DFM model is able to explicitly account for both individual fractures and their surrounding rocks, therefore allowing for an accurate prediction of impacts of fracture-matrix interactions on hydrocarbon production. We apply the DFM model to simulate three-phase (water, oil, and gas) flow behaviors in fractured shale rocks as a result of different hydraulic stimulation scenarios. Numerical results show that multiphase flow behaviors at the fracture-matrix interface play a major role in controlling both hydrocarbon production and fracturing fluid recovery rates. The DFM model developed in this study will be coupled with the existing hydro-fracture model to provide a fully integrated geomechanical and reservoir simulation capability for an accurate prediction and assessment of hydrocarbon production and hydraulic fracturing performance. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

The influence of Y-TZP surface treatment on topography and ceramic/resin cement interfacial fracture toughness.

PubMed

Paes, P N G; Bastian, F L; Jardim, P M

2017-09-01

Consider the efficacy of glass infiltration etching (SIE) treatment as a procedure to modify the zirconia surface resulting in higher interfacial fracture toughness. Y-TZP was subjected to 5 different surface treatments conditions consisting of no treatment (G1), SIE followed by hydrofluoric acid treatment (G2), heat treated at 750°C (G3), hydrofluoric acid treated (G4) and airborne-particle abrasion with alumina particles (G5). The effect of surface treatment on roughness was evaluated by Atomic Force Microscopy providing three different parameters: R a , R sk and surface area variation. The ceramic/resin cement interface was analyzed by Fracture Mechanics K I test with failure mode determined by fractographic analysis. Weibull's analysis was also performed to evaluate the structural integrity of the adhesion zone. G2 and G4 specimens showed very similar, and high R a values but different surface area variation (33% for G2 and 13% for G4) and they presented the highest fracture toughness (K IC ). Weibull's analysis showed G2 (SIE) tendency to exhibit higher K IC values than the other groups but with more data scatter and a higher early failure probability than G4 specimens. Selective glass infiltration etching surface treatment was effective in modifying the zirconia surface roughness, increasing the bonding area and hence the mechanical imbrications at the zirconia/resin cement interface resulting in higher fracture toughness (K IC ) values with higher K IC values obtained when failure probability above 20% was expected (Weibull's distribution) among all the experimental groups. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Fatigue Life Prediction of 2D Woven Ceramic-Matrix Composites at Room and Elevated Temperatures

NASA Astrophysics Data System (ADS)

Longbiao, Li

2017-03-01

In this paper, the fatigue life of 2D woven ceramic-matrix composites, i.e., SiC/SiC, SiC/Si-N-C, SiC/Si-B4C, and Nextel 610™/Aluminosilicate, at room and elevated temperatures has been predicted using the micromechanics approach. An effective coefficient of the fiber volume fraction along the loading direction (ECFL) was introduced to describe the fiber architecture of preforms. The Budiansky-Hutchinson-Evans shear-lag model was used to describe the microstress field of the damaged composite considering fibers failure. The statistical matrix multicracking model and fracture mechanics interface debonding criterion were used to determine the matrix crack spacing and interface debonded length. The interface shear stress and fibers strength degradation model and oxidation region propagation model have been adopted to analyze the fatigue and oxidation effects on fatigue life of the composite, which is controlled by interface frictional slip and diffusion of oxygen gas through matrix multicrackings. Under cyclic fatigue loading, the fibers broken fraction was determined by combining the interface/fiber oxidation model, interface wear model and fibers statistical failure model at elevated temperatures, based on the assumption that the fiber strength is subjected to two-parameter Weibull distribution and the load carried by broken and intact fibers satisfy the Global Load Sharing (GLS) criterion. When the broken fibers fraction approaches to the critical value, the composites fatigue fractures. The fatigue life S- N curves of 2D SiC/SiC, SiC/Si-N-C, SiC/Si-B4C, and Nextel 610™/Aluminosilicate composites at room temperature and 800, 1000 and 1200 °C in air and steam have been predicted.

Effect of chemical composition of Ni-Cr dental casting alloys on the bonding characterization between porcelain and metal.

PubMed

Huang, H-H; Lin, M-C; Lee, T-H; Yang, H-W; Chen, F-L; Wu, S-C; Hsu, C-C

2005-03-01

The purpose of this study was to investigate the influence of chemical composition of Ni-Cr dental casting alloys on the bonding behaviour between porcelain and metal. A three-point bending test was used to measure the fracture load of alloy after porcelain firing. A scanning electron microscope, accompanied by an energy dispersion spectrometer, was used to analyse the morphology and chemical composition of the fracture surface. An X-ray photoelectron spectrometer and glow discharge spectrometer were used to identify the structure and cross-sectional chemical composition, respectively, of oxide layers on Ni-Cr alloys after heat treatment at 990 degrees C for 5 min. Results showed that the oxide layers formed on all Ni-Cr alloys contained mainly Cr2O3, NiO, and trace MoO3. The Ni-Cr alloy with a higher Cr content had a thicker oxide layer, as well as a weaker bonding behaviour of porcelain/metal interface. The presence of Al (as Al2O3) and Be (as BeO) on the oxide layer suppressed the growth of the oxide layer, leading to a better porcelain/metal bonding behaviour. However, the presence of a small amount of Ti (as TiO2) on the oxide layer did not have any influence on the bonding behaviour. The fracture propagated along the interface between the opaque porcelain and metal, and exhibited an adhesive type of fracture morphology.

Experimental and numerical study of hydraulic fracture geometry in shale formations with complex geologic conditions

NASA Astrophysics Data System (ADS)

Ma, Xinfang; Zhou, Tong; Zou, Yushi

2017-05-01

Strike-slip fault geostress and dipping laminated structures in Lujiaping shale formation typically result in difficultly predicting hydraulic fracture (HF) geometries. In this study, a novel 3D fracture propagation model based on discrete element method (DEM) is established. A series of simulations is performed to illustrate the influence of vertical stress difference (△σv = σv-σh), fluid viscosity, and injection rate, on HF growth geometry in the dipping layered formation. Results reveal that the fracturing fluid can easily infiltrate the dipping bedding plane (BP) interfaces with low net pressure for △σv = 1 MPa. HF height growth is also restricted. With increased △σv, fracture propagation in the vertical direction is enhanced, and a fracture network is formed by VF and partially opened dipping BPs. However, it is likely to create simple VF for △σv = 20 MPa. Appropriately increasing fracturing fluid viscosity and injection rate is conductive to weakening the containment effect of BPs on HF growth by increasing the fluid net pressure. However, no indication is found on whether a higher fracturing fluid viscosity is better. Higher viscosity can reduce the activation of BPs, so a stimulated reservoir volume is not necessarily increased. All these results can serve as theoretical guidance for the optimization of fracturing treatments in Lujiaping shale formation.

[Synovial fluid from aseptically failed total hip or knee arthroplasty is not toxic to osteoblasts].

PubMed

Gallo, J; Zdařilová, A; Rajnochová Svobodová, A; Ulrichová, J; Radová, L; Smižanský, M

2010-10-01

A failure of total hip or knee artroplasty is associated with an increased production of joint fluid. This contains wear particles and host cells and proteins, and is assumed to be involved in the pathogenesis of aseptic loosening and periprosthetic osteolysis. This study investigated the effect of synovial fluid from patients with aseptically failed joint prostheses on osteoblast cultures. Synovial fluid samples were obtained from patients with failed total joint prostheses (TJP; n=36) and from control patient groups (n = 16) involving cases without TJP and osteoarthritis, without TJP but with osteoarthritis, and with stable TJP. The samples were treated in the standard manner and then cultured with the SaOS-2 cell line which shows the characteristics and behaviour of osteoblasts. Each fluid sample was also examined for the content of proteins, cells and selected cytokines (IL-1ß, TNF-α, IL-6, RANKL and OPG detected by ELISA). We tested the hypothesis assuming that the fluids from failed joints would show higher cytotoxicity to osteoblast culture and we also expected higher levels of IL-1ß, TNF-α, IL-6, and RANKL in patients with TJP failure and/ or with more severe bone loss. The statistical methods used included the Kruskal-Wallis ANOVA and Mann-Whitney U test. The fluids from failed TJPs showed the highest RANKL and the lowest OPG levels resulting in the highest RANKL/OPG ratio. However, there was no evidence suggesting that the joint fluids from failed TJPs would be more toxic to osteoblast culture than the fluids from control groups. In addition, no correlation was found between the fluid levels of molecules promoting inflammation and osteoclastic activity and the extent of bone loss in the hip (in terms of Saleh's classification) or the knee (AORI classification). In fact, the fluids from failed TJPs had higher protein levels in comparison with the controls, but the difference was not significant. The finding of high RANKL levels and low OPG concentrations is in agreement with the theory of aseptic loosening and periprosthetic osteolysis. The other cytokines, particularly TNF-α and IL-1ß, were found in low levels. This can be explained by the stage of particle disease at which the samples were taken for ELISA analysis. It is probable that the level of signal molecules reflects osteolytic process activity and is therefore not constant. The reason for no correlation found between cytokine levels and the extent of bone loss may also lie in the use of therapeutic classifications of bone defects that is apparently less sensitive to the biological activity of aseptic loosening and/or periprosthetic osteolysis. Synovial fluids from failed total hip or knee joint prostheses are not toxic to osteoblast cultures. Cytotoxicity indicators and levels of pro-inflammatory and pro-osteoclastic cytokines (IL-1ß, TNF-α, IL-6, RANKL and OPG) do not correlate well with the extent of periprosthetic bone loss. Key words: total joint replacement, arthroplasty, aseptic loosening, periprosthetic osteolysis, joint fluid, SaOS-2 cell line, cytotoxicity, cytokines, RANKL, OPG.

Polyaxial stress-dependent permeability of a three-dimensional fractured rock layer

NASA Astrophysics Data System (ADS)

Lei, Qinghua; Wang, Xiaoguang; Xiang, Jiansheng; Latham, John-Paul

2017-12-01

A study about the influence of polyaxial (true-triaxial) stresses on the permeability of a three-dimensional (3D) fractured rock layer is presented. The 3D fracture system is constructed by extruding a two-dimensional (2D) outcrop pattern of a limestone bed that exhibits a ladder structure consisting of a "through-going" joint set abutted by later-stage short fractures. Geomechanical behaviour of the 3D fractured rock in response to in-situ stresses is modelled by the finite-discrete element method, which can capture the deformation of matrix blocks, variation of stress fields, reactivation of pre-existing rough fractures and propagation of new cracks. A series of numerical simulations is designed to load the fractured rock using various polyaxial in-situ stresses and the stress-dependent flow properties are further calculated. The fractured layer tends to exhibit stronger flow localisation and higher equivalent permeability as the far-field stress ratio is increased and the stress field is rotated such that fractures are preferentially oriented for shearing. The shear dilation of pre-existing fractures has dominant effects on flow localisation in the system, while the propagation of new fractures has minor impacts. The role of the overburden stress suggests that the conventional 2D analysis that neglects the effect of the out-of-plane stress (perpendicular to the bedding interface) may provide indicative approximations but not fully capture the polyaxial stress-dependent fracture network behaviour. The results of this study have important implications for understanding the heterogeneous flow of geological fluids (e.g. groundwater, petroleum) in subsurface and upscaling permeability for large-scale assessments.

