Since the major pioneering of joint replacement surgery more than fifty years ago, much research and progress has been made in the field of arthroplasty with new insights into better materials, types of cement and bone-cell compatible coatings, and a better understanding of the causes of implant failure. With an increasingly ageing population the requirement for arthroplastic surgery is manifest; over 800,000 hips worldwide are replaced each year, and replacement surgery is performed for almost every joint of the body.

The Engineering of Human Joint Replacements covers the design, engineering, production and manufacture of human joint replacements, as well as associated engineering concerns such as surface coatings, orthopedic bone cement, the causes and effects of wear and tear, and rapid prototyping for clinical evaluation. Materials evaluation and selection is discussed, as well as production processes and insertion methods. The author provides an overview of skeletal anatomy and the effects of pain and deterioration in order to put the engineering principles into a medical context. Examples of joint replacements for the most common regions of the body are included, and aspects of clinical studies of these cases are discussed.

Key Features:

• Provides an overview of the engineering materials and processes involved in the manufacture of    human joint replacements
• Sets the scene for engineers and clinicians embarking on research into joint replacements
• Includes clinical and industrial examples and points the way to future developments
• Provides information on medical device companies with an engineering guide to the requirements for joint replacement

The Engineering of Human Joint Replacements bridges the divide between engineering and orthopaedic surgery, offering an introductory text to young engineers entering the field, as well as a reference for medical staff who will benefit from an understanding of the materials and methods used in their design, engineering and manufacture.

Preface xi

1 Introduction 1

References 5

2 Basic Anatomy 7

2.1 Terminology 7

2.2 Human Skeleton 8

2.3 Joints 10

2.4 Cartilage 10

2.5 Protein and Collagen 11

2.6 Human Bone 14

References 22

3 Anatomy of Joints 25

3.1 Shoulder 25

3.2 Elbow 29

3.3 Wrist 34

3.4 Finger 38

3.5 Hip 38

3.6 Knee 43

3.7 Ankle 49

3.8 Foot 52

3.9 Toe 52

3.10 Degradation of Joints 54

References 56

4 Methods of Inspection for Joint Replacements 59

4.1 Introduction 59

4.2 Gait Analysis 60

4.3 X-ray 61

4.4 Tomography and Computed Tomography (CT) 64

4.5 Radionuclide Scanning 66

4.6 Ultrasonography 66

4.7 Magnetic Resonance Imaging (MRI) 67

References 69

5 Materials in Human Joint Replacement 71

5.1 Introduction 71

5.2 Alloy Metals 71

5.3 Ceramics 79

5.4 Polymers 83

5.5 Joint Replacement Materials in Service 91

5.6 Nanomaterials 95

References 98

6 Methods of Manufacture of Joint Replacements 103

6.1 Introduction 103

6.2 Surface Finish 104

6.3 Tolerance 106

6.4 Wear and Friction 106

6.5 Machining 106

6.6 Forging 112

6.7 Casting 114

6.8 Manufacture of Polymer Parts 119

6.9 Surface Treatment 121

6.10 Surface Finishing of Implants 125

6.11 Manufacture of Joint Replacements 127

References 128

7 Computer-Aided Engineering in Joint Replacements 131

7.1 Introduction 131

7.2 Reverse Engineering 132

7.3 Solid Modelling 133

7.4 Finite Element Analysis (FEA) 137

7.5 Rapid Prototyping (RP) in Joint Replacement Manufacture 141

7.6 Computer-Aided Manufacture 145

7.7 Navigation 150

7.8 Robotics 153

References 162

8 Joint Replacement 167

8.1 Introduction 167

8.2 Shoulder 171

8.3 Elbow 175

8.4 Wrist 178

8.5 Fingers 180

8.6 Hip 183

8.7 Knee 191

8.8 Ankle 200

8.9 Foot and Toe 203

References 206

Index