Fabrication of low-cost hip implant using direct metal laser sintering technique

Mohd Yusof Baharuddin

Abstract

Total hip replacement (THR) is the most popular surgery been performed in orthopedic surgery due to the inclination of musculoskeletal disorder and the aging population worldwide. However, the implant’s cost-burdened the patient, especially in the ASEAN region. The main objective of this study was to fabricate the low-cost hip implant using direct laser metal sintering (DMLS). The framework starts with the three dimensional of hip anthropometric datasets from computed tomography scanner, followed with the design of hip implant, computational analysis using finite element, and finally fabrication using DMLS technique. The morphological results demonstrated the value of neck-shaft angle was 130.46º, and the femoral head offset of 30.35 mm. The finite element analysis showed strain distribution was 65 MPa for the implant in metaphyseal region and 110 MPa for intact femur under staircase physiological loading which indicated inhibition of stress shielding at medical calcar region, and micromotion was 4.8 µm which prevent the formation of fibrous tissue and promoting osseointegration between implant-bone interfaces. This study proposed the fabrication using the DMLS technique, which produced accurate implant with low-cost, which suits the ASEAN hip morphology that prolongs implant lifetime

References

1. R. J. Ferguson, A. J. R. Palmer, A. Taylor, M. L. Porters, H. Malchau, and S. Glyn-Jones. Hip Replacement, Lancet, 2018; 392: 1662–71.

2. S. M. Kurtz, K. L. Ong, E. Lau, and K. J. Bozic. Impact of the economic downturn on total joint replacement demand in the United States. J Bone Joint Surg Am, 2014; 96: 624–30

3. P. C. Noble, J. W. Alexander, L. J. Lindahl, D. T. Yew, W. M. Granberry, and H. S. Tullos. The anatomical basis of femoral component design. Clin Orthop Relat Res, 1988; 235:148–165.

4. O. Husmann, P. J. Rubin, P. F. Leyvraz, B. Roguin, and J. N. Argenson. Three-dimensional morphology of the proximal femur. J Arthroplasty. 1997; 12:444–450

5. M. Y. Baharuddin, A.H. Zulkifly, M. H. Lee, M. R. A. Kadir, A. Saat, A. A. Aziz. Three dimensional morphometry of the femur to design the total hip arthroplasty for Malay population. Adv Sci Lett. 2013; 19:2982–2987

6. M. Y. Baharuddin, M. R. A. Kadir, A. H. Zulkifly, A. Saat, A. A. Aziz, M. H. Lee. Morphology study of the proximal femur in Malay population. Int J Morphol. 2011; 29:1321–1325.

7. M. Y. Baharuddin et al. Design process of cementless femoral stem using a nonlinear three dimensional finite element analysis. BMC Musculoskeletal Disorders. 2014; 15:30.

8. F. Mangano, L. Chambrone, R. van Noort, C. Miller, P. Hatton, and C. Mangano. Direct Metal Laser Sintering Titanium Dental Implants: A Review of the Current Literature. International Journal of Biomaterials. 2014; 461534:11.

9. C. Mangano, M. Raspanti, T. Traini, A. Piattelli, and R. Sammons, Stereo imaging and cytocompatibility of a model dental implant surface formed by direct laser fabrication. Journal of Biomedical Materials Research Part A. 2009; 88:823–831.

10. M. Y. Baharuddin et al. Fabrication of low-cost, cementless femoral stem 316L stainless steel using investment casting technique. Artificial Organs. 2014; 38:603-608.

11. J. Nurhaslina et al. Physical and mechanical properties of injection molded Co-Cr-Mo alloy powder for orthopedic applications. Advanced Materials Research. 2016; 1133:80-84.

12. M. Cerea and G. A. Dolcini. Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants: A Retrospective Clinical Study on 70 Patients. BioMed Research International. 2018; 5420391:11.

13. D. S. Ruppert, O. L. A. Harryson, D. J. Marcellin-Little, S. Abumoussa, L. E. Dahners, and P. S. Weinhold. Osseointegration of Coarse and Fine Textured Implants Manufactured by Electron Beam Melting and Direct Metal Laser Sintering. 3D Print Addit Manuf. 2017; 4:91-97.