Interfacial characterization of flexible hybrid electronics

NASA Astrophysics Data System (ADS)

Najafian, Sara; Amirkhizi, Alireza V.; Stapleton, Scott

2018-03-01

Flexible Hybrid Electronics (FHEs) are the new generation of electronics combining flexible plastic film substrates with electronic devices. Besides the electrical features, design improvements of FHEs depend on the prediction of their mechanical and failure behavior. Debonding of electronic components from the flexible substrate is one of the most common and critical failures of these devices, therefore, the experimental determination of material and interface properties is of great importance in the prediction of failure mechanisms. Traditional interface characterization involves isolated shear and normal mode tests such as the double cantilever beam (DCB) and end notch flexure (ENF) tests. However, due to the thin, flexible nature of the materials and manufacturing restrictions, tests mirroring traditional interface characterization experiments may not always be possible. The ideal goal of this research is to design experiments such that each mode of fracture is isolated. However, due to the complex nonlinear nature of the response and small geometries of FHEs, design of the proper tests to characterize the interface properties can be significantly time and cost consuming. Hence numerical modeling has been implemented to design these novel characterization experiments. This research involves loading case and specimen geometry parametric studies using numerical modeling to design future experiments where either shear or normal fracture modes are dominant. These virtual experiments will provide a foundation for designing similar tests for many different types of flexible electronics and predicting the failure mechanism independent of the specific FHE materials.

Impact of Casing Expansion on the Mechanical and Petro-Physical Properties of Wellbore Cements

NASA Astrophysics Data System (ADS)

Oyibo, A. E.

2014-12-01

The main objective of this research is to investigate the applicability of expandable casing technology as a remediation technique for leaky wells resulting in gas migration problems. Micro annulus is usually created at the cement-formation/cement-casing interface or within the cement matrix either due to poor primary cementing or as a result of activities such as temperature and pressure variation or fracturing operations. Recent reports on gas migration in hydraulically fractured wellbores, has raised concerns on the contamination of fresh water aquifers resulting from fluid migration though this flow path. A unique bench-scale physical model which utilizes expandable tubulars in the remediation of micro annular gas flow has been used to simulate expansion of a previously-cemented casing under field-like conditions. Three different designs of cement slurry: regular 16.4 lb. /gal, 16.4 lb. /gal base slurry foamed to 13 lb. /gal and 16.4 lb. /gal cement slurry with 10% salt concentration. Gas flow path (microannulus) was artificially created at the pipe-cement interface by rotating the inner pipe in a pipe inside pipe assembly with cement in the annulus within the first few hours of hydration to create debonding at the cement-casing interface. Nitrogen gas flow-through experiments were performed before and after the expansion to confirm the sealing of the microannulus. The results obtained confirmed the effectiveness of this technique in the complete closure of gas leakage path, providing seal-tight cement-formation interface free of microannulus. The manipulation of the cement sheath during the casing expansion resulted in improved porosity, permeability and the strength of the cement sheath. SEM micrographs revealed decrease in pore size and fracturing of unhydrated cement grains within the cement matrix. This technology has great potential to become one of the leading cement remediation techniques for leaks behind the casing if implemented. Keywords: Wellbore Integrity, Casing Expansion, Well Gas Leaks, CSH, Pore Collapse, Cement Pore Water.

Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results.

PubMed

Cooper, Lyndon F; Stanford, Clark; Feine, Jocelyne; McGuire, Michael

2016-07-01

Single-tooth implant restorations are commonly used to replace anterior maxillary teeth. The esthetic, functional, and biologic outcomes are, in part, a function of the abutment and crown. The purpose of this clinical study was to describe the implant, abutment, and crown survival and complication rates for CAD/CAM zirconia abutment and lithium disilicate crown restorations for single-tooth implants. As part of a broader prospective investigation that enrolled and treated 141 participants comparing tissue responses at the conical interface (CI; AstraTech OsseoSpeed), flat-to-flat interface (FI; NobelSpeedy), and platform-switch interface (PS; NanoTite Certain Prevail) of single-tooth implants, computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia abutments (ATLANTIS Abutment) and cemented lithium disilicate (e.max) crowns were used in the restoration of all implants. After 2.4 years in function (3 years after implant placement), the implant, abutment, and crown of 110 participants were evaluated. Technical and biologic complications were recorded. Demographic results were tabulated as percentages with mean values and standard deviations. Abutment survival was calculated with the Kaplan-Meier method. After 2.4 years, no abutments or crowns had been lost. Abutment complications (screw loosening, screw fracture, fracture) were absent for all 3 implant groups. Crown complications were limited to 2 crowns debonding and 1 with excess cement (2.5%). Five biological complications (4.0%) were recorded. The overall complication rate was 6.5%. CAD/CAM zirconia abutments restored with cemented lithium disilicate crowns demonstrated high survival on 3 different implant-abutment interface designs. No abutment or abutment screw fracture occurred. The technical complications observed after 2.4 years were minor and reversible. The use of CAD/CAM zirconia abutments with cemented lithium disilicate crowns is associated with high technical and biologic success at 2.4 years. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Bioinspired design and interfacial failure of biomedical systems

NASA Astrophysics Data System (ADS)

Rahbar, Nima

The deformation mechanism of nacre as a model biological material is studied in this project. A numerical model is presented which consists of tensile pillars, shear pillars, asperities and aragonite platelets. It has been shown that the tensile pillars are the main elements that control the global stiffness of the nacre structure. Meanwhile, ultimate strength of the nacre structure is controlled by asperities and their behavior and the ratio of L/2D which is itself a function of the geometry of the platelets. Protein/shear pillars provide the glue which holds the assembly of entire system together, particularly in the direction normal to the platelets main axis. This dissertation also presents the results of a combined theoretical/computational and experimental effort to develop crack resistant dental multilayers that are inspired by the functionally graded dento-enamel junction (DEJ) structure that occurs between dentin and enamel in natural teeth. The complex structures of natural teeth and ceramic crowns are idealized using at layered configurations. The potential effects of occlusal contact are then modeled using finite element simulations of Hertzian contact. The resulting stress distributions are compared for a range of possible bioinspired, functionally graded architecture. The computed stress distributions show that the highest stress concentrations in the top ceramic layer of crown structures are reduced significantly by the use of bioinspired functionally graded architectures. The reduced stresses are shown to be associated with significant improvements (30%) in the pop-in loads over a wide range of clinically-relevant loading rates. The implications of the results are discussed for the design of bioinspired dental ceramic crown structures. The results of a combined experimental and computational study of mixed mode fracture in glass/cement and zirconia/cement interfaces that are relevant to dental restorations is also presented. The interfacial fracture is investigated using Brazil-nut specimens. The kinking in-and-out of the interface that occurs between glass/cement and zirconia/cement interfaces, is also shown to be consistent with predictions from a microstructure-based finite element model. The predictions are later verified using focused ion beam and scanning electron microscopy images. Finally, the adhesion between layers that are relevant to drug-eluting stents is explored. Brazil disk specimens were used to measure the interfacial fracture energies between the layers of a model drug eluting stent over a wide range of mode mixities. The trends in the overall fracture energies are predicted using a combination of adhesion theories and fracture mechanics concepts. The measured interfacial fracture energies are shown to be in good agreement with the predictions.

Metal-dielectric interactions

NASA Technical Reports Server (NTRS)

Buckley, D. H.

1979-01-01

Metal direlectric surface interactions and dielectric films on metal substrates were investigated. Since interfacial interaction depends so heavily on the nature of the surfaces, analytical surface tools such as Auger emission spectroscopy, X-ray photoelectron spectroscopy and field ion microscopy were used to assist in surface and interfacial characterization. The results indicate that with metals contacting certain glasses in the clean state interfacial, bonding produces fractures in the glasses while when a film such as water is present, fractures occur in the metal near the interface. Friction forces were used to measure the interfacial bond strengths. Studies with metals contacting polymers using field ion microscopy revealed that strong bonding forces could develop being between a metal and polymer surface with polymer transferring to the metal surface in various ways depending upon the forces applied to the surface in contact. With the deposition of refractory carbides, silicides and borides onto metal and alloy substrates the presence of oxides at the interface or active gases in the deposition plasma were shown to alter interfacial properties and chemistry. Auger ion depth profile analysis indicated the chemical composition at the interface and this could be related to the mechanical, friction, and wear behavior of the coating.

Microstructure and Hydrogen-Induced Failure Mechanisms in Fe and Ni Alloy Weldments

NASA Astrophysics Data System (ADS)

Fenske, J. A.; Robertson, I. M.; Ayer, Raghavan; Hukle, Martin; Lillig, Dan; Newbury, Brian

2012-09-01

The microstructure and fracture morphology of AISI 8630-IN625 and ASTM A182-F22-IN625 dissimilar metal weld interfaces were compared and contrasted as a function of postweld heat treatment (PWHT) duration. For both systems, the microstructure along the weld interface consisted of a coarse grain heat-affected zone in the Fe-base metal followed by discontinuous martensitic partially mixed zones and a continuous partially mixed zone on the Ni side of the fusion line. Within the partially mixed zone on the Ni side, there exists a 200-nm-wide transition zone within a 20- μm-wide planar solidification region followed by a cellular dendritic region with Nb-Mo-rich carbides decorating the dendrite boundaries. Although there were differences in the volume of the partially mixed zones, the major difference in the metal weld interfaces was the presence of M7C3 precipitates in the planar solidification region, which had formed in AISI 8630-IN625 but not in ASTM A182-F22-IN625. These precipitates make the weldment more susceptible to hydrogen embrittlement and provide a low energy fracture path between the discontinuous partially mixed zones.

Role of different compatibilizing approaches on the microstructure and mechanical properties of polypropylene/talc composites

NASA Astrophysics Data System (ADS)

Homayounfar, S. Z.; Bagheri, R.

2014-05-01

Since in a highly filled polymer, a major problem arises from non-uniformity of properties due to the poor dispersion of filler, the application of coupling agents have been directed to overcome this problem and also to enhance the mechanical performance of the composites by improving the adhesion at the interface. In this study, a comparison between two major coupling approaches is conducted: 1) Using PPgMA as a kind of compatibilizer which changes the nature of the matrix, 2) Using titanate coupling agent which takes action at the interface and reacts with hydroxyl groups at the inorganic filler surface, resulting in the formation of monomolecular layer on the inorganic surface to increase compatibility of filler/matrix interface. The comparison is made based on the mechanical properties of the composites by means of elastic modulus, yield stress, impact strength and percentage of strain-to-fracture and evaluation of their effects on both the dispersion and adhesion of talc plates in the matrix through the microscopy. Transmission optical microscopy (TOM) and scanning electron microscopy (SEM) are used to observe the deformation micromechanism and the fracture surface of the composites, respectively.

[The method and result analyses of pathogenic bacteria culture on chronic periprosthetic joint infection after total knee arthroplasty and total hip arthroplasty].

