Cambridge University Pressassets.cambridge.org/97805217/62212/index/9780521762212_index… · Cambridge University Press 978-0-521-76221-2 — Mechanics of Biomaterials Lisa A. Pruitt

Cambridge University Press978-0-521-76221-2 — Mechanics of BiomaterialsLisa A. Pruitt , Ayyana M. Chakravartula IndexMore Information

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Index

(110) plane, schematic illustration, 36(111) plane, schematic illustration, 35<1 1 1> family of directions, 3518 carat gold implant, 5152-D stress state, 259316L stainless steel alloy, 613D CT scans, 5373-D problem, simplifying, 261510(k), see also Pre-Market Notification (510(k))

AAOS (American Academy of OrthopaedicSurgeons), 620

AbioCor Replacement Heart, 495abrasive wear, 382–3abrasive wear particles, 383abutment(s), 513, 620

designs, 525geometries, 526head, 525of same materials as the implant body, 525screw, 525, 527teeth, 512

acetabular cup, 620delamination of highly crosslinked UHMWPE,

462–3femoral head penetration into, 237highly resistant to wear, 424socked portion of the joint, 424total hip replacement utilizing an UHMWPE, 117

as polymer of choice for, 432acetabulum, 620ACL, see anterior cruciate ligament (ACL)AcroFlex design, 455AcroFlex lumbar disk

replacements, 455, 469–70acrylic bone cement (PMMA), 431, 433AcrySof IOL, 583activation volume, 110, 620active materials, 71addition reaction, 106, 620adhesion, 375adhesive wear, 381–2adulterated, 620adventitia, 155, 481, 620age hardening, 48, 620aged dentin, 139aggregated proteoglycans, loss of, 532Albee, Fred, 453

Alcmaeon of Crotona, 129all-ceramic implant bodies, 523Allergan, Inc., 586Alloderm dermal implant, 577allografts, 572, 577alloplastic, 620alloplastic interpositional materials, 533alloplastic material, for dental implants, 505alloys, 17, 620, see also specific alloys, see also

medical alloysalloys

altering structure and properties of, 42imperfections in, 38–42

AlphaCor implant, 582alumina, 80, 86alveolar bone, 528alveolar crest, 508alveolar processes, 508American Academy of Orthopaedic Surgeons

(AAOS), 620American Burn Association, 575American National Standards Institute (ANSI), 409American Society for Testing and Materials, see also

ASTM InternationalAmerican Society for Testing Methods (ASTM),

standard for surgical grade stainless steel,417

Amonton’s Law, 375amorphous ceramics, forming, 83

amorphous polymers, 98, 620lacking order, 98randomly ordered or entangled chains, 103Tg characterization plot, 103uses of, 106

amorphous silicate glasses, 71amplitude loading, 341, 350anabolic, 620anabolic functional loads, 527anatomical study, 129ANCURE Endograft System, 497–8aneurysms, 489, 620angina, 489angioplasty, 620angioplasty catheter, 11anion coordination number, 72anions, 72, 620anisotropic, 620anisotropic behavior, of an arterial graft, 11

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646 Index

anisotropic composite systems, 19anisotropic material, Hooke’s Law for, 184ankylosing spondilosis, 458, 620ankylosis, 532, 533, 620annealing, 46, 48, 621annulus, 621

composed of concentric sheets of collagen, 457of each disk, 457preserving, 454

annulus fibrosus, 457anode, 55anodic materials, 55Anonymous Seven from Guidantanterior cruciate ligament (ACL), 572

1–2 million cycles per year, 573designs, synthetic, 572–3implants, comparing failure load and stiffness,

574patellar tendon as donor site, 571permanent augmentation devices, 572permanent replacements, 572reconstructive surgeries, 570

anti-coagulant medications, 487AO/ASIF implant, 535aorta, 481aneurysm in, 489

tensile strength, 156aortic arch, 156aortic valve, 479apatite form, of calcium phosphate, 86apex, 514, 621apical foreman, 508Apligraf, composite implant, 578apparent modulus, 224appendicular, 621applied crack driving force, 319applied mechanics, 130applied stresses, 36, 183arbitrary plane, intersecting the y and z axes, 34area moment of inertia, 196, 621Arrenhius equation, 110Arrhenius empirical model, 627arterial lumen, reduction of, 477arterial tissue, cross-section of, 481arterial wall, multi-layered structure of, 155arteries, 481, 621arthoplasty, early, 416arthrodesis, 454, 459, 621arthroplasty, 621arthroscope, 533, 621arthroscopy, 533artia, 480articular cartilage, 151–4, 621

collagen fiber network of, 153composition of, 152, 214, 422limited capacity for self-repair, 151microstructure and ultrastructure of, 152non-equilibrium properties, 154providing lubrication and smooth articulation,

435surgical repair difficult, 152

time-dependent strain under deformation, 215viscoelastic behavior of, 214

articular disks, 533, 534articular eminence, 509articular surfaces, of the TMJ, 538articulation, 276, 621artificial intervertebral disk, 180artificial skin, 575–6, see also skinartificial skin

as a more modern construct, 561current designs for, 576–8functional requirements of, 578uses for, 575

asperities, 371, 621astigmatism, 583, 621ASTM D638

Standard Test Method for Tensile Properties ofPlastics, 409

ASTM F562 alloy, 62ASTM F75, cast form of cobalt-chromium, 62ASTM F799 alloy, improved mechanical properties,

62ASTM F90 alloy, utilizing addition of tungsten and

nickel, 62ASTM G115–04

Standard Guide for Measuring and ReportingFriction Coefficients, 389

ASTM International, 61, 408, 621ASTM specifications, for wrought Co–Cr alloys

used in medical implants, 62ASTM Standards E466–E468 (American Society for

Testing and Materials), 335atherosclerosis, 477, 483, 621atlas vertebra, 456atomic force microscopy (AFM), 134, 387, 388atomically bonded solid, 285atoms, extra half plane of, 39atria, 479, 621austenite, 49, 621austenitic stainless steel, 61Australia, Therapeutic Goods Association (TGA),

411autoclave, 621autoclaving, 8autogenous, 621autogenous bone grafts, 89autografts, 487, 572, 577auto-immune disease, caused by breast implants,

587autologous, 621autologous tibial grafts, 453autologous transplants, for vascular grafts, 478average roughness, 371axial load

stress due to, 204stressing a part cross-section, 346

axis vertebra, 456

Braun Melsungen AG, 589bacteria, housed in the human mouth, 510bacterial contamination, elimination of, 8


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647 Index

ball and socket articulation mechanism, of the hip,425

balloon angioplasty catheter, properties of, 11balloon angioplasty, compressing plaque, 483

balloon catheter, 483, 621polymers in, 94stent shipped over outside of, 483used in percutaneous transluminal angioplasty,

