Case Study and Failure Analysis of a total hip Stem Fracture

Open access

Abstract

A total hip replacement is a procedure that requires removal of the affected joint lesions and replacing it with artificial elements. Nevertheless, like any invasive surgery, it is associated with the risk of complications, including joint infection, fracture of the bone during and after surgery, scarring and limitation of motion of the hip, and loosening of the prosthesis. In this work we present and describe the results of its investigations. In order to determine the mechanism of failure, a broken stem components were analyzed by means of macroscopic and microscopic observations and hardness measurements. The hardness, microstructure and chemical composition of the broken part of the hip stem were analyzed. Microscopic examination revealed numerous defects in material. Among them are pores and emptiness, located on the outskirts of the tested samples and a plurality of micro-cracking, debonding and delamination of the material due to the overloading of a fatigue character. There were no changes caused by intergranular corrosion or pitting, which may indicate for an even distribution of the major alloying components such as chromium and nickel. Observations of the material by using scanning electron microscopy (SEM), clearly proved that the destruction was caused by material fatigue. The investigation showed that the crack had originated due to a high stress concentration on the lateral corner section of the stem. Large surface of the fatigue crack zone area indicated for small stresses and small crack propagation velocities. There was a clear correlation between the grain size of the steel hardness. The results of hardness test revealed a significant increase hardness of stem in relation to the normative values. In addition, the measured average grain size is less than the standard accepted. Using Solid Works simulation and FEM a model of the stem was created and analyzed in terms of strength and rated the distribution of the generated stress. The finite-element analysis confirmed that there is the highest stress concentration in the middle of the stem

1. Gandhi R., Davey J.R., Mahomed N.: Patient expectations predict greater pain relief with joint arthroplasty. J. Arthroplasty, 24(5) (2009), 716-21.

2. Nunley R. M., Ruh E. L., Zhang Q., Della Valle C. J., Engh C. A,. Berend M. E, Parvizi J., Clohisy J. C., And Barrack R. L.: Do patients return to work after hip arthroplasty surgery. J. Arthroplasty, 26 (6 Suppl) (2011), 92-98.

3. Kamachi M. U., Sridhar T.M., Eliaz N., Baldev R.A.J.: Failures of stainless steel orthopaedic devices: causes and remedies. Corros Rev., 21 (2003), 231-67.

4. Martens M., Aernoudt E., De Meester P., Ducheyne P., Muller J.C., Delangh R., Kestelijn P.: Factors in the mechanical failure of the femoral component in total hip prosthesis. Acta Orthop Scandinavica, 45(5) (1974), 693-710.

5. Kotela A., Ambroziak P., Deszczyński M.J.: Złamanie trzpienia endoprotezy stawu biodrowego - opis przypadku. Ostry Dyżur, 5, 1-2 (2012).

6. Carlsson A. S., Gentz C. F., Stenport J.: Fracture of the femoral prosthesis in total hip replacement according to charnley. Acta Orthop Scand., 48(6) (1977), 650-5.

7. Wróblewski B.M.: Fractured stem in total hip replacement - a clinical review of 120 cases. Acta Orthop Scand., 53(2) (1982), 279-84.

8. Akinola B., Mahmud T., Deroeck N.: Fracture of an exeter stem - a case report. The Internet Journal of Orthopedic Surgery, 16, 1 (2009).

9. Jarvi K., Kerry R.M.: Case report segmental stem fracture of a cemented femoral prosthesis. The Journal of Arthroplasty, 22 (2007).

10. Roffey P.: Case study: Failure of a high nitrogen stainless steel femoral stem. Engineering Failure Analysis, 20 (2012).

11. Sen R.K., Mootha A.K., Saini R., Kumar V.: Segmental fracture of a cemented femoral stem - a case report and review of literature. The Internet Journal of Orthopedic Surgery, 13, 1 (2009).

12. Speidel M.O.: Nitrogen containing austenitic stainless steels. Materialwissenschaft Und Werkstofftechnik, 37, 10 (2006).

13. Cieśla M., Ducki K.J.: Effect of increased nitrogen content on the structure and properties of tool steels. Journal of Achievements in Materials and Manufacturing Engineering, 29 (2008).

14. Ducki K.J., Cieśla M., Hetmańczyk M., Kuc D., Kamiński P.: The influence of increased nitrogen contents on structure and selected properties of tool steels. Proceedings of the 7th Scientific Conference “New Production Technology and Materials in Metallurgy and Materials Engineering”, Katowice (2000), 123-128 (In Polish).

15. Standard specification for wrought nitrogen strengthened 21 chromium-10 nickel- 3 manganese-2.5 molybdenum stainless steel alloy bar for surgical implants, American Society For Testing and Materials, West Conshohocken, Pa, ASTM F1586.

16. Murty B.S., Shankar P., Baldev R., Rath B.B., Murday J.: Texstbook of Nanoscience and Nanotechnology, Springer (2013), 55 - 66.

17. Standard specification for stainless steel forgings for surgical implants, American Society For Testing And Materials, West Conshohocken, Pa, ASTM F621-12.

Advances in Materials Science

The Journal of Gdansk University of Technology

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 127 127 21
PDF Downloads 58 58 16