PubMed

Ji, Baochao; Xu, Enjie; Cao, Li; Yang, Desheng; Xu, Boyong; Guo, Wentao; Aili, Rehei

2015-02-01

To analyze the results of pathogenic bacteria culture on chronic periprosthetic joint infection after total knee arthroplasty (TKA) and total hip arthroplasty (THA). The medical data of 23 patients with chronic periprosthetic joint infection after TKA or THA from September 2010 to March 2014 were reviewed. Fifteen cases of TKA and 8 cases of THA were included in this study. There were 12 male and 11 female patients with the mean age of 62 years (range from 32 to 79 years), and among them 9 patients with sinus. All patients discontinued antibiotic therapy for a minimum of 2 weeks before arthrocentesis, taking pathogenic bacteria culture and antimicrobial susceptibility test by using synovial fluid taken preoperatively and intraoperatively of revision. Common pathogenic bacteria culture and pathological biopsy were taken on tissues intraoperatively of revision. Culture-negative specimens were prolonged the period of incubation for 2 weeks. The overall culture-positive rate of all 23 patients for 1 week before revision was 30.4% (7/23), and the positive rate of culture-negative samples which prolonged for 2 weeks was 39.1% (9/23). The overall culture-positive rate of patients for 1 week intraoperatively of revision was 60.9% (14/23), and the positive rate of culture-negative samples which prolonged for 2 weeks was 82.6% (19/23). The incubation results of 7 cases (30.4%) preoperatively conformed to that of intraoperation. The culture-positive rate of pathogenic bacteria culture can be increased evidently by discontinuing antimicrobial therapy for a minimum of 2 weeks prior to the definite diagnosis.

Effect of zoledronic acid on reducing femoral bone mineral density loss following total hip arthroplasty: A meta-analysis from randomized controlled trails.

PubMed

Gao, Jian; Gao, Chong; Li, Hui; Wang, Guo-Sheng; Xu, Chang; Ran, Jian

2017-11-01

This meta-analysis aimed to assess the efficiency of intravenous administration of zoledronic acid on reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty (THA). A systematic search was performed in Medline (1966-2017.07.31), PubMed (1966-2017.07.31), Embase (1980-2017.07.31), ScienceDirect (1985-2017.07.31) and the Cochrane Library (1966-2017.07.31). Fixed/random effect model was used according to the heterogeneity tested by I 2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software. Four studies including 185 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of periprosthetic bone mineral density in Gruen zone 1 (SMD = 0.752, 95% CI: 0.454 to 1.051, P = 0.000), 2 (SMD = 0.524, 95% CI: 0.230 to 0.819, P = 0.000), 4 (SMD = 0.400, 95% CI: 0.107 to 0.693, P = 0.008), 6 (SMD = 0.893, 95% CI: 0.588 to 1.198, P = 0.000) and 7 (SMD = 0.988, 95% CI: 0.677 to 1.300, P = 0.000). Intravenous administration of zoledronic acid could significantly reduce periprosthetic bone mineral density loss (Gruen zone 1, 2, 4, 6 and 7) after THA. In addition, no severe adverse events were identified. High-quality RCTs with large sample size were still required. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

The impact of postoperative expansion initiation timing on breast expander capsular characteristics: a prospective combined clinical and scanning electron microscopy study.

PubMed

Paek, Laurence S; Giot, Jean-Philippe; Tétreault-Paquin, Jean-Olivier; St-Jacques, Samuel; Nelea, Monica; Danino, M Alain

2015-04-01

In the first stage of expander-to-implant breast reconstruction, postoperative expansion is classically initiated at 10 to 14 days (conventional approach). The authors hypothesized that it may be beneficial to wait 6 weeks postoperatively before initiating serial expansion (delayed approach). Clinical and ultrastructural periprosthetic capsule analysis is first required before determining whether a delayed approach ultimately improves capsular tissue adherence and expansion process predictability. Patients undergoing two-stage implant-based breast reconstruction were enrolled prospectively in this study. During expander-to-implant exchange, the clinical presence of "Velcro" effect, biofilm, and double capsule was noted. Periprosthetic capsule samples were also sent for scanning electron microscopic observation of three parameters: surface relief, cellularity, and biofilm. Samples were divided into four groups for data analysis (group 1, conventional/Biocell; group 2, delayed/Biocell; group 3, conventional/Siltex; and group 4, delayed/Siltex). Fifty-six breast reconstructions were included. Each group comprised between 13 and 15 breasts. In group 1, no cases exhibited the Velcro effect and there was a 53.8 percent incidence of both biofilm and double capsule. In group 2, all cases demonstrated the Velcro effect and there were no incidences of biofilm or double capsule. Group 3 and group 4 cases did not exhibit a Velcro effect or double-capsule formation; however, biofilm was present in up to 20.0 percent. All group 2 samples revealed more pronounced three-dimensional relief on scanning electron microscopy. Variations in expansion protocols can lead to observable modifications in periprosthetic capsular architecture. There may be real benefits to delaying expander inflation until 6 weeks postoperatively with Biocell expanders.

Does cemented or cementless single-stage exchange arthroplasty of chronic periprosthetic hip infections provide similar infection rates to a two-stage? A systematic review.

PubMed

George, D A; Logoluso, N; Castellini, G; Gianola, S; Scarponi, S; Haddad, F S; Drago, L; Romano, C L

2016-10-10

The best surgical modality for treating chronic periprosthetic hip infections remains controversial, with a lack of randomised controlled studies. The aim of this systematic review is to compare the infection recurrence rate after a single-stage versus a two-stage exchange arthroplasty, and the rate of cemented versus cementless single-stage exchange arthroplasty for chronic periprosthetic hip infections. We searched for eligible studies published up to December 2015. Full text or abstract in English were reviewed. We included studies reporting the infection recurrence rate as the outcome of interest following single- or two-stage exchange arthroplasty, or both, with a minimum follow-up of 12 months. Two reviewers independently abstracted data and appraised quality assessment. After study selection, 90 observational studies were included. The majority of studies were focused on a two-stage hip exchange arthroplasty (65 %), 18 % on a single-stage exchange, and only a 17 % were comparative studies. There was no statistically significant difference between a single-stage versus a two-stage exchange in terms of recurrence of infection in controlled studies (pooled odds ratio of 1.37 [95 % CI = 0.68-2.74, I 2  = 45.5 %]). Similarly, the recurrence infection rate in cementless versus cemented single-stage hip exchanges failed to demonstrate a significant difference, due to the substantial heterogeneity among the studies. Despite the methodological limitations and the heterogeneity between single cohorts studies, if we considered only the available controlled studies no superiority was demonstrated between a single- and two-stage exchange at a minimum of 12 months follow-up. The overalapping of confidence intervals related to single-stage cementless and cemented hip exchanges, showed no superiority of either technique.

Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

PubMed Central

2012-01-01

Background Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis. Methods We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion. Results During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower stress for the Genesis II design. Conclusions Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding. PMID:22704638

Therapeutic potentials of naringin on polymethylmethacrylate induced osteoclastogenesis and osteolysis, in vitro and in vivo assessments

PubMed Central

Li, Nianhu; Xu, Zhanwang; Wooley, Paul H; Zhang, Jianxin; Yang, Shang-You

2014-01-01

Wear debris associated periprosthetic osteolysis represents a major pathological process associated with the aseptic loosening of joint prostheses. Naringin is a major flavonoid identified in grapefruit. Studies have shown that naringin possesses many pharmacological properties including effects on bone metabolism. The current study evaluated the influence of naringin on wear debris induced osteoclastic bone resorption both in vitro and in vivo. The osteoclast precursor cell line RAW 264.7 was cultured and stimulated with polymethylmethacrylate (PMMA) particles followed by treatment with naringin at several doses. Tartrate resistant acid phosphatase (TRAP), calcium release, and gene expression profiles of TRAP, cathepsin K, and receptor activator of nuclear factor-kappa B were sequentially evaluated. PMMA challenged murine air pouch and the load bearing tibia titanium pin-implantation mouse models were used to evaluate the effects of naringin in controlling PMMA induced bone resorption. Histological analyses and biomechanical pullout tests were performed following the animal experimentation. The in vitro data clearly demonstrated the inhibitory effects of naringin in PMMA induced osteoclastogenesis. The naringin dose of 10 μg/mL exhibited the most significant influence on the suppression of TRAP activities. Naringin treatment also markedly decreased calcium release in the stimulated cell culture medium. The short-term air pouch mouse study revealed that local injection of naringin ameliorated the PMMA induced inflammatory tissue response and subsequent bone resorption. The long-term tibia pin-implantation mouse model study suggested that daily oral gavage of naringin at 300 mg/kg dosage for 30 days significantly alleviated the periprosthetic bone resorption. A significant increase of periprosthetic bone volume and regaining of the pin stability were found in naringin treated mice. Overall, this study suggests that naringin may serve as a potential therapeutic agent to treat wear debris associated osteolysis. PMID:24376342

Temporal radiographic texture analysis in the detection of periprosthetic osteolysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilkie, Joel R.; Giger, Maryellen L.; Chinander, Michael R.

2008-01-15

Periprosthetic osteolysis is one of the most serious long-term problems in total hip arthroplasty. It has been primarily attributed to the body's inflammatory response to submicron polyethylene particles worn from the hip implant, and it leads to bone loss and structural deterioration in the surrounding bone. It was previously demonstrated that radiographic texture analysis (RTA) has the ability to distinguish between osteolysis and normal cases at the time of clinical detection of the disease; however, that analysis did not take into account the changes in texture over time. The goal of this preliminary analysis, however, is to assess the abilitymore » of temporal radiographic texture analysis (tRTA) to distinguish between patients who develop osteolysis and normal cases. Two tRTA methods were used in the study: the RTA feature change from baseline at various follow-up intervals and the slope of the best-fit line to the RTA data series. These tRTA methods included Fourier-based and fractal-based features calculated from digitized images of 202 total hip replacement cases, including 70 that developed osteolysis. Results show that separation between the osteolysis and normal groups increased over time for the feature difference method, as the disease progressed, with area under the curve (AUC) values from receiver operating characteristic analysis of 0.65 to 0.72 at 15 years postsurgery. Separation for the slope method was also evident, with AUC values ranging from 0.65 to 0.76 for the task of distinguishing between osteolysis and normal cases. The results suggest that tRTA methods have the ability to measure changes in trabecular structure, and may be useful in the early detection of periprosthetic osteolysis.« less

Metal artefact reduction in gemstone spectral imaging dual-energy CT with and without metal artefact reduction software.

