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Wheeless' Textbook of Orthopaedics
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Characteristics of Metals and Implants



- See:
       - Biomechanics Menu
       - Cobalt Based Alloys
       - Metal Fatigue
       - Stainless steel
       - Titanium
       - Ultimate Tensile Strength
       - Vitallium
       - Yield Strength:

- Flexibility of Metals:
    - a brittle material breaks before any plastic deformation;
    - a ductile material has a plastic behavior before it breaks;

- Battery Effect:
    - even in a single metal a battery effect can be produced;
    - if strip of iron is immersed in a salt solution, the portion nearest surface, where the oxygen tension is the greatest, becomes cathode;
           - anode is a zone at a deeper level;
    - where cathode is large & anode is small, corrosion is greatest;
           - if cathode is plate & anode is screw, severe corrosion takes place;
    - clinically, mixing of plates & screws made of more inert metals such as vitallium & titanium does not give rise to significant corosion;
    - combinations of metals:
           - dissimilar metal alloys are used in combination in total joint implants;
           - titanium based alloys & cobalt based alloys can be combined with themselves and with each other;
           - stainless steel alloys also can be combined w/ each other, but not w/ either titanium or cobalt;
           - references:
                 - Coexistence of dissimilar metals after conversion of intertrochanteric osteotomy to total hip arthroplasty. 18 patients followed for 5-20 years after conversion. 
                 - Should the galvanic combination of titanium and stainless steel surgical implants be avoided?

- Corrosion:
    - corrosion is release of ions and compounds as result of chemical action;
          - in contrast wear is loss of solid fragments from surfaces due to mechanical action;
    - fretting corrosion:
          - a process in which abrasive wear is accompanied by corrosion;
          - protective oxide layer on metal is removed by abrasion process;
          - because new passivation layer that forms after abrasion is neither as durable nor as chemically inert as original layer, metal is more susceptible to corrosion;
          - this form of corrosion often occurs between screw heads & plates;
          - stainless steel & cobalt-chromium alloys are susceptible to fretting corrosion;

- Grain Size:
    - grain size or cystal size of metal is broadly indicative of its quality;
    - in general larger grain, less the tensile strength of metal;
    - conversely, smaller or finer the grain, greater toughness or strength;
    - heating metal to approx its melting point increases grain size;
    - forging decreases the grain size;
    - deforming stainless steel stem increases the grain size primarily on outer segment;

- Oxidation:
    - chloride ions interfere w/ oxidation & formation of passivation layer in stainless steel implants;
    - practice of steam sterilization of implants w/ saline in environment gives rise to surface corrosion in both instruments & implants and should be prohibited;
    - rough usage of implants and scraatches will break the oxide film on surface of an implant and be the nidus where corrosion, especially stress corrosion, may start;
    - implants should never be thrown around in basins or shaken together in basket, nor immersed in saline;
    - oxide layer inhibits metal egress and thus inhibits corrosion;
          - this layer serves to protect the metal by insulating it from electrolyte solution;
          - chromium oxide passivation layer forms on stainless steel & cobalt-chromium alloy;
          - titanium oxide layer forms on titanium and titanium alloys;

- Toughness:
    - ability of a metal to absorb energy by bending without breakage (the strain energy in the metal at the point of ultimate stress;
    - it is the area under the stress strain curve;
          - energy a structure absorbs as it deformed by applied force is equal to the work done by that force;






Detection of Orthopaedic Implants in Vivo by Enhanced-Sensitivity, Walk-Through Metal Detectors.








Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Saturday, January 12, 2008 10:19 pm