493balloon-expanded stent delivery, 483, 484Barenblatt, 305, 307basement membrane, Type IV

collagen in, 133Basquin equation, 337, 338, 340Basquin exponent, 337BCC, see also body-centred cubic (BCC)beam equation, development of, 193–7beam theory, 169basics of, 193–7

derivation for, 194model for certain loading situations in vivo, 205solving stresses, 267

beam, under bending moment, 194bearing pair, for the hip, 426behavior regimes, for viscoelastic material, 210bending load, stress due to, 204bending modulus, for hydrated elastic fibers, 134bending moment, 193, 194Bernoulli, Daniel, 194biaxial stress states, 256bicuspid, 621bicuspid pre-molars, 507bileaflet heart valve

design, 78, 79inherent stress concentrations, 78

bileaflet valves, 487bioactive, 621bioactive ceramics, 71, 85

in the form of coatings, 86relying on porosity, 84use of, 433

bioactive glass, 86, 425, 622bioactive polymers, 113Biobrane, 577Bioceram, recent withdrawal of, 524biocompatibility, 7–8, 622

analysis of, 7assessment of, 7definition of, 7necessity for, 60of any implantable device, 4of ceramics, 85of cobalt-chromium-molybdenum alloys, 506of polymers, 113studies, 417

biocompatible, 622biocompatible materials, limited number of, 7biodegradable, 622biodegradable ceramics

composed of calcium phosphate, 86used as bone substitutes, 86

biodegradable materials, 71bioglass, 71, 87Biolimus, 485biological attack, long-term resistance to, 7biological inflammatory response, 65biological materials, prone to immunorejection or

normal resorption processes, 15biological system, interactions with mechanically

damaged synthetic biomaterial, 8biological tissues, 13biological valves, reducing risk of clotting, 487biomaterials

as hard or soft, 13classifying, 13–16complicated mechanical behaviors of, 208exhibiting viscous or fluid-like characteristics,

318experiencing forces or loads, 167overview of, 4restoration of function of a living being, 13specimen configuration requirements for,

303surface contact in, 386–7testing for friction and wear properties, 370

biomaterials science, 4BioMatrix stents, 485biomechanics, 130bioprosthetics, 486bioreactivity, 622

customizable, 72illustrating spectrum of, 85polymers range of, 94, 113schematic illustration showing, 85tailoring from inert to fully resorbable, 85

bioresorbability, of certain polymers, 19bioresorbable, see also biodegradablebioresorbable ceramics 85bioresorbable polymer sutures, 124bioresorbable polymers, uses of, 94, 113bioresorbable suture anchor, 92biotribology, study of, 387bisphosphonates, 530, 622bi-unicondylar knee implants, 437Bjork-Shiley Convexo-Concave Heart Valve, 400,

496–7blade-form endosteal implants, 513, 518–19blockage, 486blood cells

emerging from a blood vessel, 482types of, 481

blood circulation, working model of, 130blood vessels, 481

dimensions and pressures in, 482replacements of small, 156trilaminate structure of, 155

blood-contacting implants, 478blunting region, of the JR curve, 316body-centred cubic (BCC), 622body-centred cubic (BCC) crystal structure,

32body-centred cubic (BCC) crystals, 40


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648 Index

body-centred cubic (BCC) latticebody-centred atom in, 35close-packed direction in, 35layering of closest packed planes to create, 32tetrahedral site larger than octahedral site, 33

body-centred cubic (BCC) structure, 32body-centred cubic (BCC) systems, secondary slip

systems, 40bond energy U(r), general form of, 11, 12bond, stiffness of, 11bonding and crystal structure, of metals and alloys,

28–32bonding mechanisms, 16bone absorption, 203–5bone architecture, remodeling of, 88bone cement, 383, 425bone drilling, 522bone grafts, 622

from bone banks, 88need for, 87obtaining, 70physiology of successful, 88stabilizing adjacent vertebrae, 454

bone healing, 448bone marrow, damage to, 447bone periosteum, tearing of, 447bone resorption, 168, 520bone substitutes, 70, 87–9bone tissue, 140, 144bone(s)

arresting cracks, 323building up bone density under higher loading,

167compliance match to adjacent, 11mineral responsible for stiffening, 135nanoscale ceramic reinforcement, 286resorbing, 527taking from elsewhere in the body, 87types of, 140with fracture and intramedullary rod, 177

bony ingrowth, at the bone-implant interface,520

bore, of the femoral head, 429Boston Keratoprosthesis, 581, 582Boston K-Proboundary lubrication, 379boundary work, 310bovine serum, 389Bowman’s layer, 579, 622Branemark, Per Ingvar, 522Bravais space lattices, 28, 29, 622breast augmentations and reconstructions, 584breast implants

auto-immune disease caused by, 587classified as Class III devices in 1988, 586current designs and functional requirements,

585–6design evolution of, 585development of, 561evolution of, 585legislative history of, 586

post-implantation concerns, 586regulatory failure, 587–8second-generation, 585third-generation, 586

breasts, injecting substances into, 561brittle, 622brittle materials crack tip in, 356

fracture associated with, 284fracturing before yield, 241, 269highly sensitive to tensile stress, 265reducing size to improve strength, 286relying on damage mechanisms, 322stress singularity at the crack tip, 307

brittle solids, failing, 270brittle systems, as weak in tension, 244bruxism, 529, 622building blocks, of tissue, 131–6bulk deformation processes, 51, 52bulk erosion, 124bulk properties, 371bulky side groups, 99bundled fibers, 561Bureau of Chemistry, 399Burger’s vector, 39, 40, 622burn victim mortality, 575burns, 575, 576butterfly fracture, 622buttock implants, 584

cadaver autografts, not providing number of neededvalve replacements, 487

cadaveric allografts, 572, 577calcium carbonate, 86calcium phosphate, 71Canada, Therapeutic Products Directorate (TPD),

411canaliculi, 141, 622cancellous bone, see trabecular bonecancellous screws, 450canine aorta, mechanical properties of, 156cannulated, 622cannulated screws

for femoral neck repair, 451, 452sizes, 450

capsular contracture, 586carbon fiber

abrading bone in the knee, 587ligament failure, 587

carbon fiber-reinforced UHMWPE (Poly II), 444carbonate content, of bone, 135carbonated hydroxyapatite, 86cardiopulmonary bypass machines, 495cardiovascular anatomy, 479–83cardiovascular applications, of e-PTFE, 94cardiovascular biomaterials, 13cardiovascular devices, on the horizon, 500cardiovascular disease, 477, 478, 622cardiovascular implants, 478cardiovascular system, 477, 480, 622cartilage, 622

ability to regenerate in vivo, 15


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649 Index

layer of partially calcified, 153normal compared to osteoarthritic, 154optimized for compressive loading, 151surrounding a synovial joint, 422

cartilage-on-cartilage contact, 386casting, 51, 52, 622cataracts, 583, 622catgut, 124, 560catgut sutures, 565catheters, 493, 623cathode, 55cations, 72, 623Cauchy stress (true stress), 245cavitating ductile material, fracture surface, 271cavities, 510CEA (cultured epidermal autograft), 577, 625cells, in human blood, 481cement line, 623cemented hip arthroplasties, 433cementum, thin layer, 508Center for Devices and Radiological Health