PubMed

Lee, Young Han; Park, Kwan Kyu; Song, Ho-Taek; Kim, Sungjun; Suh, Jin-Suck

2012-06-01

To assess the usefulness of gemstone spectral imaging (GSI) dual-energy CT (DECT) with/without metal artefact reduction software (MARs). The DECTs were performed using fast kV-switching GSI between 80 and 140 kV. The CT data were retro-reconstructed with/without MARs, by different displayed fields-of-view (DFOV), and with synthesised monochromatic energy in the range 40-140 keV. A phantom study of size and CT numbers was performed in a titanium plate and a stainless steel plate. A clinical study was performed in 26 patients with metallic hardware. All images were retrospectively reviewed in terms of the visualisation of periprosthetic regions and the severity of beam-hardening artefacts by using a five-point scale. The GSI-MARs reconstruction can markedly reduce the metal-related artefacts, and the image quality was affected by the prosthesis composition and DFOV. The spectral CT numbers of the prosthesis and periprosthetic regions showed different patterns on stainless steel and titanium plates. Dual-energy CT with GSI-MARs can reduce metal-related artefacts and improve the delineation of the prosthesis and periprosthetic region. We should be cautious when using GSI-MARs because the image quality was affected by the prosthesis composition, energy (in keV) and DFOV. The metallic composition and size should be considered in metallic imaging with GSI-MARs reconstruction. • Metal-related artefacts can be troublesome on musculoskeletal computed tomography (CT). • Gemstone spectral imaging (GSI) with dual-energy CT (DECT) offers a novel solution • GSI and metallic artefact reduction software (GSI-MAR) can markedly reduce these artefacts. • However image quality is influenced by the prosthesis composition and other parameters. • We should be aware about potential overcorrection when using GSI-MARs.

Clinical Analysis of Propionibacterium acnes Infection After Total Knee Arthroplasty.

PubMed

Nodzo, Scott R; Westrich, Geoffrey H; Henry, Michael W; Miller, Andy O

2016-09-01

Propionibacterium acnes is a common cause of upper extremity arthroplasty infection and usually presents in an indolent subacute fashion. It is not well described how total knee arthroplasty (TKA) patients infected with P acnes present. We retrospectively compared patients undergoing revision TKA for infection from P acnes and methicillin-sensitive Staphylococcal aureus (MSSA) in our institutional infection database. Patients were classified as having a periprosthetic joint infection based on the Musculoskeletal Infection Society criteria and were excluded if they had a polymicrobial culture. Patient demographics, preoperative laboratory values, microbiology data, and synovial fluid white blood cell (WBC) counts were analyzed. Sixteen patients with a P acnes and 30 with an MSSA TKA periprosthetic joint infection were identified. Median erythrocyte sedimentation rate was significantly higher in the MSSA group compared to the P acnes group (56.0 mm/h; interquartile range [IQR], 44.3-72.9 vs 23.0 mm/h; IQR, 18.5-52.0; respectively, P = .03) as were C-reactive protein levels (5.9 mg/dL; IQR, 3.7-26.9 vs 2.0 mg/dL; IQR, 0.5-14.0; respectively, P = .04). WBC count, synovial fluid WBC, and percentage of synovial polymorphonuclear cells were similar between groups. Mean time to culture was 8.3 ± 2.0 days in the P acnes group and 1.8 ± 0.8 days in the MSSA group. P acnes TKA infections are associated with more acute inflammatory symptoms than typically appreciated, and long hold anaerobic cultures up to 14 days are necessary to accurately identify this organism as the causative agent of TKA periprosthetic infection. Copyright © 2016 Elsevier Inc. All rights reserved.

The Zeitgeist of Challenging the Evidence. A Perspective on the International Consensus Meeting on Periprosthetic Joint Infection.

PubMed

Fayaz, Hangama C; Jupiter, Jesse B

2017-01-01

The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus Meeting on Periprosthetic Joint Infection (ICMPJI) to be the "flawless pledge of international academics" to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process. The proceedings of the ICMPJI was reviewed, and the critical consensus agreements that were reached were communicated via e-mail to 48 leading orthopaedic surgeons, microbiologists and statisticians around the world. Of these, 30 responded, 8 did not, and 10 of respondents were not aware of the ICMPJI. A thorough review of the ICMPJI proceedings identified a clear need to resolve some of the dilemmas that we highlight in this paper. The Delphi procedure has been described as a survey technique that enables a group dynamic-based practice. Although there have been several published reports on this procedure, its scientific merit is still being debated. Several challenges and questions have been raised regarding the application of the Delphi technique, but there is no doubt that it is a vital approach for achieving consensus on subjects where none currently exists. Performing prospective clinical studies in this area is currently the best and only option to overcome this challenge. In the long term, this approach will not only incorporate the standard of clinical evidence but also adopt regional mores for treating infection, which include patient values, cultural differences and local financial resources.

The Zeitgeist of Challenging the Evidence. A Perspective on the International Consensus Meeting on Periprosthetic Joint Infection

PubMed Central

Fayaz, Hangama C.; Jupiter, Jesse B.

2017-01-01

Background: The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus Meeting on Periprosthetic Joint Infection (ICMPJI) to be the “flawless pledge of international academics” to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process. Methods: The proceedings of the ICMPJI was reviewed, and the critical consensus agreements that were reached were communicated via e-mail to 48 leading orthopaedic surgeons, microbiologists and statisticians around the world. Of these, 30 responded, 8 did not, and 10 of respondents were not aware of the ICMPJI. Results: A thorough review of the ICMPJI proceedings identified a clear need to resolve some of the dilemmas that we highlight in this paper. The Delphi procedure has been described as a survey technique that enables a group dynamic-based practice. Although there have been several published reports on this procedure, its scientific merit is still being debated. Several challenges and questions have been raised regarding the application of the Delphi technique, but there is no doubt that it is a vital approach for achieving consensus on subjects where none currently exists. Conclusion: Performing prospective clinical studies in this area is currently the best and only option to overcome this challenge. In the long term, this approach will not only incorporate the standard of clinical evidence but also adopt regional mores for treating infection, which include patient values, cultural differences and local financial resources. PMID:28271085

Correlation of quantitative histopathological morphology and quantitative radiological analysis during aseptic loosening of hip endoprostheses.

PubMed

Bertz, S; Kriegsmann, J; Eckardt, A; Delank, K-S; Drees, P; Hansen, T; Otto, M

2006-01-01

Aseptic hip prosthesis loosening is the most important long-term complication in total hip arthroplasty. Polyethylene (PE) wear is the dominant etiologic factor in aseptic loosening, which together with other factors induces mechanisms resulting in bone loss, and finally in implant loosening. The single-shot radiograph analysis (EBRA, abbreviation for the German term "Einzel-Bild-Röntgenanalyse") is a computerized method for early radiological prediction of aseptic loosening. In this study, EBRA parameters were correlated with histomorphological parameters of the periprosthetic membrane. Periprosthetic membranes obtained from 19 patients during revision surgery of loosened ABG I-type total hip pros-theses were analyzed histologically and morphometrically. The pre-existing EBRA parameters, the thickness of the PE debris lay-er and the dimension of inclination and anteversion, were compared with the density of macrophages and giant cells. Addi-tionally, the semiquantitatively determined density of lymphocytes, plasma cells, giant cells and the size of the necrotic areas were correlated with the EBRA results. All periprosthetic membranes were classified as debris-induced type membranes. We found a positive correlation between the number of giant cells and the thickness of the PE debris layer. There was no significant correlation between the number of macrophages or all semiquantitative parameters and EBRA parameters. The number of giant cells decreased with implant duration. The morphometrically measured number of foreign body giant cells more closely reflects the results of the EBRA. The semiquantitative estimation of giant cell density could not substitute for the morphometrical analysis. The density of macrophages, lymphocytes, plasma cells and the size of necrotic areas did not correlate with the EBRA parameters, indicating that there is no correlation with aseptic loosening.

Cohesive zone modelling of wafer bonding and fracture: effect of patterning and toughness variations

NASA Astrophysics Data System (ADS)

Kubair, D. V.; Spearing, S. M.

2006-03-01

Direct wafer bonding has increasingly become popular in the manufacture of microelectromechanical systems and semiconductor microelectronics components. The success of the bonding process is controlled by variables such as wafer flatness and surface preparation. In order to understand the effects of these variables, spontaneous planar crack propagation simulations were performed using the spectral scheme in conjunction with a cohesive zone model. The fracture-toughness on the bond interface is varied to simulate the effect of surface roughness (nanotopography) and patterning. Our analysis indicated that the energetics of crack propagation is sensitive to the local surface property variations. The patterned wafers are tougher (well bonded) than the unpatterned ones of the same average fracture-toughness.

Tensile strength of Fe-Ni and Mg-Al nanocomposites: Molecular dynamic simulations

NASA Astrophysics Data System (ADS)

Pogorelko, V. V.; Mayer, A. E.

2018-01-01

In this work, molecular dynamic simulations of the tensile strength of Fe-Ni and Mg-Al nanocomposites in the conditions of high-rate uniaxial tension were carried out. Two different mechanisms of fracture were identified. In the case of nickel inclusion in iron matrix, the fracture begins on the interface between the inclusion and the matrix, a formed void penetrates both into the inclusion and into the matrix; presence of inclusion reduces the tensile strength. In the case of aluminum inclusion in magnesium matrix, fracture takes place into magnesium matrix and does not touch the inclusion; presence of inclusion has practically no effect on the tensile strength. Molecular dynamic simulations were carried out in a wide range of strain rates and temperatures.

Effect of Bonding Time on Interfacial Reaction and Mechanical Properties of Diffusion-Bonded Joint Between Ti-6Al-4V and 304 Stainless Steel Using Nickel as an Intermediate Material

NASA Astrophysics Data System (ADS)

Thirunavukarasu, Gopinath; Kundu, Sukumar; Mishra, Brajendra; Chatterjee, Subrata

2014-04-01

In the current study, solid-state diffusion bonding between Ti-6Al-4V (TiA) and 304 stainless steel (SS) using pure nickel (Ni) of 200- μm thickness as an intermediate material was carried out in vacuum. Uniaxial compressive pressure and temperature were kept at 4 MPa and 1023 K (750 °C), respectively, and the bonding time was varied from 30 to 120 minutes in steps of 15 minutes. Scanning electron microscopy images, in backscattered electron mode, revealed the layerwise Ti-Ni-based intermetallics like either Ni3Ti or both Ni3Ti and NiTi at titanium alloy-nickel (TiA/Ni) interface, whereas nickel-stainless steel (Ni/SS) interface was free from intermetallic phases for all the joints. Chemical composition of the reaction layers was determined by energy dispersive spectroscopy (SEM-EDS) and confirmed by X-ray diffraction study. Maximum tensile strength of ~382 MPa along with ~3.7 pct ductility was observed for the joints processed for 60 minutes. It was found that the extent of diffusion zone at Ni/SS interface was greater than that of TiA/Ni interface. From the microhardness profile, fractured surfaces, and fracture path, it was demonstrated that the failure of the joints was initiated and propagated apparently at TiA/Ni interface near Ni3Ti intermetallic for bonding time less than 90 minutes, and through Ni for bonding time 90 minutes and greater.

IPS-Empress II inlay-retained fixed partial denture reinforced with zirconia bar: three-dimensional finite element and in-vitro studies.

