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….?

A

alloy

22
Q

Which metal is very resistant to corrosion without alloy components?

A

titanium

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
Q

What is crevice corrosion?

A

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
Q

What are two methods for improving corrosion resistance?

A

nitric acid immersion

titanium nitride coating

27
Q

What toxic metals are released from corrosion?

A

vanadium

aluminium

28
Q

Name the most important tissue reactions to implanted materials

A

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
Q

What causes tissue necrosis after implant insertion?

A

bone cement generating intense heat as it cures

30
Q

What can happen as a result of immune response to wear particles?

A

cell mediated bone resorption

31
Q

What metals can the body become sensitised to as a result of implants?

A

chromium
nickel
cobalt

32
Q

Why are ceramic components undesirable?

A

they fail in a brittle manner with no warning

33
Q

What one material has provided a satisfactory alternative to traditional implant materials?

A

carbon fibre reinforced plastic