Studies of Modular Connections for Surgical Implant Devices

摘要

In vivo damage to modular connections for medical and dental multipart construct implant devices, such as hip and tooth root replacements, that transfer forces from host function to bone, has been shown to be complex and multifactorial. Many investigators have recommended that if we are to better understand the most critical factors that influence in vivo modular connection damage, studies should include interrelated data from the patient health and function, the details of surgery and rehabilitation, and the biomaterial and biomechanical properties of the device. Once again, focusing on the device construct design, biomaterial bulk and surface properties, and the established mechanisms of general, pitting, crevice, fretting, fatigue, stress, intergranular, and galvanic corrosion, evaluations have shown that a multifactorial series of considerations exist. These various properties and mechanisms may or may not influence modular interface region damage, and these also should be considered. The intent of this summary is to review and provide relative information based on past (1970-1990s) and more recent (2000-2014) experiences with a focus on the mental-on-metal, ceramic-on-ceramic, and metal- or ceramic-on-polymer assemblies, including articulations for orthopaedic and dental implant systems. This paper also focuses on modifications and new consensus standards that may be needed for future (after 2015) device evaluations related to treatments that include device modularity.