PubMed

Kermanshah, Hamid; Geramy, Allahyar; Ebrahimi, Shahram Farzin; Bitaraf, Tahereh

2012-12-01

This study evaluated von Mises stress distribution, flexural strength and interface micrographs of IPS-Empress II (IPS) inlay-retained fixed partial dentures (IRFPD) reinforced with Zirconia bars (Zb). In the Finite element analysis, six three-dimensional models of IRFPD were designed using Solid Works 2006. Five models were reinforced with different Zb and a model without Zb was considered as a control. The bridges were loaded by 200 and 500 N forces at the middle of the pontic on the occlusal surface. Subsequently, von Mises stress and displacement of the models were evaluated along a defined path. In the experimental part, 21 bar shape specimens were fabricated from lithium disilicate and zirconia ceramic in three different designs. The zirconia-IPS interfaces and the fractured surfaces of flexural test were observed using SEM. In the connector area, von Mises stress and displacement of the models with Zb under a load of 500 N were decreased compared to the model without the Zb; however, this difference was not considerable at a load of 200 N. In the mesial connector, Von Mises stress and displacement was decreased from 12.5 Mpa for the control model tested at 500 N to 7.0 Mpa for the model with Zb and from 0.0050-0.0041 mm, respectively. SEM analyses showed that, before fracture, interfacial gaps were not observed along the interfaces, but initiated cracks propagated along the interfaces after flexural loading. IPS IRFPD reinforced by Zb can tolerate higher stresses while still functioning effectively and the interfaces may have desirable adaption.

Distinct Element Method modelling of fold-related fractures in a multilayer sequence

NASA Astrophysics Data System (ADS)

Kaserer, Klemens; Schöpfer, Martin P. J.; Grasemann, Bernhard

2017-04-01

Natural fractures have a significant impact on the performance of hydrocarbon systems/reservoirs. In a multilayer sequence, both the fracture density within the individual layers and the type of fracture intersection with bedding contacts are key parameters controlling fluid pathways. In the present study the influence of layer stacking and interlayer friction on fracture density and connectivity within a folded sequence is systematically investigated using 2D Distinct Element Method modelling. Our numerical approach permits forward modelling of both fracture nucleation/propagation/arrest and (contemporaneous) frictional slip along bedding planes in a robust and mechanically sound manner. Folding of the multilayer sequence is achieved by enforcing constant curvature folding by means of a velocity boundary condition at the model base, while a constant overburden pressure is maintained at the model top. The modelling reveals that with high bedding plane friction the multilayer stack behaves mechanically as a single layer so that the neutral surface develops in centre of the sequence and fracture spacing is controlled by the total thickness of the folded sequence. In contrast, low bedding plane friction leads to decoupling of the individual layers (flexural slip folding) so that a neutral surface develops in the centre of each layer and fracture spacing is controlled by the thickness of the individual layers. The low interfacial friction models illustrate that stepping of fractures across bedding planes is a common process, which can however have two contrasting origins: The mechanical properties of the interface cause fracture stepping during fracture propagation. Originally through-going fractures are later offset by interfacial slip during folding. A combination of these two different origins may lead to (apparently) inconsistent fracture offsets across bedding planes within a flexural slip fold.

What experimental approaches (eg, in vivo, in vitro, tissue retrieval) are effective in investigating the biologic effects of particles?

PubMed Central

Bostrom, Mathias; O'Keefe, Regis

2009-01-01

Understanding the complex cellular and tissue mechanisms and interactions resulting in periprosthetic osteolysis requires a number of experimental approaches, each of which has its own set of advantages and limitations. In vitro models allow for the isolation of individual cell populations and have furthered our understanding of particle-cell interactions; however, they are limited because they do not mimic the complex tissue environment in which multiple cell interactions occur. In vivo animal models investigate the tissue interactions associated with periprosthetic osteolysis, but the choice of species and whether the implant system is subjected to mechanical load or to unloaded conditions are critical in assessing whether these models can be extrapolated to the clinical condition. Rigid analysis of retrieved tissue from clinical cases of osteolysis offers a different approach to studying the biologic process of osteolysis, but it is limited in that the tissue analyzed represents the end-stage of this process and, thus, may not reflect this process adequately. PMID:18612016

What experimental approaches (eg, in vivo, in vitro, tissue retrieval) are effective in investigating the biologic effects of particles?

PubMed

Bostrom, Mathias; O'Keefe, Regis

2008-01-01

Understanding the complex cellular and tissue mechanisms and interactions resulting in periprosthetic osteolysis requires a number of experimental approaches, each of which has its own set of advantages and limitations. In vitro models allow for the isolation of individual cell populations and have furthered our understanding of particle-cell interactions; however, they are limited because they do not mimic the complex tissue environment in which multiple cell interactions occur. In vivo animal models investigate the tissue interactions associated with periprosthetic osteolysis, but the choice of species and whether the implant system is subjected to mechanical load or to unloaded conditions are critical in assessing whether these models can be extrapolated to the clinical condition. Rigid analysis of retrieved tissue from clinical cases of osteolysis offers a different approach to studying the biologic process of osteolysis, but it is limited in that the tissue analyzed represents the end-stage of this process and, thus, may not reflect this process adequately.

Controlled release of vancomycin from thin sol-gel films on implant surfaces successfully controls osteomyelitis.

PubMed

Adams, Christopher S; Antoci, Valentin; Harrison, Gerald; Patal, Payal; Freeman, Terry A; Shapiro, Irving M; Parvizi, Javad; Hickok, Noreen J; Radin, Shula; Ducheyne, Paul

2009-06-01

Peri-prosthetic infection remains a serious complication of joint replacement surgery. Herein, we demonstrate that a vancomycin-containing sol-gel film on Ti alloy rods can successfully treat bacterial infections in an animal model. The vancomycin-containing sol-gel films exhibited predictable release kinetics, while significantly inhibiting S. aureus adhesion. When evaluated in a rat osteomyelitis model, microbiological analysis indicated that the vancomycin-containing sol-gel film caused a profound decrease in S. aureus number. Radiologically, while the control side showed extensive bone degradation, including abscesses and an extensive periosteal reaction, rods coated with the vancomycin-containing sol-gel film resulted in minimal signs of infection. MicroCT analysis confirmed the radiological results, while demonstrating that the vancomycin-containing sol-gel film significantly protected dense bone from resorption and minimized remodeling. These results clearly demonstrate that this novel thin sol-gel technology can be used for the targeted delivery of antibiotics for the treatment of periprosthetic as well as other bone infections. Copyright 2008 Orthopaedic Research Society

Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

PubMed

Bosco, Joseph A; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett

2015-08-01

Infection is a rare, serious complication following total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Comparable outcome of culture-negative and culture-positive periprosthetic hip joint infection for patients undergoing two-stage revision.

PubMed

Wang, Jin; Wang, Qiaojie; Shen, Hao; Zhang, Xianlong

2018-03-01

Lack of peri-operative microbiological evidence is an unfavourable factor in one-stage revision. The objective of this study was to figure out whether being culture-negative was an unfavourable factor for periprosthetic hip joint infection (PHJI) in patients undergoing two-stage revision. Records of PHJI patients treated between October 2003 and December 2016 were reviewed at our institution. Information such as microbiological data, clinical outcomes, and other details of patients' clinical courses were recorded. A total of the 58 cases were reviewed. The median follow-up duration was 68.5 months. The infection control rate of PHJI was 93.1% after two-stage revision. Kaplan-Meier analysis showed no significant difference in infection control rates between culture-negative and culture-positive groups. Culture-positive sinus secretions were significantly associated with an increased rate of reinfection (P = 0.039). Two-stage revision had a high success rate for eradication of PHJI. Culture-negative PHJI had a comparable outcome with culture-positive PHJI.

Serum and Wound Vancomycin Levels After Intrawound Administration in Primary Total Joint Arthroplasty.

PubMed

Johnson, Jeremiah D; Nessler, Joseph M; Horazdovsky, Ryan D; Vang, Sandy; Thomas, Avis J; Marston, Scott B

2017-03-01

Periprosthetic joint infection is the most common cause of readmissions after total joint arthroplasty (TJA). Intrawound vancomycin powder (VP) has reduced infection rates in spine surgery; however, there are no data regarding VP in primary TJA. Thirty-four TJA patients received 2 g of VP intraoperatively to investigate VP's pharmacokinetics. Serum and wound concentrations were measured at multiple intervals over 24 hours after closure. All serum concentrations were subtherapeutic (<15μg/mL) and peaked 12 hours after closure (4.7μg/mL; standard deviation [SD], 3.2). Wound concentrations were 922 μg/mL (SD, 523) 3 hours after closure and 207 μg/mL (SD, 317) at 24 hours. VP had a half-life of 7.2 hours (95% confidence interval, 7.0-9.3) in TJA wounds. VP produced highly therapeutic intrawound concentrations while yielding low systemic levels in TJA. VP may serve as a safe adjunct in the prevention of periprosthetic joint infection. Copyright © 2015 Elsevier Inc. All rights reserved.

Infection burden for hip and knee arthroplasty in the United States.

PubMed

Kurtz, Steven M; Lau, Edmund; Schmier, Jordana; Ong, Kevin L; Zhao, Ke; Parvizi, Javad

2008-10-01

We quantified the current and historical incidence of periprosthetic infection associated with hip and knee arthroplasty in the United States using the Nationwide Inpatient Sample, as well as corresponding hospitalization charges and length of stay. The rate of infected knee arthroplasties was 0.92%, significantly greater than that of infected hip arthroplasties with 0.88%. Length of stay was significantly longer for infected hip (9.7 days) and knee (7.6 days) arthroplasties compared to uninfected procedures (hip, 4.3 days; knee, 3.9 days) (P < .0001). Hospitalization charges were also significantly greater for infected joint arthroplasties than for uninfected arthroplasties (hips, 1.76 times; knees, 1.52 times) (P < .0001). Urban-non-teaching hospitals experienced the highest burden of infection with 1.18% for hips and 1.26% for knees compared to rural (0.61% for hips and 0.69% for knees) and urban-teaching hospitals (0.73% for hips and 0.77% for knees). We found an increasing number of joint arthroplasties being diagnosed with periprosthetic infection.

Innate Immunity Sensors Participating in Pathophysiology of Joint Diseases: A Brief Overview

PubMed Central

Gallo, Jiri; Raska, Milan; Konttinen, Yrjö T.; Nich, Christophe; Goodman, Stuart B.

2015-01-01

The innate immune system consists of functionally specialized “modules” that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis. A number of diseases are mediated by a maladaptation of the innate immune response, perpetuating chronic inflammation and tissue damage. Here, we review recent evidence on the cross talk between innate immune sensors and development of rheumatoid arthritis, osteoarthritis, and aseptic loosening of total joint replacements. In relation to the latter topic, there is a growing body of evidence that aseptic loosening and periprosthetic osteolysis results from long-term maladaptation of periprosthetic tissues to the presence of by-products continuously released from an artificial joint. PMID:25747032

Future Research Opportunities in Peri-Prosthetic Joint Infection Prevention.

PubMed

Berbari, Elie; Segreti, John; Parvizi, Javad; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty. A panel of PJI content experts identified nine PJI prevention research opportunities based on both evidence gaps identified through the guideline development process (transfusion, immunosuppressive therapy, anticoagulation, orthopedic space suit, and biofilm) and expert opinion (anesthesia, operative room environment, glycemic control, and Staphylococcus aureus nasal screening and decolonization. This article offers a road map for PJI prevention research.

