Cette thèse présente le développement d’implants en titane poreux sur mesure pour la chirurgie maxillo-faciale. Après avoir caractérisé mécaniquement le titane grade 2 obtenu par un procédé de fabrication additive, le Selective Laser Melting, nous avons réalisé des simulations éléments finis afin de développer un motif élémentaire aux propriétés mécaniques proches de celles de l’os. L’affaiblissement des propriétés initiales du titane permet d’éviter les phénomènes de résorption osseuse menant au descellement de prothèses par exemple. La structure développée garantit une ostéointégration optimale en permettant au tissu osseux de croître à l’intérieur des porosités.Pour accélérer l’intégration des implants dans l’os, nous avons développé un traitement de surface composé d’une immersion dans de l’hydroxyde de sodium et d’une anodisation. Ceci permet de créer une nouvelle couche d’oxyde, en surface du titane, avec laquelle l’os va pouvoir créer rapidement des liens chimiques forts.Enfin, un modèle numérique propre à un patient a été réalisé pour étudier l’influence d’implants crâniens en différents matériaux sur la distribution des températures au niveau de la tête. Il s’est avéré qu’un implant en titane poreux présente un comportement thermique proche de celui du tissu osseux, ce qui garantit la protection thermique du cerveau. Un modèle simplifié assimilant la tête à une sphère a été confronté au modèle précédent. Les résultats de ces deux modèles coïncident, il est donc suffisant de réaliser un modèle simple pour prédire la distribution de la température dans la tête. Ces travaux ont conduit à plusieurs implantations de substituts osseux en titane poreux. / This thesis deals with the development of patient specific porous titanium implants for maxillo-facial surgery. Once the mechanical properties of Selective Laser Melted commercially pure grade 2 titanium were characterized, finite elements simulations were carried out to create an elementary pattern with mechanical properties close to those of human bone.Weakening the initial properties of titanium enables to avoid the bone resorption phenomenon that frequently leads to prosthesis loosening. The ability of bone to grow into the porosities of the designed structure ensures optimal osseointegration of the implants.A new surface treatment composed of an immersion in sodium hydroxyde followed by an anodic oxydation was developed to improve the substitute integration to bone. This treatment enables to create a new oxyde layer on titanium with which bone will quickly create strong chemical links.We designed a patient specific numerical model in order to check the impact of cranial substitutes made of various materials on the modification of temperature fields in the head. Porous titanium implant and bone showed very similar thermal responses. Therefore, a porous titanium implant provides excellent thermal protection of brain. This model was set against a simplified one where the head was considered as a sphere. Since the results of these models were very similar, we concluded that the simplified modelling is appropriate to quickly predict temperature fields in the head with implant.So far, several porous bone substitutes based on the elementary pattern developed in this thesis were successfully implanted in humans

There are many aspects that have direct effects on total hip replacement performance (THR), such as material properties, applied loads, surgical approach, femur size and quality, prosthesis design, bone-implant interface etc. Bone mechanics and traditional implant materials cause a frequent problem for patients of total hip arthroplasty (THA): the bone becomes shielded from the loading. Bone structure follows what is called "Wolff's Law", meaning it has an adaptive structure, which alters its geometry when experiencing forces over its life (Goldstein, 1987); (Pearson & Lieberman, 2004). The improved femoral stems act weakly in transferring stress onto the remnant bone and bone tissue atrophies at the interface, which will result in loosening of the implant, pain and thus, revision surgery will need to take place to correct the issue ( Feldt, 2011). For the current study, an innovative hollow spherical structure is developed for femoral hip stems. The aim is to extract volume in the spherical shape from the stainless steel hip implant stems, in order to focus solely on correlating with titanium behaviour. Internal geometry for the femoral stem is optimised in order to transfer more stress onto the bone. Moreover, the approach involves extracting volume in the spherical shape from internal structure to reduce stress shieling. New novel implant is proposed that demonstrated reduction in stress shielding. A new structure has been developed in this study for biomedical applications, such as implants, with the aid of the rule of mixtures and finite element analysis was applied to various models with different complex internal structures. Firstly, the rule of mixtures was used as finite element could not handle the simulation due to the large number of elements created, and also helped developing the designs analysed in this study. Secondly, computational analysis was applied to simplified finite elements containing hollow spheres in their outer shell. Moreover, a compression test was applied to a solid sample and the experimental case. This approach was adopted to investigate the effects of a hollow structure near the side surface and the bone-implant interface. The same method was applied to samples containing uniformly distributed hollow spheres. In the both scenarios, the specimens were designed differently based on the sphere size, their distance from wall and that from each other. Finally, finite element was applied to actual implant samples containing hollow spheres. The sphered models have a smaller Young's modulus and strength than the solid stainless steel sample. The spheres in hollowed structures reduce the stress shielding and they transfer more stress onto the bone when compared to the solid stainless steel models. This approach also involves restructuring a hard material, such as stainless steel, to enhance osseointegration. The reduction of the Young's modulus and stress directly depends on the volume of the hollow spheres in the models; however, there is certain volume that can be extracted from solid.

