Orthopedic Implant Failure

Orthopedic implant failure is the most common complication of orthopedic surgery, causing serious trauma and resulting in a tremendous economic burden for patients. There are many reasons for implant failure, among which peri-implant infection (or implant-related infection) and aseptic loosening are the most important. At present, orthopedic doctors have many methods to treat these complications, such as revision surgery, which have shown good results. However, if peri-implant infection can be prevented, this will bring about significant social benefits. Many studies have focused on adding antibacterial substances to the implant coating, and with a deeper understanding of the mechanism of implant failure, adding such substances by different modification methods has become a research hot spot. This review aims to summarize the antibacterial and anti-inflammatory substances that can be used as coating materials in orthopedic implants and to provide a reference for the prevention and treatment of implant failure caused by implant-related infection and excessive inflammation.

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Allergy to Metals as a Cause of Orthopedic Implant Failure

International Journal of Occupational Medicine and Environmental Health ◽

10.2478/v10001-006-0025-6 ◽

2006 ◽

Vol 19 (3) ◽

Cited By ~ 16

Author(s):

Beata Kręcisz ◽

Marta Kieć-Świerczyńska ◽

Katarzyna Bąkowicz-Mitura

Keyword(s):

Implant Failure ◽

Orthopedic Implant

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Effect of Metal Substrate Nanometer Topography on Osteoblast Metabolic Activities

MRS Proceedings ◽

10.1557/proc-823-w13.6 ◽

2004 ◽

Vol 823 ◽

Cited By ~ 2

Author(s):

Brian C. Ward ◽

Thomas J. Webster

Keyword(s):

Metal Surfaces ◽

Orthopedic Implants ◽

Metal Substrate ◽

Implant Failure ◽

Orthopedic Implant ◽

Energy Dispersion Spectroscopy ◽

Metal Substrates ◽

Cell Functions ◽

Metabolic Activities

AbstractSurgeons and bioengineers have continuously been challenged by implant failure. Many of these engineers and surgeons trace implant failure to poor osseointegration (the bonding of an orthopedic implant to juxtaposed bone) and to the inability of implants to match the physical properties of surrounding bone. Researchers have recently shown that nanostructured materials (or materials with fundamental length scales less than 100 nm) enhance cell functions pertinent to effectively regenerating the tissue of numerous organs. Specifically, in a recent study, researchers demonstrated that metal surfaces utilizing low-micron to nanophase topography fostered increased adhesion of osteoblasts, the cells that create the matrix of bone. In this study, Ti, Ti6Al4V, and CoCrMo alloys were investigated, and these alloys were identical to current orthopedic implant alloys except for surface topography. The objective of this in vitro research was to determine whether these same nanophase metal surfaces not only foster osteoblast adhesion but also increase osteoblast metabolic activities leading to bone regeneration. Light microscopy and Energy Dispersion Spectroscopy (EDS) were used to verify the presence of calcium and phosphorous deposition by osteoblasts cultured on the metal substrates. Results indicated that both calcium and phosphorous are being deposited on several of the metal substrates. More importantly, compared to conventional metals, results provided the first evidence that more calcium and phosphorous was deposited by osteoblasts cultured on respective nanophase metals (Ti, Ti6Al4V, and CoCrMo). Nanophase CoCrMo had the most calcium and phosphorous minerals deposited by osteoblasts compared to any other metal substrate. Thus, the results of this study continue to provide evidence for the use of nanophase metals for the design of the next generation of more successful orthopedic implants.

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Cobalt-Alloy Implant Debris Induce HIF-1α Hypoxia Associated Responses: A Mechanism for Metal-Specific Orthopedic Implant Failure

PLoS ONE ◽

10.1371/journal.pone.0067127 ◽

2013 ◽

Vol 8 (6) ◽

pp. e67127 ◽

Cited By ~ 41

Author(s):

Lauryn Samelko ◽

Marco S. Caicedo ◽

Seung-Jae Lim ◽

Craig Della-Valle ◽

Joshua Jacobs ◽

...

Keyword(s):

Implant Failure ◽

Orthopedic Implant ◽

Cobalt Alloy

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Early Diagnosis of Orthopedic Implant Failure Using Macromolecular Imaging Agents

Pharmaceutical Research ◽

10.1007/s11095-014-1310-x ◽

2014 ◽

Vol 31 (8) ◽

pp. 2086-2094 ◽

Cited By ~ 6

Author(s):

Ke Ren ◽

Anand Dusad ◽

Yijia Zhang ◽

P. Edward Purdue ◽

Edward V. Fehringer ◽

...

Keyword(s):

Early Diagnosis ◽

Implant Failure ◽

Imaging Agents ◽

Orthopedic Implant

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Occupant Extremity Loading in Frontal Motor Vehicle Impacts: Prediction of Potential Orthopedic Implant Failure

ASME 2009 4th Frontiers in Biomedical Devices ◽

10.1115/biomed2009-83064 ◽

2009 ◽

Author(s):

Timothy J. Long ◽

Darleen M. Bajgrowicz

Keyword(s):

General Formula ◽

Motor Vehicle ◽

Coefficient Of Restitution ◽

Center Of Gravity ◽

Implant Failure ◽

Orthopedic Implant ◽

Artificial Joints ◽

Vehicle Impact

The analysis of motor vehicle impacts and the resulting injury exposure to occupants with artificial joints can be correlated to a parameter referred to as delta-v. The delta-v of a vehicle involved in a motor vehicle impact is defined as the change of velocity of the vehicle at its center of gravity during impact. The delta-v is a function of the closing speed between the two vehicles and the mass of each vehicle. A general formula for delta-v is as follows: ΔVi=(1+ε)·(mj/(mi+mj))·Vc Where: Vc – closing speed between the two vehicles; ε – coefficient of restitution; m – mass of each vehicle.

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Is perioperative antibiotic necessary in straightforward implant placement procedures?

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00282 ◽

2020 ◽

Author(s):

Elçin Bedeloğlu ◽

Mustafa Yalçın ◽

Cenker Zeki Koyuncuoğlu

Keyword(s):

Clavulanic Acid ◽

Dental Implant ◽

Prophylactic Antibiotic ◽

Antibiotic Use ◽

Implant Failure ◽

Control Group ◽

Implant Placement ◽

Significant Difference ◽

Amoxicillin Clavulanic Acid ◽

Experimental Group

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p >0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p <0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.

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