Miniature bulge test and energy release rate in HIPed aluminum/aluminum interfacial fracture

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, C.; Lovato, M. L.; Clarke, K. D.

We summarize the development of a technique of using miniature bulge test combined with three-dimensional digital image correlation (3D-DIC) for measuring energy release rate or fracture toughness of bimaterial interface of thin metal foils. Furthermore, the energy release rate associated with the HIPed aluminum/aluminum interfacial delamination is determined experimentally using the proposed technique. Detailed discussions of the schemes of preparing and conducting the bulge test, and computing various quantities required for the determination of the energy release rate are presented.

Miniature bulge test and energy release rate in HIPed aluminum/aluminum interfacial fracture

DOE PAGES

Liu, C.; Lovato, M. L.; Clarke, K. D.; ...

2017-10-13

We summarize the development of a technique of using miniature bulge test combined with three-dimensional digital image correlation (3D-DIC) for measuring energy release rate or fracture toughness of bimaterial interface of thin metal foils. Furthermore, the energy release rate associated with the HIPed aluminum/aluminum interfacial delamination is determined experimentally using the proposed technique. Detailed discussions of the schemes of preparing and conducting the bulge test, and computing various quantities required for the determination of the energy release rate are presented.

Numerical investigation of the effect of delaminations on fracture characteristics of glare

NASA Astrophysics Data System (ADS)

Bhat, Sunil; Narayanan, S.

2013-10-01

A finite element examination of the effect of delaminations on fracture characteristics of fibre metal laminate (Glare), by comparing energy release rates of normal cracks in laminates with and without delaminations, is presented in the paper. Glare comprising thin cracked 2024-T3 aerospace aluminum alloy layers alternately bonded with E-glass fibre based composite prepregs is considered for the analysis. Delaminations are modeled with interface cohesive elements. Energy release rates of normal cracks in laminates with delaminations are found to be higher than those in the laminates without delaminations.

Can serpentinization induce fracturing? Fluid pathway development and the volume increase enigma

NASA Astrophysics Data System (ADS)

Plümper, Oliver; Jamtveit, Bjørn; Røyne, Anja

2013-04-01

Serpentinization of ultramafic rocks has first-order effects on global element cycles, the rheology of the oceanic lithosphere, plays a key role in plate tectonics by lubricating subduction zones and has been linked to the origin of life due to the creation of abiogenic hydrocarbons. In addition, the capability of ultramafic rocks to safely store enormous amounts of carbon dioxide through mineral reactions may provide a unique solution to fight global warming. However, all the aforementioned processes are reliant on the creation and maintenance of fluid pathways to alter an originally impermeable rock. Although the forces that move tectonic plates can produce these fluid pathways by mechanical fracturing, there is ample evidence that serpentinization reactions can 'eat' their way through a rock. This process is facilitated by solid volume changes during mineral reactions that cause expansion, fracturing the rock to generate fluid pathways. Natural observations of serpentinization/carbonation in ultramafic rocks indicate that the associated positive solid volume change alone exerts enough stress on the surrounding rock to build up a fracture network and that the influence of external tectonic forces is not necessary. Through various feedbacks these systems can either become self-sustaining, when an interconnected fracture network is formed, or self-limiting due to fluid pathway obstruction. However, extensively serpentinized outcrops suggest that although crystal growth in newly opened spaces would reduce permeability, serpentinization is not always self-limiting as porosity generation can occur concomitantly, maintaining or even increasing permeability. This is consistent with theory and demonstrates that fluids transported through fracture networks can alter vast amounts of originally impermeable rock. Nevertheless, whether serpentinization can actually generate these fracture networks is still a matter of debate and only a few scientific investigations have focused on this topic so far. Here, we investigate the feasibility of reaction-induced fracturing and pore space evolution during serpentinization by combining microstructural investigations using scanning/transmission electron microscopy and synchrotron micro-tomography of natural samples with theoretical considerations on the forces exerted during solid volume increasing reactions. We particularly focus on the interface-scale mechanism of reaction-induced fracturing (Plümper et al. 2012) and the establishment of microstructural markers (e.g., inert exsolutions in olivine) to identify volume changes and estimate crystallization pressures (Kelemen and Hirth 2012). Our investigations suggest that reaction-induced fracturing during serpentinization is possible and during certain physico-chemical circumstances a positive feedback to alter vast amounts of originally impermeable rock is established. Plümper O., Røyne A., Magraso A., Jamtveit B. (2012) The interface-scale mechanism of reaction-induced fracturing during serpentinization. Geology. 40, 1103-1106. Kelemen, P. B. & Hirth, G. (2012) Reaction-driven cracking during retrograde metamorphism: Olivine hydration and carbonation. Earth and Planetary Science Letters 345, 81-89.

Fracture Characterization in Reactive Fluid-Fractured Rock Systems Using Tracer Transport Data

NASA Astrophysics Data System (ADS)

Mukhopadhyay, S.

2014-12-01

Fractures, whether natural or engineered, exert significant controls over resource exploitation from contemporary energy sources including enhanced geothermal systems and unconventional oil and gas reserves. Consequently, fracture characterization, i.e., estimating the permeability, connectivity, and spacing of the fractures is of critical importance for determining the viability of any energy recovery program. While some progress has recently been made towards estimating these critical fracture parameters, significant uncertainties still remain. A review of tracer technology, which has a long history in fracture characterization, reveals that uncertainties exist in the estimated parameters not only because of paucity of scale-specific data but also because of knowledge gaps in the interpretation methods, particularly in interpretation of tracer data in reactive fluid-rock systems. We have recently demonstrated that the transient tracer evolution signatures in reactive fluid-rock systems are significantly different from those in non-reactive systems (Mukhopadhyay et al., 2013, 2014). For example, the tracer breakthrough curves in reactive fluid-fractured rock systems are expected to exhibit a long pseudo-state condition, during which tracer concentration does not change by any appreciable amount with passage of time. Such a pseudo-steady state condition is not observed in a non-reactive system. In this paper, we show that the presence of this pseudo-steady state condition in tracer breakthrough patterns in reactive fluid-rock systems can have important connotations for fracture characterization. We show that the time of onset of the pseudo-steady state condition and the value of tracer concentration in the pseudo-state condition can be used to reliably estimate fracture spacing and fracture-matrix interface areas.

The Processing and Mechanical Properties of High Temperature/High Performance Composites. Book 2, Section 2: Strength and Fracture Resistance

DTIC Science & Technology

1989-10-15

tensions of. the integral equawin methods used in these earlier papers. Cook and Erdogan (1972) and Erdogan and Diniakolo (1973) investigate the...main crack impinging the interface at right angles. Additional work along these same lines is reported by Lu and Erdogan (1963). The tendency for a...crack approaching an interface or a free surface at 3n oblique unlet to be deflected one way or the other has been elucidated by itudics or Erdogan and

Impact-induced fracture mechanisms of immiscible PC/ABS (50/50) blends

NASA Astrophysics Data System (ADS)

Machmud, M. N.; Omiya, M.; Inoue, H.; Kishimoto, K.

2018-03-01

This paper presents a study on fracture mechanisms of polycarbonate (PC)/acrylonitrile-butadiene-styrene (ABS) (50/50) blends with different ABS types under a drop weight impact test (DWIT) using a circular sheet specimen. Formation of secondary crack indicated by a stress-whitening layer on the mid-plane of scattered specimens and secondary surface of fracture perpendicular to primary fracture surface were captured under scanning electron microscope (SEM). Although the both blends finally failed in brittle modes, SEM observation showed that their secondary fracture mechanisms were completely different. Observation through the thickness of the etched PC/ABS specimen samples using SEM also clearly showed that PC and ABS were immiscible. The immiscibility between PC and ABS was indicated by presence of their layer structures through the thickness of the blends. It was revealed that layer of ABS structure was influenced by size of rubber particle and this latter parameter then affected microstructure and fracture mechanisms of the blends. Impact-induced fracture mechanisms of the blends due to such microstructures are discussed in this paper. It was also pointed out that the secondary cracking was likely caused by interface delamination between PC and ABS layers in the core due to transverse shear stress generated during the impact test.

Ceramic-on-ceramic total hip arthroplasty in patients younger than 55 years.

PubMed

Shah, Roshan P; Scolaro, John A; Componovo, Roger; Garino, Jonathan P; Lee, Gwo-Chin

2014-12-01

To review the outcomes of 65 patients younger than 55 years who underwent uncemented total hip arthroplasty (THA) using third-generation ceramic-on-ceramic prostheses. Medical records of 30 men and 35 women (80 hips) aged 18 to 55 (mean, 39) years who underwent uncemented THA using third-generation ceramic-onceramic prostheses by a single surgeon were reviewed. 61 THAs used the Reflection cup with the Synergy stem (n=49), Spectron stem (n=7), or Anthology stem (n=5), and 19 THAs used the Trident cup with the Secur-Fit stem. Outcomes were assessed based on the UCLA Activity Score and Harris Hip Score, as well as radiolucency around the implants, malposition, and subsidence on radiographs. Patients were asked about their satisfaction with current activity level (yes/no), activity limitation (no limitation, musculoskeletal limitation, psychological impediments and lack of motivation, and pain or disability of the operative hip), and change in occupational activity level (same or similar, more active, and less active or disability). The mean follow-up period was 54 (range, 24-110) months. Six patients were excluded from the analysis owing to prosthetic failure secondary to ceramic liner fracture after falling (n=2), acetabular component loosening (n=1), intolerable squeak (n=1), periprosthetic fracture (n=1), and instability (n=1). The mean UCLA Activity Score improved from 4.0 (range, 1-10) to 7.7 (range, 2-10) [p<0.001], and the mean Harris Hip Score improved from 52.8 (range, 25-69) to 91.0 (range, 38-100) [p<0.001]. No hip had evidence of subsidence, loosening, or osteolysis. 52 (80%) patients were satisfied with their activity level; 28 (43%) patients reported no activity limitation; and 57 (88%) patients kept the same or similar occupation. Ceramic-on-ceramic THA achieved acceptable clinical and radiographic outcomes.

Comparison of outcome measures and complication rates following three different approaches for primary total hip arthroplasty: a pragmatic randomised controlled trial.

