Biomaterials for hip implants – important considerations relating to the choice of materials

This article is a review of important material requirements for hip biomaterials including their response to the body environment (biocompatibility), mechanical properties, wear resistance, fretting corrosion and availability as well as the price. The application of proper biomaterials for hip implants is one of the major focal points in this article. Background information is also provided on metals used in other prosthetic devices and implant components. Titanium and its alloys, cobalt base alloys and stainless steels (bio-steels) are used for load-bearing hip implants. These three groups of metallic materials will be introduced and discussed in detail. Metals and their alloys are crystalline materials since their properties depend on the crystal lattice, chemical and phase compositions, grain size, lattice defects, crystalline texture and residual micro- and macro-stresses. All these features of biomaterials are formed during technological manufacturing, such as metallurgical process, solidification, plastic deformation (rolling and forging), machining, heat treatment and coating. All these technological processes work in optimal conditions in order to achieve the optimal microstructure and mechanical, chemical and biological properties. Amongst the above-mentioned particular properties of biomaterials, fretting is a major concern as regards hip implants at the femoral head and neck taper interface. Additional important mechanisms of interaction between the implant and the human body must be taken into account, i.e. diffusion stream of foreign particles and atoms from the implant to body fluids, to the tissue and to the bone. These foreign particles and atoms are released from the implant to the body fluid, to the tissue and to the bone as wear product during use. All together they contribute to the wear, i.e. loss of weight, strength or volume of hip components. Wear rates of ultrahigh molecular weight polyethylene mated against Ti-6Al-4V are significantly greater than the ones for Co-Cr-Mo alloys. Therefore, thermochemical surface treatments like diffusion ion nitriding should be applied to increase the resistance of titanium alloys to wear. Austenitic stainless steels are also used for temporary applications, but they have lower resistance to pitting corrosion than titanium and cobalt alloys. The purpose of the paper is to introduce a group of metallic materials, which is often chosen for surgical hip implants. Conclusions of the paper refer to information which support important medical and patient decisions on hip implants. Also, the development of biomaterials, their treatments, properties, surface layers and coatings are considered. All these features develop over time and need synergy and experience in the progress of the biomedical, mechanical and materials science.