Titanium and its

biomedical uses: Total

Hip Arthroplasty (THA)
Danny Freitas
Chris Mah
Siavash Soltani

Background/Introduction

Causes of Total Hip Arthroplasty

Designs for Fixed Bearing THA

Osteoarthritis.
Bone tumors.
Injury to the hip joint.
Metal on Plastic
Metal on Metal
Ceramic on Ceramic
Ceramic on Plastic

THA Components [1]

Advantages/Disadvantages

Wear properties
Fracture rate
Osteolysis
Metal-on-Metal THA [2]

Anatomy of hip [8]

History of Total Hip Arthroplasty (THA)

1925: Mold arthroplasty proposed
by Marius Smith-Peterson, using
glass as a hollow shell to be fit
over the femoral head2.
1891: First THA design using Ivory
adhered with glue, proposed by
Themistocles Gluck1

1930s: Marius Smith-Peterson and

Phillip Wiles proposed the stainless
steel hip replacement, fitted to the
bone with bolts and screws3.

1953: First instance of metalon-metal THA, proposed by

George McKee4.

1970s: Sir John Charnley proposes

THA design, using a metal femoral
stem, polyethylene acetabular
component and acrylic bone cement1.

History of Total Hip Arthroplasty (THA)

Ivory hip implant [1]

X-ray, total hip arthroplasty post-op [3]

Titanium alloy hip implant w/ HA coating [2]

Properties
Commercially pure Ti and low interstitial Ti-6Al-4V are the two most common
Ti based implants

Biologically inert
No adverse reactions and are tolerated by human tissues
No allergic reactions
Formation of passive oxide layer
Low elastic modulus is achievable to avoid stress shielding

Manufacturing Techniques

Traditional methods: casting and machining

Vs

Advance techniques: injection molding and additive layer manufacturing

Advantages: Design flexibility, cost saving, reduce waste, custom-shaped

implants

Injection Molding

Metal Injection Molding (MIM)

A specialized form
of plastic injection molding
uses metal powder
mixed with some type of binder
Four steps:
1) Feedstock preparation
2) Injection molding
3) Removing the binder
4) Sintering
Flow chart for Ti-PIM process [S4]

Injection Molding
SEM micrograph showing removal of binder during thermal debinding.

SEM of an as moulded component surface

CP-Ti within PEG/PMMA/Stearic Acid binder system
[S5]

brown part after the removal of the PMMA during

thermal pyrolysis [S5]

Injection Molding
A TGA test can confirm that debinding was successful:

Shorter period of time in Argon

Weight loss curves for PMMA at a heating rate of 5 C/min for Ti/binder mix
before and after thermal pyrolysis [S5]

Injection Molding

Comparison of surface properties of machined and MIM Ti

Surface profiles coming from machined samples and sintered samples [S7]

Additive Layer Manufacturing

Using a laser beam or electron
beam to melt the metal powder
to build complicated
components

Stress Shielding

Biomechanical mismatch of Ti-6Al-4V

Outer cortical region of dense bone:

E=16 to 20 GPa
Inner trabecular bone:
E= an order of magnitude less than cortical
Elastic modulus for commercial Ti-6Al-4V
is about 105 to 110 GPa

Additive Layer Manufacturing

Diamond and hatch structures of Ti-6Al-4V manufactured by ALM

SEM image of Ti6Al4V diamond and hatched structure [S11]

Additive Layer Manufacturing

the diamond structure exhibits properties comparable with trabecular bone,
whereas the hatched structures properties lie in between those of trabecular
and cortical bone

Mechanical properties of the untreated cellular Ti6Al4V structures tested in compression with the loading direction parallel and perpendicular to the building
direction of the specimens, where E is elastic modulus, y0.2 is the yield strength, max is the maximum strength [S10]

Biocompatibility of Titanium and its Alloys

Biocompatibility - An implanted
materials ability to be accepted
by the surrounding tissue and
broadly, the body as a whole.