PubMed

Talia, Adrian J; Coetzee, Cassandra; Tirosh, Oren; Tran, Phong

2018-01-08

Total hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty. This is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre. It is a pragmatic, parallel three-arm, randomised controlled trial. Sample size will be 243 participants (81 in each group). Randomisation will be secure, web-based and managed by an independent statistician. Patients and research team will be blinded pre-operatively, but not post-operatively. Intervention will be either direct anterior, lateral or posterior approach for total hip arthroplasty, and the three arms will be directly compared. Participants will be aged over 18 years, able to provide informed consent and recruited from our outpatients. Patients who are having revision surgery or have indications for hip replacement other than osteoarthritis (i.e., fracture, malignancy, development dysplasia) will be excluded from the trial. The Oxford Hip Score will be determined for patients pre-operatively and 6 weeks, 6, 12 and 24 months post-operatively. The Oxford Hip Score at 24 months will be the primary outcome measure. Secondary outcome measures will be dislocation, infection, intraoperative and peri-prosthetic fracture rate, length of hospital stay and pain level, reported using a visual analogue scale. Many studies have evaluated approaches for total hip arthroplasty and arthroplasty registries worldwide are now collecting this data. However no study to date has compared these three common approaches directly in a randomised fashion. No trial has used patient-reported outcome measures to evaluate success. This pragmatic study aims to identify differences in patient perception of total hip arthroplasty depending on surgical approach. Australian New Zealand Clinical Trials Registry, ACTRN12617000272392 . Registered on 22 February 2017.

Assessment of carbon fibre composite fracture fixation plate using finite element analysis.

PubMed

Saidpour, Seyed H

2006-07-01

In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress shielding in the layer of bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. In this study a novel forearm internal fracture fixation plate made from short carbon fibre reinforced plastic (CFRP) was used in an attempt to address the problem. Accordingly, it has been possible to analyse the stress distribution in the composite plates using finite-element modelling. A three-dimensional, quarter-symmetric finite element model was generated for the plate system. The stress state in the underlying bone was examined for several loading conditions. Based on the analytical results the composite plate system is likely to reduce stress-shielding effects at the fracture site when subjected to bending and torsional loads. The design of the plate was further optimised by reducing the width around the innermost holes.

The effect of carbide precipitation on the hydrogen-enhanced fracture behavior of alloy 690

DOE Office of Scientific and Technical Information (OSTI.GOV)

Symons, D.M.

1998-04-01

Alloy 690 is susceptible to hydrogen embrittlement where hydrogen reduces the ductility and causes the fracture morphology to change to predominantly intergranular. The role of carbide precipitation in the embrittlement behavior is not well defined. The objective of this work is to understand the effect of intergranular carbide precipitation on the hydrogen embrittlement of alloy 690. The work reported herein used tensile and compact-tension specimens in both the solution-annealed condition (minimal grain-boundary carbide precipitation) and in the solution-annealed condition followed by an aging treatment to precipitate grain-boundary carbides. By performing the mechanical tests on materials in both uncharged and hydrogen-chargedmore » conditions, it was possible to evaluate the degree of embrittlement as a function of the carbide precipitation. It is shown that the embrittlement due to hydrogen increased as the material was aged to allow grain-boundary carbide precipitation. It is proposed that the increase in embrittlement was caused by increased hydrogen at the carbide/matrix interface due to the trapping and increased stresses at the precipitate interface, which developed from strain incompatibility of the precipitate with the matrix. It is further shown that increasing the hydrostatic stress increased the tendency for intergranular fracture, as is consistent with other nickel-base alloys.« less

Joining of alumina via copper/niobium/copper interlayers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marks, Robert A.; Chapman, Daniel R.; Danielson, David T.

2000-03-15

Alumina has been joined at 1150 degrees C and 1400 degrees C using multilayer copper/niobium/copper interlayers. Four-point bend strengths are sensitive to processing temperature, bonding pressure, and furnace environment (ambient oxygen partial pressure). Under optimum conditions, joints with reproducibly high room temperature strengths (approximately equal 240 plus/minus 20 MPa) can be produced; most failures occur within the ceramic. Joints made with sapphire show that during bonding an initially continuous copper film undergoes a morphological instability, resulting in the formation of isolated copper-rich droplets/particles at the sapphire/interlayer interface, and extensive regions of direct bonding between sapphire and niobium. For optimized aluminamore » bonds, bend tests at 800 degrees C-1100 degrees C indicate significant strength is retained; even at the highest test temperature, ceramic failure is observed. Post-bonding anneals at 1000 degrees C in vacuum or in gettered argon were used to assess joint stability and to probe the effect of ambient oxygen partial pressure on joint characteristics. Annealing in vacuum for up to 200 h causes no significant decrease in room temperature bend strength or change in fracture path. With increasing anneal time in a lower oxygen partial pressure environment, the fracture strength decreases only slightly, but the fracture path shifts from the ceramic to the interface.« less

Comparison of Rooting Strategies to Explore Rock Fractures for Shallow Soil-Adapted Tree Species with Contrasting Aboveground Growth Rates: A Greenhouse Microcosm Experiment

PubMed Central

Nie, Yunpeng; Chen, Hongsong; Ding, Yali; Yang, Jing; Wang, Kelin

2017-01-01

For tree species adapted to shallow soil environments, rooting strategies that efficiently explore rock fractures are important because soil water depletion occurs frequently. However, two questions: (a) to what extent shallow soil-adapted species rely on exploring rock fractures and (b) what outcomes result from drought stress, have rarely been tested. Therefore, based on the expectation that early development of roots into deep soil layers is at the cost of aboveground growth, seedlings of three tree species (Cyclobalanopsis glauca, Delavaya toxocarpa, and Acer cinnamomifolium) with distinct aboveground growth rates were selected from a typical shallow soil region. In a greenhouse experiment that mimics the basic features of shallow soil environments, 1-year-old seedlings were transplanted into simulated microcosms of shallow soil overlaying fractured bedrock. Root biomass allocation and leaf physiological activities, as well as leaf δ13C values were investigated and compared for two treatments: regular irrigation and repeated cycles of drought stress. Our results show that the three species differed in their rooting strategies in the context of encountering rock fractures, however, these strategies were not closely related to the aboveground growth rate. For the slowest-growing seedling, C. glauca, percentages of root mass in the fractures, as well as in the soil layer between soil and bedrock increased significantly under both treatments, indicating a specialized rooting strategy that facilitated the exploration of rock fractures. Early investment in deep root growth was likely critical to the establishment of this drought-vulnerable species. For the intermediate-growing, A. cinnamomifolium, percentages of root mass in the bedrock and interface soil layers were relatively low and exhibited no obvious change under either treatment. This limited need to explore rock fractures was compensated by a conservative water use strategy. For the fast-growing, D. toxocarpa, percentages of root mass in the bedrock and interface layers increased simultaneously under drought conditions, but not under irrigated conditions. This drought-induced rooting plasticity was associated with drought avoidance by this species. Although, root development might have been affected by the simulated microcosm, contrasting results among the three species indicated that efficient use of rock fractures is not a necessary or specialized strategy of shallow-soil adapted species. The establishment and persistence of these species relied on the mutual complementation between their species-specific rooting strategies and drought adaptations. PMID:29018464

Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

PubMed Central

Disseldorp, Dominique J. G.; Poeze, Martijn; Hannemann, Pascal F. W.; Brink, Peter R. G.

2015-01-01

Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site morbidity, delayed union at bone–graft interfaces, size mismatch between graft and osteotomy defect, and additional operation time. Purpose The goal of this study was to assess bone healing and secondary fracture displacement in the treatment of malunited distal radius fractures without the use of bone grafting. Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations without bone grafting were performed for malunited distal radius fractures. The minimum follow-up time was 12 months. Primary study outcomes were time to complete bone healing and secondary fracture displacement. Preoperative and postoperative radiographs during follow-up were compared with each other, as well as with radiographs of the uninjured side. Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months, but reinterventions were not necessary. No cases of secondary fracture displacement or hardware failure were observed. Significant improvements in all radiographic parameters were shown after corrective osteotomy and plate fixation. Conclusion This study shows that bone grafts are not required for bone healing and prevention of secondary fracture displacement after corrective osteotomy and plate fixation of malunited distal radius fractures. Level of evidence Therapeutic, level IV, case series with no comparison group PMID:26261748

The mechanical design of hybrid graphene/boron nitride nanotransistors: Geometry and interface effects

NASA Astrophysics Data System (ADS)

Einalipour Eshkalak, Kasra; Sadeghzadeh, Sadegh; Jalaly, Maisam

2018-02-01

From electronic point of view, graphene resembles a metal or semi-metal and boron nitride is a dielectric material (band gap = 5.9 eV). Hybridization of these two materials opens band gap of the graphene which has expansive applications in field-effect graphene transistors. In this paper, the effect of the interface structure on the mechanical properties of a hybrid graphene/boron nitride was studied. Young's modulus, fracture strain and tensile strength of the models were simulated. Three likely types (hexagonal, octagonal and decagonal) were found for the interface of hybrid sheet after relaxation. Although Csbnd B bonds at the interface were indicated to result in more promising electrical properties, nitrogen atoms are better choice for bonding to carbon for mechanical applications.

Fractal Viscous Fingering in Fracture Networks

NASA Astrophysics Data System (ADS)

Boyle, E.; Sams, W.; Ferer, M.; Smith, D. H.

2007-12-01

We have used two very different physical models and computer codes to study miscible injection of a low- viscosity fluid into a simple fracture network, where it displaces a much-more viscous "defending" fluid through "rock" that is otherwise impermeable. The one code (NETfLow) is a standard pore level model, originally intended to treat laboratory-scale experiments; it assumes negligible mixing of the two fluids. The other code (NFFLOW) was written to treat reservoir-scale engineering problems; It explicitly treats the flow through the fractures and allows for significant mixing of the fluids at the interface. Both codes treat the fractures as parallel plates, of different effective apertures. Results are presented for the composition profiles from both codes. Independent of the degree of fluid-mixing, the profiles from both models have a functional form identical to that for fractal viscous fingering (i.e., diffusion limited aggregation, DLA). The two codes that solve the equations for different models gave similar results; together they suggest that the injection of a low-viscosity fluid into large- scale fracture networks may be much more significantly affected by fractal fingering than previously illustrated.

Development and application of computer assisted optimal method for treatment of femoral neck fracture.

PubMed

Wang, Monan; Zhang, Kai; Yang, Ning

2018-04-09

To help doctors decide their treatment from the aspect of mechanical analysis, the work built a computer assisted optimal system for treatment of femoral neck fracture oriented to clinical application. The whole system encompassed the following three parts: Preprocessing module, finite element mechanical analysis module, post processing module. Preprocessing module included parametric modeling of bone, parametric modeling of fracture face, parametric modeling of fixed screw and fixed position and input and transmission of model parameters. Finite element mechanical analysis module included grid division, element type setting, material property setting, contact setting, constraint and load setting, analysis method setting and batch processing operation. Post processing module included extraction and display of batch processing operation results, image generation of batch processing operation, optimal program operation and optimal result display. The system implemented the whole operations from input of fracture parameters to output of the optimal fixed plan according to specific patient real fracture parameter and optimal rules, which demonstrated the effectiveness of the system. Meanwhile, the system had a friendly interface, simple operation and could improve the system function quickly through modifying single module.

