Failure Analysis of a Titanium Hip Prosthesis
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CASE HISTORY—PEER-REVIEWED
Failure Analysis of a Titanium Hip Prosthesis . S. S. M. Tavares . D. F. Dias . A. R. Pimenta . S. R. Correa A. L. Sobreiro . M. G. Diniz
Submitted: 3 August 2020 / in revised form: 27 September 2020 / Accepted: 28 September 2020 Ó ASM International 2020
Abstract Total hip arthroplasty or total hip replacement (THR) is a surgical procedure for inserting an implant, which aims to restore the functionality of movements lost due to fractures, joint wear, bone loss and other problems. Although the THR procedure is consolidated in medicine, failures in THR implants associated with different problems are frequently reported in the literature. The aim of the present study was to identify and evaluate the reasons that led a THR implant to fail prematurely after 2 years of use in a 65-year-old female patient. In order to identify the reason of the failure, the following techniques were used: optical microscopy, scanning electron microscopy, chemical analysis by energy-dispersive spectroscopy, Vickers microhardness measurements, digital image processing A. R. Pimenta (&) LISComp, Federal Institute of Rio de Janeiro, Sebastia˜oLacerda, St, Paracambi, RJ 26600-000, Brazil e-mail: [email protected] S. S. M. Tavares Departamento de Engenharia Mecaˆnica, Universidade Federal Fluminense, Nitero´i, Brazil D. F. Dias Faculdade de Medicina, Universidade de Vassouras, Vassouras, Brazil S. R. Correa Centro Universita´rio de Volta Redonda, Volta Redonda, Brazil A. L. Sobreiro Sociedade Brasileira de Ortopedia e Traumatologia, Rio De Janeiro, Brazil M. G. Diniz Programa de Po´s-Graduac¸a˜o em Engenharia Mecaˆnica, Universidade do Estado do Rio de Janeiro, Rio De Janeiro, Brazil
technique and a mathematical method of finite element analysis. It was concluded that the fractured implant presented a fatigue mechanism, due to existence of pits on the surface. Keywords Failure analysis Total hip replacement (THR) Titanium-based implant Fatigue
Introduction Hip fractures are usually associated with traffic accidents, sports injuries, or high-energy impacts. However, fractures can occur more frequently in older people, due to small falls or impacts, especially in those who suffer from some bone comorbidity such as osteoporosis [1–3]. Uncomplicated hip fractures can be treated by screw fixation. However, total hip replacement (THR) is recommended in two situations: more severe injuries and less severe injuries in physically active patients. The THR procedure promotes reliable and long-term results. THR is a surgical procedure; it aims to replace the hip joint with a metallic implant. Although THR is a well-known and usually surgery, only in the UK, for example, is estimated to be 0.4 million of precedents in 2035 [4]. Nevertheless, there are several reports in the literature of failures in THR prostheses due to incorrect implant positioning [5], inadequate implant design [2, 6], presence of contaminants in metal alloys [2], corrosion processes [7], particle release due to friction wear [7], and manufa
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