<p>Implants are commonly used for orthopaedic and dental applications. There is however a problem with implants; they have a tendency to get loose after 10-15 years of usage. Bone that is not used will get weaker; this can be concluded from studies of people being immobilised or in microgravity. When an implant is put into bone, the surrounding bone does not experience any deformation and it will resorb. This is called stress shielding. Finally the implant will get loose. To avoid this problem we want to give electrical stimulation to the bone surrounding the implant. Electricity has been used before to stimulate bone, and it has been shown that immobilised bone can almost be maintained by using electric stimulation.</p><p>Piezoelectricity is a property of certain materials that make them generate electricity when they are deformed. When an implant is coated with a piezoelectric material, electrical stimulation can be achieved for the surrounding bone that is stress shielded.</p><p>In this diploma work, a test-equipment is built to stimulate cells. Cells will be grown on a piezoelectric plate that is bent by the test-equipment. Thus, the cells will be stimulated by both mechanical stress and electric potential since the piezoelectric material generates electricity when it is deformed. Piezoelectric samples and culture wells suitable for bending applications are prepared and tested in the equipment.</p><p>Some initial cell growth experiments have been performed to see that the material is suitable for cell growth.</p>

Implants are commonly used for orthopaedic and dental applications. There is however a problem with implants; they have a tendency to get loose after 10-15 years of usage. Bone that is not used will get weaker; this can be concluded from studies of people being immobilised or in microgravity. When an implant is put into bone, the surrounding bone does not experience any deformation and it will resorb. This is called stress shielding. Finally the implant will get loose. To avoid this problem we want to give electrical stimulation to the bone surrounding the implant. Electricity has been used before to stimulate bone, and it has been shown that immobilised bone can almost be maintained by using electric stimulation. Piezoelectricity is a property of certain materials that make them generate electricity when they are deformed. When an implant is coated with a piezoelectric material, electrical stimulation can be achieved for the surrounding bone that is stress shielded. In this diploma work, a test-equipment is built to stimulate cells. Cells will be grown on a piezoelectric plate that is bent by the test-equipment. Thus, the cells will be stimulated by both mechanical stress and electric potential since the piezoelectric material generates electricity when it is deformed. Piezoelectric samples and culture wells suitable for bending applications are prepared and tested in the equipment. Some initial cell growth experiments have been performed to see that the material is suitable for cell growth.

In the field of maxillofacial surgery, the treatment for the recovery of the fracture at condyle region of the mandible has been carried out using Bio-metals such as Titanium, Cobalt, Stainless-Steel because they were considered the standard materials for Implant plate devices for fracture fixation. Using these materials have led to undesired disturbances where the patient must undergo secondary surgery after recovery leading to exposure of the fracture site to the surrounding, metal-ion release into the human system, stress-shielding and interruption during imaging i.e. (Computerized tomography scans). The healing of the mandible requires a delicate and stable fixation procedure for the bone structure to heal. Bio-resorbable materials are the renovation for substituting metals for recovery of the fracture. The main dis-advantage using resorbable plates is absence of mechanical strength and stability. Bio-composites are the innovation for the treatment of the fractures the main study for this thesis is comparing the combination bio-ceramic and bio-resorbable materials using Finite Element Analysis software.

Long bone fractures are fixed with bone plates to restrain movement of bone fragments. Fracture site must experience some pressure for proper healing. Bone plates are mostly made up of metals having 5 - 10 times higher elastic modulus than bones and most of the load is carried by them, leading to stress shielding and a bony tissue with low mineral density and strength. To avoid these problems, biodegradable polymer-based composite plates were designed and tested in this study. Poly(L-lactide) and Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) biodegradable polymer composite fibers containing hydroxyapatite (HAP) nanoparticles were produced by extrusion and spinning techniques to reinforce the polymeric bone plates. The composite fibers were expected to mimic the natural organization of bone so that HAP nanorods aligned parallel to the loading axis of bone plate. Also, lactic acid was grafted on HAP surfaces and had a positive effect on the mechanical properties of the PLLA composites. A 50% (w/w) HAP nanoparticle content was found to increase tensile modulus value (4.12 GPa) ca. 2.35 times compared to the pure polymeric fiber with a reduction to one third of the original UTS (to 50.4 MPa). The fibers prepared were introduced to polymeric plates with their long axes parallel. Fiber reinforced bone plates were compression tested longitudinally and up to a 4% increase in the Young&rsquo / s Modulus was observed. Although this increase was not high was not high probably due to the low fiber content in the final plates, this approach was found to be promising for the production of biodegradable polymeric bone plates with mechanical values closer to that of cortical bones. Biological compatibility of fibers was validated with in vitro testing. The osteoblasts attached and spread on the fibers indicating that bone fractures fixed with these could attract of bone forming osteoblasts into defect area and help speed up healing.