(CDRH), 397, 403, 404–8Centerpulse Orthopedics, 467ceramic abutments, 525ceramic coating, surface modifications with, 523ceramic heart valve, critical crack length in, 78–9ceramic materials, 72, 623ceramic systems, 330ceramic total hip replacement femoral heads, 284ceramics

as implant materials, 70, 71bonding and crystal structure, 71–5characteristics of, 241classifying, 85complex crystal structures of, 72drawback of using, 85failure mechanisms in, 272fatigue behavior of, 359forms of, 71fracture mechanisms in, 322high elastic modulus values, 16in a variety of applications, 70in medical implants, 85–7in structural applications, 70ionic bonding, 72low fracture toughness of, 322mechanical behavior of, 75–82processing of, 82–4properties of, 18resistance to fatigue crack growth, 330sensitive to tensile normal stresses, 77stronger in compression than in tension, 273structure and mechanical behavior of, 75susceptibility to fracture, 71toughening mechanisms, 79, 80wear resistance, 433

Ceravital, 71, 87cervical spine, 454, 456, 623chain branching, in polymers, 98chain length, impeding long-range ordering, 99chain scission, 9

chain structure, one-dimensional, 97chains, entanglement of, 107characteristic test frequency, inverse of, 227Charite implant, design evolution of, 461Charite intervertebral disk, 460Charnley hip, innovative low-friction, 431Charnley, Sir John, 390, 417chemical bonds, 16Chercheve, Raphael, 522chewing, mechanical demands of, 136chondrocytes, 151, 623chordae tendineae, 481Christensen TMJ device, slightly modified, 537chromium carbide, precipitation of, 57chromium precipitates, 48chromium-depleted zones, 58ciliary muscles, 580Class I devices, 9, 403, 405, 623Class I implantsClass I recall, of all Proplast-Teflon Vitek TMJ total

joint prosthesis, 544Class II devices, 10, 403, 623Class II implantsClass III devices, 10, 403, 623Class III implantsclassifying, biomaterials, 13–16cleaning protocols, 7Cleaver, Mouse, 561clenching, 530clinical application, of biomaterials, 13clinical concerns, in design of soft tissue

replacements, 562clinical issues, as paramount, 4clinical performance, 10clinical trials, 10close-packed planes, 30, 31, 34, 75close-packed spheres, planar section of, 30close-packed structures, 30clot formation, reducing blood loss, 483cobalt-chrome alloys, replaced stainless steel,

443cobalt-chromium (Co-Cr) alloys

blade implants, 518cast form limitations, 62elastic modulus, 61, 63femoral head exhibiting surface damage, 463high strength and fatigue resistance, 62in hip implants, 432in the fracture fixation industry, 453intergranular attack of, 66providing enhanced corrosion resistance, 27uses of, 61

CoCr total TMJ replacement, Kummoona designed,535

COD, see crack opening displacement (COD)coefficient K, specifying relative strength of the

stress singularity, 288coefficient of friction, 373, 623

defined, 375for common materials pairs, 375low for UHMWPE, 117


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650 Index

Coffin-Manson equation, 344coherent flaw, 334, 623cohesive stress, 307cohesive zone, length of, 319cold forged stainless steels, 62cold rolling, 47, 623cold working, 40, 46, 640cold-rolled brass, 46collagen

abundance of, 131known types of, 132variants of, 133

collagen fibers appearing in a variety ofconformations, 132

composition of, 133crimped form of, 151

in articular cartilage, 153in dentin, 139schematic of, 132structural hierarchy inside, 140

collagen fibrils, 133collagen molecules, 133, 140, 141collagen sub-fiber, hole zones in, 141collagenous osteoid, organization of, 141comminuted fracture, 448, 623compact bone, see cortical bonecompact tension geometry, 290, 349compact tension specimen, illustration of, 349complex modulus, 228, 230, 623compliance, 11, 623compliance match to bone, 450compliance matrix, 205compliant, 623compliant materials, stretching at a crack tip, 323complications, arising from corrosion, wear, fatigue

or fracture, 8composite beam

bending of, 199finding the neutral axis of, 197–9for a custom implant, 199

composite materials, 169, 623composite systems, 19composite(s)

characteristics of, 241composed of unidirectional fibers, 200undergoing longitudinal transverse loading, 200with matrices of polymers, metals, or ceramics,

19compression fracture, 448, 623compression loading, flaws closing, 77compression, described by negative values for strain,

171compressive portion, of variable amplitude loading,

276compressive strength, 623

of ceramics, 18, 75of enamel, 138of human dentin, 139

compressive stresses, 80, 264compressive yield strength, 264condensation reaction, 106, 623

condylar, 623condylar prosthesis, 534condylar type tibial component, 276condyles, 10, 623conforming, 623conforming ball-and-socket joint, 421congenital, 623congenital defect, 486congenital heart defects, blocking, 495congestive heart failure, 477, 623constant bending moment, 335constant stress (creep) response, 217constitutive behavior, 181–2constrained dislocation loop, around particles, 48contact fatigue, 384contact lenses

as common intervention, 581composition of, 581designs and functional requirements, 580–1tearing during ordinary use, 284

contact loading, between tibial insert and femoralcomponent, 278

contact shielding, 320, 355contact stresses, 66, 277, 623contracture, 586, 624contraindications

for implants, 530for maxillary and mandibular implants, 530for temporomandibular joint (TMJ) replacements,

538cooling, very rapid, 49coordinate axes, changing, 173coordinate rotation, 260coordinate transformation, applying, 175coordination number, 30, 624

for octahedral site, 33for tetrahedral site, 33

co-polymerization, with PLA, 125co-polymers, 95coral, 71, 624

as a bone substitute, 70, 87–9as bioresorabable ceramic, 86attributes for bone grafting, 88porosity of, 86structure of, 88, 89

coral-derived bone substitutewidespread clinical success, 89

coral polyps, hard mineral deposit built up by, 88coral secant modulus, 188, 639cornea

curvature of, 578layers of, 578, 579ultimate tensile strength, 582

corneal edema, one month after IOL implantation,588

corneal replacements, 581–3coronal plane, 624coronary artery bypass graft (CABG), 489, 624coronary heart disease, 477, 624coronary stent designs, 485corrodibility, scale of, 55


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651 Index

corrosion, 624at the mechanical junction, 429in metals, 18, 26in modular orthopedic implants, 64–7pathways in metallic systems, 55

corrosion debris, 53, see also wear debriscorrosion processes, 53–60

at the taper connection, 66occurring in a modular total hip replacement, 66resulting from reacting with an aqueous

environment, 54corrosion resistance designing for, 54

of alloys, 27of cobalt-chromium alloys, 62of metals, 60stainless steel known for, 62

corrosion-induced degradation, 417corrosion-resistant materials (cathodic), 55corrosive attack, in crevices, 65corrosive wear, 383cortical bone, 140–3, 624

as an example of a hierarchical material, 323composition of, 140coral as a substitute for, 89deformation behavior, 142finding strains in, 186majority of body’s calcium in, 144organization into osteons, 142stress-strain curve for, 192tension and compression response of, 143

cortical screws, 450cosmetic breast implants, see breast implantscosmetic implants, 584–6cosmetic surgeries, numbers of invasive, 584costs, dictating manufacturing method for an

implant, 53covalent bonding, 71, 95, 624covalent-ionic ceramic structures, 13covalently bonded materials, 13crack advance correlated to peak value of stress

intensity, 356in polymers, 361mechanisms, illustration of, 356, 357rate of, 348

crack bridging, 81, 320, 624crack deflection, 320, 355crack driving force coming from stored energy from,