Driving Force
in vivo corrosion resistance
poor ability to combat wear
alloyed composition
Corroded titanium implant [4]

Corrosion

Corrosion - The tendency for a metal to dissolve in the presence of air or

water, releasing metallic ions in the surrounding environment (eq. 1)
Dependant upon;

The mechanical and chemical properties of the metal.

The environment you choose to observe.

Corrosion

In biological systems, the equilibrium between metal dissolution and

metal redeposition is never reached, and corrosion is allowed to continue
because of a cyclic redox reaction between the metal dissolution (anode)
(eq. 1) and biological reduction (cathode). (eq. 2)

Passivation

Formation of a protective oxide layer, the lowest energy state most metals
can attain, that makes them less reactive with both air and water. (eq. 3)

Passivation

Passivation and contamination of titanium over time [5]

Active, Passive and Transpassive states related to

electric potential [6]

Corrosion Resistance
The electric potential at which the metal
can still dissolve to form metallic ions
The electric potential at which the metal
can still form an oxide layer

The electric potential at which the metal

will readily corrode in the body

Regardless of material properties, the morphology and geometry or wear particles have been shown to be toxic.

THA using PE to reduce wear [7]

Potential Solutions

Anodising titanium in acid

Flame, plasma and detonation gun sprayed coatings
Nitride coating
Conversion coating

Alternative Materials

Stainless Steel

Cobalt Alloys

Fe-18-18Cr-14Ni-2.5Mo
316L ASTM F138
Co-28Cr-6Mo
Cast CoCrMo ASTM F75
Co-35Ni-20Cr-10Mo
Wrought CoNiCrMo ASTM F562

Alumina (not in clinical uses in the United States)

ASTM F603
Compressive strength: 4000MPa
Flexural strength: 400MPa
Elastic Modulus: 380GPa

Properties

316L

Cast
CoCrMo

Wrought
CoNiCrMo

Tensile
Strength
(MPa)

862

655-889

1206

Yield
Strength
(MPa)

689

448-517

965-1000

Elastic
Modulus
(GPa)

200

210

232

Mechanical properties of various materials used in total hip replacement implants

[C1][C2][C3]

Stainless Steel 316L

Inexspensive
Manufactured with common
methods
Readily available
High yield strength
High tensile strength

Stainless steel 316L rods [C4]

SEM imaging of SS316L showing pitting after accelerated

corrosion[C5]

Long term exposure in a body

environment results in crevice
corrosion and pitting
Relatively low fatigue strenth
(383MPa at 107 cycles)
High elastic modulus compared
to bone

Cobalt Alloys

Most commonly used metals for hip

implants
Cobalt not particularly biocompatible

Chromium addition creates a passivating

oxide film

Hip joint made of Co-Ni-Cr-Mo (ASTM

F562) [C2]

Corrosion resistance an order of

magnitude better than SS316L

High fatigue strength (793MPa for F562

107 cycles)
Broken implant made of Co-Cr-Mo
(ASTM F75)[C2]
High wear resistance Brittle
Relatively poor biocompatibility
High elastic modulus compared to
bone

Alumina

Very high compressive strength (4000MPa)

Excellent corrosion resistance
Bioinert
Exceptionally low friction coefficient and
wear rate

Alumina-on-alumina bearing for hip replacement [C5]

Friction and wear of alumina-alumina hip joint compared to a metal-PE prosthesis[C2]

Difficult manufacturing requirements

grain size under 4um
99.7% purity
1700C sintering temperature
If loosely fitted, encapsulation growth
can reach 100s of um
Brittle
Extremely high elastic modulus

Advantages of Titanium

A comparison of orthopaedic metallic implant materials[C6]

Advantages of Titanium

Elastic modulus values of orthopaedic alloys[C6]

Lowest elastic modulus of solid implant

materials
TiO2 passivating layer is spontaneously
grown when Ti is exposed to oxygen
Contributes to its relatively high
corrosion resistance
Mixing of hydroxyl functional groups in the
TiO2 layer allows for relatively good
osseointegration
Basis for further research
Alloys
Grain structuring
Structure