Made available in DSpace on 2016-06-02T19:10:19Z (GMT). No. of bitstreams: 1 5667.pdf: 13990597 bytes, checksum: b95cfd98b18d138da54ab95fa27e9034 (MD5) Previous issue date: 2013-12-16 / Universidade Federal de Sao Carlos / The stress shielding phenomenon, resulting from the large difference between materials usually employed in prosthesis and the femur Young modulus, promotes significant bone mineral density loss, which originates several complications after hip arthroplasty. In this work, cervical-diaphisary angle and stem length influence over the mechanical stimulus for the bone remodelling, besides the effect of the low modulus alloy adoption, were evaluated by numerical simulation using the finite element method. In order to validate the computational model, a circular polariscope bending test was proposed, aming to photoelastic stress analysis. Results obtained on numerical simulation and on tests with optical monitoring seem to be both well enough confluent. It can be said that stem length reduction caused considerable increase in load transfer to femur, while cervical-diaphisary angle reduction did not produce so relevant effect. The employment of a low modulus stem, on the other side, really provided the elevation of load transfer to femur on higher levels than it has been achieved by the redesign of prosthesis geometrical features. It is understood that the combination of numerical simulation and photoelastic stress analysis may clearly contribute on an improvement of hip prosthesis design and registration process at ANVISA. / O fenômeno stress shielding, decorrente da grande diferença entre o módulo de elasticidade dos materiais comumente empregados em próteses e o módulo de elasticidade do fêmur, promove uma perda significativa de densidade mineral óssea, a qual origina diversas complicações após uma artroplastia de quadril. Neste trabalho, a influência do ângulo colodiafisário e do comprimento da haste femoral sobre o estímulo mecânico ao remodelamento ósseo, assim como o efeito da adoção de um material de módulo de elasticidade reduzido, foram avaliados por meio de simulação númérica, utilizando o método dos elementos finitos. Visando validar o modelo computacional, foi proposto um ensaio de flexão em polariscópio circular, direcionado à análise fotoelástica de tensões. Os resultados obtidos nas simulações numéricas e nos ensaios sob monitoramento óptico mostraram-se satisfatoriamente confluentes. Pode-se dizer que a redução do comprimento da haste ocasionou um aumento bastante considerável na transferência de carga ao fêmur, ao passo que a diminuição do ângulo colodiafisário não produziu efeito tão relevante. O emprego de uma haste com módulo de elasticidade reduzido, por sua vez, proporcionou a elevação da transferência de carga ao fêmur em níveis muito superiores ao que pode ser obtido pelo reprojeto das variáveis geométricas da prótese. Entende-se que o emprego de simulação numérica combinada com a análise fotoelástica de tensões pode efetivamente contribuir com o aprimoramento do projeto e do processo de registro das próteses de quadril junto à ANVISA.

The total knee arthroplasty (TKA) has become one of the most successful procedures in all of medicine, with an average of over 966,000 operations performed a year. Since its introduction in 1968, the TKA’s surgical process and implant designs have continuously been improved to increase survivability. However, the need for a revision TKA – due to aseptic loosening – continues to be a problematic aspect of the procedure. Stress shielding induced by different design parameters of the implant has generated controversy in the determination of an ideal configuration. The purpose of this study is to investigate how implant design parameters – fixation technique, stem geometry, cement stiffness, and interface condition – affect the stress shielding within the tibia, and to find an optimal combination of designs that mitigates stress shielding. A CT scan of a tibia was used to simulate multiple configurations of TKAs for finite element analysis in ABAQUS. Stress shielding was assessed by taking the average minimum principal stress of different regions at interval cuts along the depth of the tibia. The results concluded a short, full-cement stem to be the ideal combination of stem length and fixation technique, high-stiffness cement to be ideal for hybrid cements, low-stiffness cement to be ideal for full cements, and a sliding friction interface to be ideal for all models.

The present research focuses on analyzing the possibility of implementing three dimensional woven composite (3DWC) materials in hip implants. The integration of 3DWCs in hip implants has the possibility to both extend the life-time and improve patient outcomes; by spatially varying mechanical properties to meet both biological needs as well as required mechanical loading. In this study, the bulk material properties of 3DWCs were varied based on woven composite architecture and determined using physics based models, which reflect the realistic geometries of fibers in compaction and preform. The multi-digital chain method combined with Extended Finite Elemental Analysis (XFEA) are adopted in this micro-analysis for composite design. Four different woven architectures with a combination of different existing biocompatible fiber and resins are considered in this study. The main objective is to assess the mechanical response of these biocompatible materials in the design of 3D woven architectures and determine their ability to match the required modulus at different regions of a hip implant. Results obtained show 3DWCs are viable candidates for this application. Multiple architectures and materials chosen, were able to achieve the desired mechanical response. Additional studies can use these results as a starting point and framework for further mechanical and biological testing.

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