295overcoming, 294work in the system providing, 320

crack equilibrium, 294crack growth

ahead of the notch, 268as stable or unstable, 298

correlation to stress intensity factor, 356energy dissipated by, 295in a material, 320initiation of, 316presence of a notch or small crack, 272primary regimes of, 351rate, 351

resistance and, 294–6resistance curves, 295, 316–17under application of tensile stress, 291

crack initiation criteria, 316designing against, 317failure criterion, 317in Regime II, 316time, 319, 624

crack loading, Modes I, II, and III, 292crack nucleation

from a sharp notch, 268in the component, 266

crack opening displacement (COD), 304–5, 624crack propagation

in ceramics, 359in most metals, 357intrinsic resistance to, 348value for the onset of, 59

crack shielding mechanisms, 355crack surface, 294crack tip

brittle materials accommodating stress singularityat, 307

compliant materials stretching extensively at, 323compressive stresses retarding growth of the

flaw at, 80effective, 301, 304elastic-plastic singularity, 311–14in a ductile metal, 356in brittle materials (ceramics), 356inelasticity, 305physical as blunted, 304plasticity, 304–5stress becoming singular near, 289stresses, 77, 311studying extreme stresses at, 284viscous dissipation at, 318

crack velocity, 22, 60crack wake

in a ductile metal, 356inelastic region around, 320mechanisms, 357

crack wedging, 320crack(s)

as extreme stress concentrators, 287–8behavior under moderate and severe crack tip

plasticity, 307distance from, 288forming during loading, 283nucleated, 269subjected to tensile stress in a ceramic, 77under complicated global stress states, 291under complicated load conditions, 296

cracked plate, thickness approaching plastic zonesize, 301

crack-opening mode, 291craniofacial, 624craniofacial features, 506craniomaxillofacial, 624craze, 624crazing, 274, 275, 276


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652 Index

creep, 19, 208, 210, 624creep (time-dependent) strain response for the

Kelvin model, 220of the Maxwell model, 218

creep and cycle strain softening behavior, ofUHWMPE, 225

creep behavior, over a range of applied stresses, 237creep compliance of the SLS, 223

over time for UHMWPE, 225creep response

of the SLS, 222vital to assessment of performance, 212

creep strain, for the Kelvin Model, 220, 221creep time constant, for the SLS, 223crest, 624crest module, 514, 524, 624crestal bone

loss as marginal, 527supra-physiologic loading of, 527v-shaped resportion around root-form implants,

527crevice corrosion, 58, 624

in metal components, 26minimizing, 26schematic illustrating, 58stainless steel susceptible to, 62

crimp, in collagen fibers, 149, 151crimped collagen bundles, 193critical crack length, 60

as an inspection parameter, 78form of, 78

resulting in fracture, 297solving for, 353

critical crack opening displacement, 304critical flaw size, 624defining relative fracture toughness, 297determining, 298for pyrolytic carbon, 79for toughened zirconia ceramic, 79in component loaded in shear, 293ratio of, 298using fracture toughness to determine, 77

critical flaw, initiation or propagation of,333

critical normal stresses, 258critical strain, for low cycle fatigue in a tibial

plateau, 345–6crosslinked system, lightly compared to fully, 112crosslinked UHMWPE, sacrificed resistance to

fatigue crack propagation, 463crosslinking, 9, 624

at the expense of fatigue and fracture resistance,428

effect on glass transition temperature of apolymer,104

in the collagen network affected by environment,213

of collagen increasing with age, 133resistance as a function of, 428

crosslinks

compared to entanglements, 108resulting in permanent covalent bonds, 107

cross-shear articulation, 427crown, 136, 507crown, natural, 624crown, synthetic, 624cruciate ligaments, retaining in the unicondylar

procedure, 438crystal atoms, loading of, 76crystal lattices

distortion to, 33orienting in a coordinate system, 34

crystal planes, displacement of atoms across, 36,37

crystal structures in structural ceramics, 72, 73of metals, 27

crystal systems, 622classification of, 28, 29general, 28

crystal(s)different kinds of constituents in, 74in enamel, 136

Crystalline Bone Screw (CBS), 523crystalline ceramics, 72, 330crystalline domains, polymers forming, 98crystalline lamellae, 98, 101crystalline materials, metals and alloys as, 28crystalline solids, 28crystalline structure, 625crystallinity, 625

facilitating through chain folding, 99of polymers, 98, 102

crystallite development, in polymer systems, 101crystallographic planes and directions, 34–5cubic structures, more available slip systems, 45cubic system, close packed plane, 34cultured epidermal autograft (CEA), 577, 625curved resorbable collagen scaffold, 411curves, see specific curvescurves

indicating roughness and wavinessresulting from friction tests

cycles to failure, for a spinal implant, 338–40cyclic fatigue exponent, 357cyclic loading

effects on fatigue or fracture, 261of polymers, 360

cyclic plastic strain amplitude, 345cyclic plastic strains, 335cyclic softening, in UHMWPE, 225cyclic strain

data representing, 343hardening, 625softening, 625

cyclic stressesresulting from kinematics of the joint, 277with tensile stresses, 426

cyclic stress-strain loops, evolution of, 334cyclic yield stress, 333cylindrical designs, more easily implanted, 524cylindrical osteons, composition of, 141


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653 Index

da Vinci, Leonardo, 130Dacron, 478, 625

fibers, 121grafts, 490

Dahl, Gustav, 515Dalkon Shield, 400damage mechanisms, 274, 275damage processes, utilized in ceramics, 274damper, 217, 230dashpot, see damperDe humani corporis fabrica, 129Deborah number, 211debridement, 533, 625debris, see also wear debris, see also particulate

debris, see also corrosion debrisdeciduous, 625deciduous teeth, 507deep zone, collagen fibers in, 153defect tolerant, 625defect-tolerant approach, to fatigue failure, 333defect-tolerant method, 297defect-tolerant philosophy, 348–62defects, presence of, 75deformable materials, 171deformation plasticity, 308, 625deformation(s), 45, 375

altering orientation of grains, 45categories, 167enhancing resistance to crack advance, 320important in implant design, 167in response to loading, 169localized and extreme nature of near a sharp flaw,

286micromechanism of, 333

degradable polymers, 94degradation rate, of biodegradable ceramics, 86deionized (DI) water, 389delamination, 625

in total knee replacements, 22, 279on articulating surfaces of knee joint, 277prevalent region of, 463wear, 386with clinical dislocation, 464

Delrin, disk made of, 486dense bone, implantation in more successful, 526densification, 147density, relationship with crystallinity, 102dental applications, from investment casting, 52dental biomaterials, 13dental caries, 625

as a leading cause of tooth loss, 510described, 510

dental enamel, see enameldental implants, 505, 510–30

anchoring via osseointegration, 520clinical reasons for, 510–12cylindrical in shape, 82described, 505examples of different types of, 513filling cavities in tooth enamel, 81functional requirements, 530

future improvements, 544–5historical development of, 515immediate and early loading of, 545innovation in, 515integrating into underlying bone, 70replacement materials used against enamel, 383thermal stresses or strains, 81, 82types of, 513–15

dental plaque, 510dental prosthesis, 511dentin, 136–9, 625

as more compliant than enamel, 139decay of, 510middle layer of, 507providing protective cover for pulp, 507secondary, 508structure of, 136

dentinal tubules, 138illustration of, 139

dentino-enamel junction, 138dentition, 511, 625denture base, 511dentures, 512deoxyribonucleic acid (DNA), 625depressed fracture, 448, 625Dermagraft, 577, 578dermal acellular implants, 577, 625dermal cellular implants, using neonatal fibroblast

cells, 577dermatome, 577, 625dermis, 155, 625Descemet’s membrane, 580, 625design factors, for friction and wear, 389deviatoric, 625deviatoric component 173deviatoric portion of the normal and shear stresses,

