Fixation Flashcards

1
Q

What is the area between the bone and the fixator known as?

A

bone-implant interface

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2
Q

What is the main operational difference between screws and nuts and bolts?

A

Screws require access to one side of the bone only whereas nuts and bolts need two

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3
Q

What is interference fit?

A

fixation technique relying on a tight contact between the implant and the bone providing friction to prevent movement at the interface

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4
Q

What happens if the interference fit is too tight?

A

the bone spits

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5
Q

What type of joint replacement is this technique used for?

A

cementless implants

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6
Q

Is bone cement adhesive ?

A

No

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7
Q

What material is bone cement more like?

A

grout - a filling material

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8
Q

what advantage does bone cement give to implants?

A

it can fill gaps so a perfect geometrical match is not required

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9
Q

Why is it difficult to apply adhesives to bone?

A

Bone is wet and difficult to access for cleaning

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10
Q

What are two methods of biological fixation?

A

beaded coating the same material as the metallic implant with pores

HAp coating - plasma spray coating

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11
Q

Why are prosthesis stems tapered?

A

press outwards on bone to prevent subsistence

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12
Q

What is biocompatibility?

A

acceptance by the body tissues and systems

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13
Q

What two factors are important in biocompatibility?

A

extent of which body fluids and tissues affect a material (corrosion)

Extent of which the material adversely affects body tissues (tendency to cause abnormal tissue changes)

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14
Q

What is corrosion?

A

the progressive unwanted removal of a material by an electrochemical process.

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15
Q

How does corrosion occur?

A

it occurs when two electrodes are immersed in a liquid that conducts electricity. a current flows from one material to another through the electrolyte, allowing a chemical reaction to take place.

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16
Q

What makes up the electrolyte in the body?

A

body fluids which contain salts of variable kinds (they are very corrosive)

17
Q

What does corrosion cause in implants?

A

pits and craters - loss of material

18
Q

What makes corrosion worse?

A

electrodes are different materials

19
Q

How does corrosion occur in a single metal component?

A

non-homogenous regions within the material like altered distribution of alloy components

20
Q

How can corrosion occur between two electrodes of the same material?

A

slight differences in the manufacturing of the two materials

21
Q

Some metals become more resistant to corrosion by mixing together certain metals together to form an….?

22
Q

Which metal is very resistant to corrosion without alloy components?

23
Q

Why is titanium inherently resistant to corrosion?

A

it has a passivation layer of titanium oxide when exposed to a corrosive environment

24
Q

What is fretting corrosion?

A

abrasion of materials that removes the protective metal oxide coating and corrosion occurs

25
What is crevice corrosion?
occurs in crevices between implants where body fluid becomes trapped - it is starved of oxygen and creates a high concentration of acid leading to corrosion
26
What are two methods for improving corrosion resistance?
nitric acid immersion | titanium nitride coating
27
What toxic metals are released from corrosion?
vanadium | aluminium
28
Name the most important tissue reactions to implanted materials
growth of thin fibrous layer between implant and body tissue local infection - before, during or after surgery body sensitisation to metals (chromium, cobalt, nickel) inflammation in regions of corrosion tissue necrosis immunological reaction to wear particles tumours
29
What causes tissue necrosis after implant insertion?
bone cement generating intense heat as it cures
30
What can happen as a result of immune response to wear particles?
cell mediated bone resorption
31
What metals can the body become sensitised to as a result of implants?
chromium nickel cobalt
32
Why are ceramic components undesirable?
they fail in a brittle manner with no warning
33
What one material has provided a satisfactory alternative to traditional implant materials?
carbon fibre reinforced plastic