Advancements in Titanium-Alloys

-phase
T<833C
HCP - brittle
Stabilizers: Al, O, N, C
-phase
T833>C
BCC - ductile
Stabilizers

-isomorphous
Mo,V,Nb,Ta
Most interest as
alloys give lowest
E

-eutectoid
Fe,W,Cr,Si,Ni,Co,
Mn,H

( + ) Ti Alloys
Provides higher YS, UTS, and
fatigue strength
Ti-6Al-4V, Ti-6Al-7Nb, Ti-5Al-2.5Fe
Fatigue Stress at 107 cycles
(MPa): 625, 600, 580
Ti Alloys
Provides a lower elastic modulus
Lower notch sensitivity compared to
and ( + ) Ti Alloys
Mo>10
Ti-12Mo-6Zr-2Fe (TMZF), Ti-15Mo3Nb-0.3Si(21SRx), Ti-35.5Nb-7.3Zr5.7Ta(TNZT)
Fatigue strength at 107 cycles
(MPa): 525, 490, 265

Advancements in Titanium-Alloys

Properties of various titanium alloys[C6]

Advancements in Titanium-Sever Plastic Deformation

Properties of the 4 grades of Ti CP[C3]

Chemical compositions of the 4 grades of Ti CP[C3]

Alternative approach to alloying in order to get more favorable

mechanical properties and prevent potentially harmful ion release
Efficient fabrication of bulk nanocrystalline titanium
High plastic strains, complex stress rates, hydrostatic pressure, high
strains break down coarse grains to ultrafine(100nm-1000nm) or nanosized(under 100nm) grains

Advancements in Titanium-Severe Plastic Deformation

Equal Channel Angular Extrusion (ECAP):

High Pressure Torsion (HPT)

Small disk is placed between two anvils

High pressure is applied and one anvil is rotated
Pure shear stress

Accumulative Roll Bonding(ARB)

Material pressed through a special die with two channels intersecting at a 90120
angle
Material can have multiple passes

Sheets of material are ran through two rolls causing a severe reduction ratio

Hydrostatic Extrusion(HE)

Material surrounded by hydrolic fluid and pressed through die

Advancements in Titanium-Severe Plastic Deformation

Mechanical Properties of nanostructured titanium and Ti-based alloys produced with various SPD methods[C8]

Advancements in Titanium-Structure

(a) SEM imaging of the overall structure of porous titanium with a porosity gradient (b)
Enlarged SEM imaging of porous structure[C9]

Decrease in elastic modulus with

compressive strength close to bone
Porous gradient structures maintain low
elastic modulus, but provide better stress
capabilities in comparison to a uniformed
porous material
Outer shell of porous gradient has
architecture mimicking that of natural bone
porosity of 70% and size distribution in
the range of 200-500um
Allows for new bone tissue growth

Mechanical properties of sample with gradient porosity and uniform porosity[C9]

Mechanical Properties degrade with higher pore size

Difficult to control pore structure

Solid Ti rod - inner

Ti powder - outer
Ammonium bicarbonate - space-holding
Mould, 200MPa pressure, 200C (burn out),
1200C (sinter)

Advancements in Titanium-Structure

Controllable pore size: 58% porosity, 490um average

pore size
Can control depth of solid base with etching time
Compressive strength: 110MPa
Elastic Modulus: 5GPa
Mechanical properties can be increased for various
uses by decreasing the etching time and increasing
the solid core diameter

Titanium wire is rolled into coils, stretched,

woven, compressed at ~300MPa, and
sintered
Mg ingot melted under inert state, Ti is
immersed in molten form
Soaked in 10% HCl (volume)
Cleaned with acetone

(a)Schematic diagram showing the fabrication of the

graded porous TiMg composite (b) sample images
(from left to right): porous Ti preform, TiMg
composite, and graded porous TiMg composite[C11]

Economic, Legal, and Ethical Issues

Conclusion

Designs for fixed bearing THA

Biocompatibility of titanium and its alloys

Manufacturing techniques

Alternative Materials

Advancements in titanium