250of the stress, 245

deviatoric stress tensor, 175device classifications, 403–4diabetic foot ulcers, 575, 577diagnostics biomaterials, 13dialing hook, in cataract surgery, 588diamond cubic lattice, utilizing FCC lattice, 72diamond-like carbon (DLC) coatings, 84diaphyseal, 625diaphyseal (cortical) bone, 450diaphysis, 140, 625die casting, with steel molds, 52diethylene glycol, 399differential scanning calorimetry (DSC), 102, 625dilatational, 625

component 173stress tensor, 174stresses, 249

dilational portion, of stress, 249directions, within the lattice structure, 34disk arthrosis, spinal fusion used to treat, 454disk replacement technology, 460dislocation, 40, 47, 626dislocation force fields, causes of, 42


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654 Index

dislocation initiation rates, in polymers, 111dislocation line, 39dislocation movement (slip), 243dislocation pile-ups, 42dislocation slip, 251dislocation theory, full treatment of, 39dislocations

in ceramic structures, 75in shear processes in metals, 40types of, 39

disorders, necessitating TMJ replacement, 532displacement vector, 39dissipated energy, from a single load cycle, 229distal, 626distortional energy, 243, 249, 250, 626distortional energy criterion, 253distortional or deviatoric stressesdistortional portion, of stress, 249distortional strain energy, 250D-lactide form, of PLA, 123DNA disablement, 8Dohlman Doane Deratoprosthesis, 581double modular hip prosthesis, corrosion-induced

fracture of, 463–7Dow Corning, lawsuits filed against, 587drawing, 51drawn glass fibers, experimental testing of, 286driving force, 294, 320, 626drug efficacy, demonstrating, 400drug-eluting stents, reducing restenosis, 483ductile materials

behavior, 626deforming through shear, 243facilitating dissipation of near-tip crack stresses,

322undergoing fatigue experience cyclic damage,

356yielding before fracture, 241, 269

ductile metals, 250, 357ductile processes, of polymersductile systems, generally utilizing shear

deformation, 270ductility

in metals, 35loss of, 46

Dugdale, 305, 306Dugdale plastic zone, 306duocondylar knee, 439dynamic compression plate, 451, 452dynamic loading, during downhill skiing, 208dynamic mechanical analysis (DMA), 227, 626

finding upper and lower limit of, 200–3line slope, 187material constant, 181measured value for, 181range for estimates in uniaxial fiber composites,

202range of values for, 181

edema, 626edentulism (tooth loss), 505, 511, 626

edentulous, 626edentulous individuals, biting forces of, 511edge dislocations, 39, 271, 626

forces between, 41parallel repelling each other, 40visualized as an extra half plane of atoms, 39

edges, common to two anion polyhedra, 73effective crack tip, 301effective creep compliance, of the SLS, 223effective stress, 626

calculating, 241determining, 260independent of coordinate frame, 260using 2-D analysis, 260

effective stress range, 338effective von Mises stress, 345

for a compressive loading state, 264for a loading state, 259

Egyptians, placing hand-shaped prosthesis intodeceased, 515

eigenvalues, 179, 180–1eigenvectors, 179, 180–1elastic behavior, 109, 245elastic collagenous tissues, elastin found in,

133elastic component, of the strain amplitude, 344elastic deformation, 16, 109, 167elastic energy, material’s ability to store, 243elastic fibers

elastin and fibrillin-based microfibrils, 133mechanical properties of, 134recoil in, 134schematic of, 134

elastic J, dominating in LEFM, 314elastic modulus, 15, 181

alternative methods for calculating, 188described, 16estimating, 11finding from a stress-strain curve, 189following rule of mixtures, 202for ligaments, 150for skin and blood vessels, 156for stainless steel, 61for viscoelastic material, 211formula for, 13in a fiber-reinforced composite, 202lower reducing complication of stress shielding,

63materials with high, 16materials with lower, 16of articular cartilage, 154of C-Cr alloys, 63of dentin, 139of enamel, 136of human enamel, 138of human trabecular bone, 148of hydrated collagen fibers, 133of materials, 11, 81, 187of tendons, 149of the Maxwell model, 219physical foundation for, 11


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655 Index

range associated with each material class, 13uses of, 205values, comparison of, 17

elastic modulus (E), 626elastic strain, 13, 109elastic strain energy, storing, 109elastic stress, 287elastic-plastic behavior, 308elastic-plastic crack tip singularity, 311–14elastic-plastic fracture handbook, 314elastic-plastic fracture mechanics (EPFM), 303–5,

626admitting inelastic behavior, 308deformation plasticity, 308fracture instability in, 316fracture toughness measure, 316J for many engineering problems of interest, 316summary of, 318true conditions, 314valid for moderate yielding, 312

elastic-plastic generalization, of crack drivingforce, 303

elastin, 133–4described, 131in arterial wall, 156in ligament, 148, 151in tendon, 151responsible for stiffness of soft tissues, 134

elastohydrodynamic lubrication, 377elastomeric material, under mixed mode conditions,

470elastomeric polymer, time temperature superposition

behavior for, 233elastomeric-viscoelastic properties, of silicones,

123Electric Power Research Institute (EPRI), at General

Electric, 314electron beam method, 9electron disruptions, damaging living cells, 8electronegativity, 72, 626electrospinning, 157electrostatic attraction, 28electrostatic valency, 73ellipse, equation for, 253ellipsoidal pores, in bone, 141elongation at break, 187elution time, 107embedded ellipse, in an infinite plate, 266embolus, 483, 626embrittlement, caused by cold working, 46emulsion, 626emulsion methods, used for ceramics, 83enamel, 136–9, 626

acids in the plaque reacting with, 510brittleness of, 138composition of, 136crystals larger than bone, 135elastic modulus of, 136, 138energetic toughness of, 138energy of fracture of, 138most mineralized tissue in the body, 136

outer layer of, 507tensile strength of, 138thermal expansion coefficient for, 82

endocardium, 479, 626endosteal, 626endosteal dental implants, 513, 514, 529endotenon, 149, 626endothelial cells, 155, 157endothelium, 580, 626endovascular stent-graft, alternative conduit for

blood flow, 489endurance limit, 626

at zero mean stress, 340between test specimens and components,

348compared to the cyclic driving force, 340defined, 336error, 347–8factors affecting, 337for a notched bar, 267for an unnotched bar, 267for certain metals, 336for the material, 329of metals, 330

endurance limiting factors, 346energetic description, of crack growth, 295energetic methods, in fracture mechanics, 293–4energetic toughness, 49, 626

of enamel, 138of UHMWPE, 117

energy dissipation, 208energy of fracture for human dentin, 139

of enamel, 138energy release rate, 294, 626

crack as a growth driving force, 294critical value of, 296describing an energetic condition, 296for an unbounded center-cracked plate, 296form of the negative of the derivative of a

potential, 294J as, 309

energy storage component, 229energy, supplying to sustain crack growth to failure,