Fatigue of the Resin-Enamel Bonded Interface and the Mechanisms of Failure

PubMed Central

Yahyazadehfar, Mobin; Mutluay, Mustafa Murat; Majd, Hessam; Ryou, Heonjune; Arola, Dwayne

2013-01-01

The durability of adhesive bonds to enamel and dentin and the mechanisms of degradation caused by cyclic loading are important to the survival of composite restorations. In this study a novel method of evaluation was used to determine the strength of resin-enamel bonded interfaces under both static and cyclic loading, and to identify the mechanisms of failure. Specimens with twin interfaces of enamel bonded to commercial resin composite were loaded in monotonic and cyclic 4-point flexure to failure within a hydrated environment. Results for the resin-enamel interface were compared with those for the resin composite (control) and values reported for resin-dentin adhesive bonds. Under both modes of loading the strength of the resin-enamel interface was significantly (p≤0.0001) lower than that of the resin composite and the resin-dentin bonded interface. Fatigue failure of the interface occurred predominately by fracture of enamel, adjacent to the interface, and not due to adhesive failures. In the absence of water aging or acid production of biofilms, the durability of adhesive bonds to enamel is lower than that achieved in dentin bonding. PMID:23571321

Synergistic Effects of Temperature and Oxidation on Matrix Cracking in Fiber-Reinforced Ceramic-Matrix Composites

NASA Astrophysics Data System (ADS)

Longbiao, Li

2017-06-01

In this paper, the synergistic effects of temperatrue and oxidation on matrix cracking in fiber-reinforced ceramic-matrix composites (CMCs) has been investigated using energy balance approach. The shear-lag model cooperated with damage models, i.e., the interface oxidation model, interface debonding model, fiber strength degradation model and fiber failure model, has been adopted to analyze microstress field in the composite. The relationships between matrix cracking stress, interface debonding and slipping, fiber fracture, oxidation temperatures and time have been established. The effects of fiber volume fraction, interface properties, fiber strength and oxidation temperatures on the evolution of matrix cracking stress versus oxidation time have been analyzed. The matrix cracking stresses of C/SiC composite with strong and weak interface bonding after unstressed oxidation at an elevated temperature of 700 °C in air condition have been predicted for different oxidation time.

Comparison of ultra-congruent mobile- and fixed-bearing navigation-assisted total knee arthroplasty with minimum 5-year follow-up.

PubMed

Kim, Seong Hwan; Lim, Jung-Won; Ko, Young-Bong; Song, Min-Gu; Lee, Han-Jun

2016-11-01

The purpose of this study was to compare the midterm outcomes between fixed and mobile ultra-congruent (UC) bearings in total knee arthroplasty (TKA). This is a retrospective matched-pairs case-control study of patients who underwent primary navigation-assisted TKA with a minimum 5-year follow-up. A total of 182 cases involved the fixed UC bearing system as Group 1 and 101 cases involved mobile UC bearing system group as Group 2. After 1:1 matching, 73 knees in each group were enrolled. Clinical and radiographic outcomes were evaluated. The overall survival was 143 of 146 cases (97.9 %) at final follow-up, and 72 of 73 cases (96.3 %) in Group 1 and 71 of 73 cases (95.8 %) in Group 2 at final follow-up based on an endpoint of revision surgery. The reasons of revision TKA were periprosthetic fracture in Group 1, infection and bearing dislocation in Group 2. There was no statistical difference in Hospital for Special Surgery (HSS) scores, Knee Society Scores (KSS), WOMAC index score evaluations between groups. This study demonstrated that the fixed-bearing UC prosthesis could provide satisfactory performance compared with that of the mobile-bearing UC prosthesis with minimum 5-year follow-up. The fixed-bearing UC prosthesis could be considered in navigation-assisted TKA with theoretical advantages of UC design. IV.

Profix cemented total knee replacement: a 5-year outcome review from Lagos, Nigeria.

PubMed

Ugbeye, M E; Odunubi, O O; Dim, E M; Ekundayo, O O

2012-01-01

Total knee replacement is a standard treatment for severe osteoarthritis of the knees. It is however, still a novel procedure in Nigeria. Literature on the procedure and outcome of management are sparse in Nigeria. This study aimed at describing Total Knee prosthetic Replacement as it is practiced in National Orthopaedic Hospital, Lagos. Data on patients treated with Total knee replacement between 2006 and 2010 were analyzed retrospectively. The standard anterior approach, with a medial parapatellar incision under pneumatic tourniquet was used in all cases. There were a total of 59 knees in 48 patients operated, with a female: male ratio of 5:1. Patients were in the sixth to ninth decades of life. There was a statistically significant relationship between duration of symptoms and severity of angular deformity. The average pre-operative Knee score (KS) was 27 and average function score (FS) was 43. Average duration of surgery was 126.38 minutes. Tourniquet removal after wound closure was associated with reduced intra-operative blood loss (p < 0.05). Post-operative complications included peri-prosthetic fracture (1.69%), post-operative anaemia (8.47%), superficial wound dehiscence (3.39%) and foot drop (3.39%). The mean post-operative KS and FS increased to 80 and 75 respectively. Total knee replacement, though a novel procedure in our institution is beneficial to patients with severe osteoarthritis. A long term outcome study is being planned.

Investigation of the Microstructure and Mechanical Properties of Copper-Graphite Composites Reinforced with Single-Crystal α-Al₂O₃ Fibres by Hot Isostatic Pressing.

PubMed

Zhang, Guihang; Jiang, Xiaosong; Qiao, ChangJun; Shao, Zhenyi; Zhu, Degui; Zhu, Minhao; Valcarcel, Victor

2018-06-11

Single-crystal α-Al₂O₃ fibres can be utilized as a novel reinforcement in high-temperature composites owing to their high elastic modulus, chemical and thermal stability. Unlike non-oxide fibres and polycrystalline alumina fibres, high-temperature oxidation and polycrystalline particles boundary growth will not occur for single-crystal α-Al₂O₃ fibres. In this work, single-crystal α-Al₂O₃ whiskers and Al₂O₃ particles synergistic reinforced copper-graphite composites were fabricated by mechanical alloying and hot isostatic pressing techniques. The phase compositions, microstructures, and fracture morphologies of the composites were investigated using X-ray diffraction, a scanning electron microscope equipped with an X-ray energy-dispersive spectrometer (EDS), an electron probe microscopic analysis equipped with wavelength-dispersive spectrometer, and a transmission electron microscope equipped with EDS. The mechanical properties have been measured by a micro-hardness tester and electronic universal testing machine. The results show that the reinforcements were unevenly distributed in the matrix with the increase of their content and there were some micro-cracks located at the interface between the reinforcement and the matrix. With the increase of the Al₂O₃ whisker content, the compressive strength of the composites first increased and then decreased, while the hardness decreased. The fracture and strengthening mechanisms of the composite materials were explored on the basis of the structure and composition of the composites through the formation and function of the interface. The main strengthening mechanism in the composites was fine grain strengthening and solid solution strengthening. The fracture type of the composites was brittle fracture.

Bayesian Markov Chain Monte Carlo inversion for weak anisotropy parameters and fracture weaknesses using azimuthal elastic impedance

NASA Astrophysics Data System (ADS)

Chen, Huaizhen; Pan, Xinpeng; Ji, Yuxin; Zhang, Guangzhi

2017-08-01

A system of aligned vertical fractures and fine horizontal shale layers combine to form equivalent orthorhombic media. Weak anisotropy parameters and fracture weaknesses play an important role in the description of orthorhombic anisotropy (OA). We propose a novel approach of utilizing seismic reflection amplitudes to estimate weak anisotropy parameters and fracture weaknesses from observed seismic data, based on azimuthal elastic impedance (EI). We first propose perturbation in stiffness matrix in terms of weak anisotropy parameters and fracture weaknesses, and using the perturbation and scattering function, we derive PP-wave reflection coefficient and azimuthal EI for the case of an interface separating two OA media. Then we demonstrate an approach to first use a model constrained damped least-squares algorithm to estimate azimuthal EI from partially incidence-phase-angle-stack seismic reflection data at different azimuths, and then extract weak anisotropy parameters and fracture weaknesses from the estimated azimuthal EI using a Bayesian Markov Chain Monte Carlo inversion method. In addition, a new procedure to construct rock physics effective model is presented to estimate weak anisotropy parameters and fracture weaknesses from well log interpretation results (minerals and their volumes, porosity, saturation, fracture density, etc.). Tests on synthetic and real data indicate that unknown parameters including elastic properties (P- and S-wave impedances and density), weak anisotropy parameters and fracture weaknesses can be estimated stably in the case of seismic data containing a moderate noise, and our approach can make a reasonable estimation of anisotropy in a fractured shale reservoir.

Inclined Fiber Pullout from a Cementitious Matrix: A Numerical Study

PubMed Central

Zhang, Hui; Yu, Rena C.

2016-01-01

It is well known that fibers improve the performance of cementitious composites by acting as bridging ligaments in cracks. Such bridging behavior is often studied through fiber pullout tests. The relation between the pullout force vs. slip end displacement is characteristic of the fiber-matrix interface. However, such a relation varies significantly with the fiber inclination angle. In the current work, we establish a numerical model to simulate the entire pullout process by explicitly representing the fiber, matrix and the interface for arbitrary fiber orientations. Cohesive elements endorsed with mixed-mode fracture capacities are implemented to represent the bond-slip behavior at the interface. Contact elements with Coulomb’s friction are placed at the interface to simulate frictional contact. The bond-slip behavior is first calibrated through pull-out curves for fibers aligned with the loading direction, then validated against experimental results for steel fibers oriented at 30∘ and 60∘. Parametric studies are then performed to explore the influences of both material properties (fiber yield strength, matrix tensile strength, interfacial bond) and geometric factors (fiber diameter, embedment length and inclination angle) on the overall pullout behavior, in particular on the maximum pullout load. The proposed methodology provides the necessary pull-out curves for a fiber oriented at a given angle for multi-scale models to study fracture in fiber-reinforced cementitious materials. The novelty lies in its capacity to capture the entire pullout process for a fiber with an arbitrary inclination angle. PMID:28773921

Inclined Fiber Pullout from a Cementitious Matrix: A Numerical Study.

PubMed

Zhang, Hui; Yu, Rena C

2016-09-26

It is well known that fibers improve the performance of cementitious composites by acting as bridging ligaments in cracks. Such bridging behavior is often studied through fiber pullout tests. The relation between the pullout force vs. slip end displacement is characteristic of the fiber-matrix interface. However, such a relation varies significantly with the fiber inclination angle. In the current work, we establish a numerical model to simulate the entire pullout process by explicitly representing the fiber, matrix and the interface for arbitrary fiber orientations. Cohesive elements endorsed with mixed-mode fracture capacities are implemented to represent the bond-slip behavior at the interface. Contact elements with Coulomb's friction are placed at the interface to simulate frictional contact. The bond-slip behavior is first calibrated through pull-out curves for fibers aligned with the loading direction, then validated against experimental results for steel fibers oriented at 30 ∘ and 60 ∘ . Parametric studies are then performed to explore the influences of both material properties (fiber yield strength, matrix tensile strength, interfacial bond) and geometric factors (fiber diameter, embedment length and inclination angle) on the overall pullout behavior, in particular on the maximum pullout load. The proposed methodology provides the necessary pull-out curves for a fiber oriented at a given angle for multi-scale models to study fracture in fiber-reinforced cementitious materials. The novelty lies in its capacity to capture the entire pullout process for a fiber with an arbitrary inclination angle.