What's a Hip Replacement made out of? | H10
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- เผยแพร่เมื่อ 26 ก.ย. 2024
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Evidence base @LifetimeHip
It depends on whether you've got a cemented or uncemented implant, or a mixture of the two: that's a hybrid hip replacement. In the UK, there's roughly equal numbers- just over a third each- of cemented and uncemented implants.
We ask a lot of the materials that make up a joint replacement:
1. Strong enough to withstand 5x our body weight, sometimes a lot more, through the 1 to 3 million steps per year;
2. Not rust in the salty human body;
3. Not be toxic or damaging to the human body;
4. Fix well to bone, stay fixed and not rattle loose over time; and
5. Moving parts that are hard enough and don't wear out over 10, 20 or 30yrs..
The first cemented Charnley hips from the 1960s were made of a stainless-steel stem with a plastic cup fixed in place using cement, an acrylic cement which is; a perspex like 'grout'. A combination that's largely still in use today.
The shape of the stem has evolved and the material used is stainless steel or cobalt chrome but the design principle is the same. And the results of a well performed cemented hip replacement should, arguably, be considered 'gold standard'. See our episode on how long will my hip replacement last?:
• How long will my Hip R...
Uncemented implants rely on bone growing onto or into the surface of the cup or stem. The stiffness, or bendiness, of the material needs to be similar to that of bone. We commonly use a titanium stem with a titanium shell, each with a roughened or treated surface. Bone loves titanium: so wedge the stem and press the cup in place and bone will grow onto and into the surface of these implants over a 6 to 12 week period, effectively become part of you..
The titanium shell uses a liner that the head of the hip replacement moves against; this moving part that will 'wear out' over time. It's this crucial part of the hip replacement.
There's three materials that make a good liner: metal, ceramic or plastic; and these are used in various combinations.
Metal on metal hip replacements are no longer being used as there was an unpredictable reaction to the microscopic metal debris produced in some patients.
Ceramic is hard wearing, with a very small risk of breaking and about a 2 in 100 risk of 'squeaking' if we use a ceramic head on a ceramic liner, a ceramic on ceramic.
The quality of the plastic liner has markedly improved over the last 15 years or so; we now have highly cross-linked polyethylene that is showing virtually no wear in patients out to the ten-year mark. We don't know what will happen beyond 10 years but the results look promising. And using a ceramic head against this polyethylene theoretically produces even less wear, but again, actual results in real patients will take 10 to 20 years to come out.
And the same can be said for other newer bearing surface materials that are in development and other exciting materials that have quietly revolutionised revision, or second time, hip replacement.
Broadly speaking, your hip replacement will likely to made up of a cemented steel-like or an uncemented titanium stem and a titanium shell with a plastic (or maybe a ceramic) liner. A metal stem, plastic liner and metal shell.
#jointpain #painrelief #arthritis #kneepain #hippain #health #jointpainrelief #arthritisrelief #osteoarthritis #musclepain #inflammation #healthylifestyle #surgery #jointreplacement
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Evidence base @LifetimeHip
Thanks for watching!
Very good
Thanks
How do you figure out what materials your hip replacement is made of?
I have this but it’s all medical jargon to me
My bone did not grow into the cup. Why didn't he cement my hip replacement?
Sorry to hear about your problems. Uncemented and cemented are both good cup options. Uncemented offers more options on the bearing surface, that is the moving part of the hip replacement.
Revising a loose cup would usually require changing to another uncemented cup. Here trabecular metal has quietly revolutionised revision surgery over the last 15 years. Good luck!
HAve you any article on this that I can using for referencing for my project?
Hi William- the @LifetimeHip Twitter feed summarises the evidence base. Let me know if there's anything in particular I can help with?
What does a hybrid mean
Thank you I think this is what I’ve got
Why don’t the use of “programmed print magnetic’s” principles being used for replacement parts??? Non-wearing plus using its abilities to repel with zero heating non-friction parts seem logical???
Just sayin???
I get to “strong of strong” thing but if two or more parts never were to touch (repoltion as well as no friction ) would be better… No???
Thanks Allan. What’s the best reference to read more about ‘programmed print magnetics’? Any biomaterial needs to fix to bone, be similarly stiff, not corrode in the body, not be toxic to human tissue and if used as a bearing be hard and tough enough not to wear excessively. It’s quite a list!
Sir from where i can get archard wear simulation extension file to do simulation in ansys
Not sure exactly what you're after. Perhaps approach one of the implant companies?
@@LifetimeHip ok sir
Please send me details on this, I'm suffering from this, Dr. Suggested for TOTAL HIP REPLACEMENT Surgery. .
My hip replacement lasted 10 years. Dislocated twice. Now surgeon wants to do a girdle stone procedure. What in the world for? I don't accept that.
I’m sorry to hear that. There are other options and a Girdlestone is usually a last resort.
..an excision arthroplasty or Girdlestone would be an option if there was also infection present.
sir what type of contact is occuring between the liner and the outer cup
and is that femoral ahead and liner in frictional contact?
Good question: the liner is fixed in the shell ('outer cup'). Yes, movement is between the femoral head and the liner, which is subject to friction and subsequent wear.
Sir can i get your email id pls.
Thank you verymuch for your reply
Can i say that the liner is bonded with the outer shell?
In ansys how can i find its wear. I am trying to do simulation in ansys 2020 r1.
From where i get the archrd wear simulation extension file?
Sir life of hip resurfacing how many years?please reply
@@LifetimeHip it's not that small. The metals are tearing up thousands of people.
Where can i buy?
E you don’t buy it you have to have a hip replacement
Have you tried Aldi,
@@314WESTERN Hi. No, what is that?
Ive got a titanium one for sale.
How much price
Ceramic on poly best
It is a good option Rst Tamim. Potential trunnion damage at revision surgery needs thought when comparing to metal on (highly cross-linked) poly
Hip lift legg
What if you have a allergy to cobalt and nichol.
Hi Lisa- generally speaking skin allergies don't correlate well with deep tissue reactions. However, discuss your history with your surgeon and discuss minimising the content of Cobalt and Nickel in the implants you choose, particularly the moving parts e.g. consider a ceramic femoral head on a highly cross-linked polyethylene liner.