295engineering attributes, of ceramics used in medical

implants, 72engineering design analysis, for total hip

replacement, 435engineering materials defined, 14

properties remaining unchanged over largedurations of time, 209

selecting for an implant design, 15used in the body, 13utilizing for medical implants, 4

engineering mechanics, in tissues, 130engineering polymers, overlap with hard and soft

tissues, 17engineering strain, 191, 205engineering stress, 191, 205engineering stress-strainengineering stress-strain behavior, 242


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656 Index

engineering stress-strain curve, 191entanglements, compared to crosslinks, 107,

108enzymes, serving as a solubilizing agent to the

polymer, 125EPFM, see elastic-plastic fracture mechanics

(EPFM)epicardium, 479, 626Epicel, 577epidermis, 154, 627epiphysis, 627epitenon, 149epithelium, 579, 580, 627EPRI estimation procedure, 315e-PTFE, see also expanded polytetrafluoroethylene

(e-PTFE)equal biaxial stress, 256equal yet opposite edge dislocations, 40equibiaxial stress state, 256equilibrium atomic separation, 75equilibrium condition, 294equilibrium elastic modulus, for articular cartilage,

153, 154erosion, 124, 627erosive wear, 384ethylene oxide (EtO) gas sterilization, 9ethylene oxide gas, 627Euler, Leonhard, 194European Union (EU), Directorate General for

Health and Consumers, 410eutectoid reaction, microstructure development

through, 49Elixir Sulfanilimide, for sore throats, 399expanded polytetrafluoroethylene (e-PTFE), 113,

490, 627in facial reconstruction implants, 120introduced in the 1970s, 478microporous structure, 120reconstructing ligaments, 94

expendable mold, 52extension, 171, 627extension flexion, of the joint, 277extracellular matrix, 627extrinsic crack-tip shielding effect, 355extrinsic mechanisms, altering effective driving

force, 320extrinsic toughening, 320, 355, 627extrusions, 51, 330, 627eye

anatomy of, 578, 579changes in geometry of, 580

eyeglasses, 581Eyring model, 109, 111, 620, 627

fabrics, for synthetic grafts, 490face-centred cubic (FCC), 30face-centred cubic (FCC) lattice, 627

close packed direction in, 35metals flowing under stress, 40packing density, 30packing density of, 30–2

transformation into a HCP structure, 62yielding, 30

faces, common to two anion polyhedra, 73facet screws, for spinal stabilization, 453facial changes, associated with aging, 511facial implants, locations of common, 584facial reconstruction implants, 120

uses of e-PTFE in, 94factor of safety (FS), 627

against failure, 241against plastic deformation, 255against yielding, 249, 255, 259determining, 264, 339

failure assessment diagrams, two-parameter, 305,317

failure criterion, basic form of, 265failure envelope, 265failure mechanisms

in ceramics, 272in metals, 271–2in polymers, 274–6

failure strength (Sf), 187, 627failure stress, 251, 265, 340failure theories, for ductile materials, 279family of directions, denoting, 351 1 1 family of planes, 34far field, 289fascicles, 149, 151, 627fast fracture criterion, of the implant, 330fast fracture regime, 351Father of Bioengineering, 130fatigue, 331–3, 627fatigue behavior

difference between ductile and brittle solids, 355of an engineering biomaterial, 333of ceramics, 359of metals, 357–9of polymers, 360–2of structural materials, 354–7under cyclic compressive loading, 277

fatigue characterization, of a material, 334fatigue crack(s)

growth rate, 359, 360nucleating under cyclic compression loading, 268propagation, 349–54, 362propagation resistance, 350under cyclic tensile loading in UHMWPE, 277velocity of a moving, 350

fatigue cyclesfor a total hip replacement, 329mean stress of, 338

fatigue damage, mitigating, 330fatigue data, from accelerated and idealized tests,

346fatigue failures

as a consequence of crack nucleation, 333in medical devices, 329occurring well below yield strength of material,

330fatigue fracture resistance, loss in, 21fatigue fractures


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657 Index

in trapezoidal hip stems, 362–4of the abutment connection, 528

fatigue lifebased on propagation of an initial flaw, 348compared, 329of flawed components, 297

fatigue loading, 363fatigue resistance design centred upon stress-based

tests, 335designing for, 333for bearing surfaces in knee arthroplasty, 443in ball-and-socket joint of the hip, 11remaining limited in ceramics, 330

fatigue resistant implant, 329fatigue sensitivity, to notches, 268fatigue strength, 336, 337, 627fatigue stress concentration factor, 267, 268fatigue striations, 358fatigue tests, in fully reversed loading, 341fatigue threshold, 351FCC, see face-centred cubic (FCC)FDA, see Food and Drug Administration (FDA)feathered fusion, 453Fe-C steel, phase diagram for, 50Fe-C system, eutectoid point, 49Federal Food, Drug and Cosmetic Act, 399femoral head, 627

articulating junction with acetabulum, 426penetration into an acetabular cup, 237properties of, 424providing ball portion of the joint articulation,

424utilizing ceramics, 433

femoral neck, design requirements, 424femoral stem, 627

design evolving away from sharp corners, 364design requirements, 424

fractures, 362multiaxial loading, 259–61side crack in, 365total life approximation for, 340–1

femoral trabeculae, stress lines in, 146femoral trabecular bone, stress trajectories in, 146femur, compliance matrix for dry, 186fenestrations, 516, 627ferrous alloys (steel), endurance limit, 336fiber recruitment, 151fibers, thinner as stronger, 286fibril alignment, 149fibrillin, 133, 627fibrils, in skin and arterial wall, 155fibroblasts, 627

embedded among collagen fibers, 149fibrocartilage, 627fibrocartilage callus, 448fibrosa, 479, 627fibrous peri-implant tissues, formation of, 545fibrous pseudo-periodontal membrane, 520filling, 627filling material, within tooth enamel, 81first degree burns, 576, 627

first moment of molecular weight, 107first-order imperfections, 38first throw hold, 570, 627first-order viscoelastic material models, 217–21fixation materials, properties of, 433fixation, of knee components, 442fixed bridges, 512fixed partial bridges, 512fixed-hinge-knee design, 437flat bone, 140flat plane X-ray, to catch strut fracture, 499flaw size, reaching critical value, 59flaws

evaluating in ceramic components, 78in ceramics, 75making cast form of Co-Cr prone to fracture or

fatigue failures, 62subjected to a tensile stress in a ceramic, 77

flexibility, of an arterial graft, 11Flexicore device, 461flexion, 628fluid

bearing pressure, 214constituent behavior, 214

fluid flow, regulating without damaging red bloodcells, 477

fluorocarbon polymers, 119, 628fluoroscopy, 499, 628fold length, measure of, 102food additives, testing of, 398Food and Drug Administration (FDA), 399, 628

510(k) guidance document for TMJ implants, 544approval, 7avoiding giving specific test requirements, 408classifying implants, 9final word in medical device regulation, 401gaining approval from, 397guidance contact lenses, 581guidance for keratoprostheses, 582guidance for submission of PMAs for breast

implants, 586guidance for sutures, 570guidance for synthetic ligament implants, 574guidance in the submission process, 408history of, 401legislative history, 398–401medical devices regulated by, 92medical devices subject to pre-market approval by,

93not upholding regulatory duties, 544products regulated by, 397reclassified all types of TMJ implants, 544recognizing international testing standards, 408risks characterized for grafts, 491schematic representation of the organization, 405timeline of legislative history, 402types of characterization for mechanical heart

valves, 489Food and Drug Administration Modernization Act

(1997), 400Food and Drug and Insecticide Administration, 399


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658 Index

food and drugs, adulterated and misbranded, 398Foods and Food Adulterants experiment, 398force vector, resolving, 171force(s)

for activating yield, 40for the separation of atoms, 11physical definition of, 294translating between a plate, screw and bone, 450

Ford, Gerald, 400foreign body giant cell reaction (FBGCR), 537forging, 51, 628forming, 51, 628fossa prosthesis, 534fossa-eminence implant, 534Fourier Transform infrared (FTIR) spectroscopy, 21Fox and Flory equation, 104fractional lifetime, 341, 342fractional recovery, 236, 628fractography, 290

estimating fracture toughness, 290–1insight into mechanism of failure, 270of fractured trapezoidal T-28 stem, 363

fracture behavior, 303fracture callus, 448fracture fixation, 446–53, 628

broadly defined, 446clinical reasons for, 448designs, 450–1in a spine, 451in a spine using plate and screws, 451materials used in, 451plate, alloy used in, 60

fracture fixation devicesdesign concerns in, 453functional requirements, 449properties, 450

fracture healing anatomy of, 447improvement in understanding of, 447

fracture instability, in EPFM, 316fracture mechanics, 628

concepts, 348–62described, 284ensuring appropriate structural analysis, 274estimating fatigue life, 329origin of modern, 283

fracture mechanismsin ceramics, 322in metals, 322in structural materials, 322–3in tissues, 323

fracture plate, 628fracture processes, associated with chronology of

failure events, 463fracture resistance, of ceramics, 85fracture strength, of ceramics, 272fracture surface of a cavitating ductile material,

270orientation of, 270with fiber debonding in the UHMWPE matrix,

444fracture toughness, 15, 59, 60, 77, 78, 297, 628

as different from mechanical strength, 284associated with stress corrosion cracking, 322EPFM measure, 316estimate of, 291estimating from fractography of a tibial implant,

290–1improvement in, 301influencing critical flaw size, 79low for ceramics, 18, 433of ceramics, 75of elephant dentin, 139wide range in polymers, 322

fracture types, basic classifications associated with,448

fracture(s) as catastrophic, 283characterized by types of loads generating,

449compressing, 451critical tensile stress for, 324failure mode distinct from strength, 284governed by localized processes, 284of trabecular bone, 148

fractured bones, implants used to properly align, 449free volume, for polymersfrequency domain analysis, 227–33fretting, 628

at the mechanical junction, 429in metals, 17minimizing, 26wear, 384wearing away protective oxide film, 464

friction, 373–5classic definition, 374kinetic, 628static, 628wear test methods and, 387–9

friction test, standard curve, 375frictional forces, reducing amount of force applied to

teeth, 369frictionless contact, not existing in the real world,

369frontal, 628FTIR spectra, showing oxidation of an UHMWPE

component, 21fully reversed loading, 338, 628function, restoring to the tissue or biological

component, 14functional requirements, 628

breast implants, 585–6contact lenses, 580–1corneal replacements, 581–3cosmetic implants, 585for dental implants, 530for temporomandibular joint (TMJ) replacements,

538for TMJ replacements, 538

fracture fixation devices, 449hip replacement, 424–9intraocular lenses, 583of artificial skin, 578of components of total knee replacement, 443


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659 Index

of fracture fixation devices, 449of knee replacements, 442–3of sutures, 568–70of synthetic ligaments, 573spinal implants, 459

G, measured value of, 297gait analysis, showing loads on the hip, 425Galen, catgut sutures used by, 560Galen, Claudius, 129Galileo, 130galvanic corrosion, 18, 57, 628galvanic potential, minimizing, 26galvanic series, 55, 56gamma (γ ) phase, of iron (austenite), 49gamma irradiation, generating free radicals in

polymers, 20gamma process, as deeply penetrating, 9gamma radiation, 3, 628gamma sterilization process, 8gap, at the interface, 65gas plasma, 9, 628gel permeation chromatography (GPC), 107, 628general failure criterion, 251general yield criterion, benefit of developing, 255generalized Hooke’s law, 250, 264generalized Kelvin model, 226, 628generalized linear models, strength of, 227generalized linear viscoelasticity, 226–7, 628generalized Maxwell model, 226, 629generic composite beam, 198geometric parameters, tabulation of, 315geometry, of the critical flaw size, 297–8Gershkoff, 515gingiva, 629gingival ligaments, 508gingivitis, 510glass ceramics, 86glass fibers, 283, 286glass hip socket, 417glass transition temperature, 103, 210, 234, 629glasses, 83, 629glassy plateau, 210, 629glassy polymers, 629

characteristics of, 103undergoing shear banding and crazing, 276

glaucoma, 583, 629glenoid, 629glenoid components, shoulders, 432glenoid fossa, 509, 629Global Harmonization Task force, 411global loading, stored energy from, 295Gluck, Thoeodorus, 436Gluck, Thomas, 416glycoprotein, forming a scaffold for elastin

deposition, 134glycosaminoglycan (GAG), 629glycosaminoglycan scaffold, with a semipermeable

silicone layer, 577glycosylation reactions, 133gold, as dental material, 26

Goldberg, 515gold-silver binary system, used in dentistry, 47Goodman equation, 340, 341–2Goodman line, 339Goodman relationship, between endurance limit and

mean stress, 339Gore-Tex Cruciate Ligament Prosthesis implant, 572grafts, 491, 629grain boundaries, 42

as a nucleation site for dislocation pile-ups, 42,46

chromium-depleted zones at, 62corrosion along, 57creating more, 46dislocations at, 271mismatch modeled with an array of parallel edge

dislocations, 42modeled as an array of edge dislocations, 43serving to impede dislocation motion, 42, 43

grain sizemaking smaller, 42reduction in, 46relating yield strength to, 46smaller increasing yield stress, 44

grain(s), 42as a source of weakness, 57large reducing strength of Co-Cr alloys, 62larger facilitating the working process, 46

graphite, structure of, 84green body, 83Greenfield, Edward, 520greenstick fracture, 449, 629Griffith energy balance, 294Griffith, A.A., 283, 285, 286Gruentzig, Andreas, 483Guidance Documents, with FDA recommendations,

408Gunston, 437

Hall-Petch equation, 46Hall-Petch relationship, 272hard (bony) callus phase, 448hardenability, 629

of metals, 35Harvey, Wiley, 398Harvey, William, 130Havers, Clopton, 141Haversian canals, 141, 629Haversian system, 141, 629, 635HCP structure, see hexagonal close packed (HCP)

structureHDPE, see high density polyethylene (HDPE)head diameter, optimizing, 390healing abutment, 514healing, failure during, 526healthy hip joint, frontal cross-section of, 423heart

anatomy of, 479chambers, 479layers, 479

heart muscle, electrical simulation of, 477


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660 Index

heart valves, 486–9, 629design, 78, 487replacements currently available, 488representative sample of, 488schematics of, 480

heat treatmentsof alloyed titanium, 63tailoring an alloy with, 42, 43, 44thermal processes, 48

heel region, 134, 629helical polypeptide chains, 132helical wire implants, 520hematoma, formation of, 447hematopoiesis, 144, 629hemi-osteons, 144hemocompatibility, of pyrolytic carbon, 79herniated (ruptured)

intervertebral disk, 459, 629Hertzian contact, 376heterogeneous mixtures, of tissues, 323heterograft valves, 487heterografts, 629

using bovine vasculature, 478heteroplastic, 629heteroplastic material, for dental implants, 505hexagonal close packed (HCP), 629hexagonal close packed (HCP) structure

c/a ratio for, 31creating, 30FCC lattice transformation into, 62packing density, 30–2titanium, pure existing as, 63

hexagonal closest packed (HCP) lattices, 30hexagonal manner, packing, 30hexagonal yield surface, 247hexene-based elastomer, 469Hibbs, Russell, 453hierarchical, 629hierarchical structure, of articular cartilage, 152hierarchical toughening mechanisms, 89high cycle fatigue, 334, 344, 629high density polyethylene (HDPE), 94, 116, 117, 629high-frequency loading, 208high noble metals, 26, 630high-strength Ti alloy, 303high-toughness Co-Cr alloy, 303high-cycle fatigue, withstanding, 477highly crosslinked acetabular liners, fracture of,

324–5highly crosslinked UHMWPE, fracture toughness

test, 303hinge mechanism first utilized in total knee

reconstruction, 436replicating kinematics of the knee, 436

hip, 421anatomy of, 422forces of everyday activities, 426

hip fractures, number of, 431hip implants

contemporary, 430–1designs, 431

fatigue crack propagation in a flawed, 353–4showing signs of moderate-to-severe corrosive

attack, 65success rate of, 341taking up much of the loading, 167

hip joint, anatomy of a healthy, 422hip prostheses, bolted design and early ball and

socket design, 418hip replacements

engineering design process for, 434experiencing low contact stresses, 421functional requirements, 424–9material and design evolution in total, 5total, 15

hip stemcircular and rectangular cross-section for, 197cross-section, designing, 196–7factors in the design of, 203fixed into a femur, 204processes involved in machining, 52, 53

hole zones, 132, 140hollow basket root-form implant, schematic of,

521homolytic bond cleavage, 20homoplastic, 630homoplastic material, for dental implants,

505homoplastic tooth replacements, utilizing, 515homopolymers, 95Homsey, Charles, 543Hooke’s Law, 181, 630

3D, 254applying 3D, 254applying to multiaxial loading, 182developing three-dimensional, 182development of 3D, 182for an orthotropic material, 185for anisotropic material, 184linear portion described by, 187versions of, 205

horizontal plane, 630hot isostatic pressing (HIP), 62hot rolling, 46, 630hot working, grain size remaining unaltered, 46HRR field, 311, 312, 630HRR stress singularity, 312Hufnagel, Charles, 486hyaline cartilage, see articular cartilagehydrated tissues

in articular cartilage, 214multi-phase behavior, 214

hydration, collagen requiring, 133hydrodynamic lubrication, 377hydrogels, limited fracture toughness, 284hydrogen bonding, 95, 630hydrophilic, 630hydrophilic ceramics, molding, 83hydrophilic nature, of a polymer, 124hydrophilic polymers, 125hydrophilicity, degree of, 125hydrostatic component, see dilatational component


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661 Index

hydrostatic component of stress, 264hydrostatic portion, of strain energy, 250hydrostatic pressure, 258hydrostatic stress, 247, 257, 630hydroxyapatite (hydroxlapatite), 71

carbonated biologically active, 86composites used as bone substitutes, 81converting coral into, 88described, 131, 135–6implants with coatings of, 523lending itself to substitution, 86platelets spreading out between collagen

molecules, 141serving as a reservoir for mineral exchange, 135similar to mineral component of bones and hard

tissues, 86wet precipitation techniques yielding, 84

hydroxyapatite-coated polymer sleeve, cross-sectionof, 203

hydroxyl groups, substitutions for, 86Hylamer polymer system, 445hyperopia, 581, 630hyperplasia, 486, 630hypothetical yield surface, 245hysteresis loops, 630hysteretic heating, 333, 361

idealized stress-strain curves, 192immunosuppressant agent, 630impacted fractures, 448, 630imperfections

in ceramics, 75in metals and alloys, 38–42presence of, 75utilized to strengthen metals, 46

implant body, 513, 514implant design, 6implant loading, 545implant migration, as a serious issue, 560implant therapy, time required to complete, 544implant tissue system, 125implant(s)

bodies, width and height of, 525costs dictating manufacturing methods, 53fatigue resistance of, 331in vivo degradation of, 7mechanical fixation, 424monitoring of, 7partial loosening of, 427restoring function, 462structural requirements of, 7used to treat coronary heart disease, 478utilized in the body, 81

in vivo, 631in vivo degradation, 4

of implants, 7owing to biological attack or immunological

response, 126incremental damage, 342inelastic zone, engulfing singularity zone, 299,

303

inert, 630inert biomaterials, 71inert ceramics, 71, 85, 86inert medical polymers, uses of, 113inferior, 630inferior vena cava, 481infinitesimal cube, inside an object under loading,

174infinitesimal element, undergoing rotation, 176inflammation, around posterior abutments of

subperiosteal implants, 517inflammatory response, 7, 630initial flaw size, from non-destructive evaluation

(NDE) techniques, 352initial relaxation response, misinterpreting, 237initiation, of a critical flaw, 333injection molding, 83, 630inkjet method, 83, 630in-phase component, 229instability condition, 296Institute of Medicine, 587Integra, temporary but immediate skin replacement,

577integrity, restoring to the tissue or biological

component, 14interatomic force potential, assessment of, 11interfacial bone tissue growth, 85Intergraft carbon fiber composites, 587intergranular corrosion, 57, 62, 630interlamellar layer, 142intermediate crack growth, 351intermetallic compounds, fatigue of, 357intermetallics, 17, 630internal fracture fixation development of, 446

for a fractured tibia, 447internal tensile stresses, components with, 58international regulatory bodies, 410–11International Team of Oral Implantology (ITI),

523Inter-Op acetabular shells, recall of, 467interpositional, 630interpositional disk, 509Interpositional Proplast Implant, 543interstitial defect, 38interstitial sites, 32, 38, 630interstitial solid solution, 47, 631intervertebral disks

afflicted with scoliosis and kyphosis., 458between vertebra, 457degenerative disease of, 459primary components of, 458serving as shock absorbers, 457

intima, 155, 481, 631intra-aortic balloon pump (IABP), 493,

494intramedullary, 631intramedullary rods, 417

for fracture in long bones, 451, 452forces in, 176repairing a tibial fracture, 176stabilizing long bones, 193


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662 Index

intraocular lenses (IOLs), 583, 631currently marketed, 583designs and functional requirements, 583development of, 561foldable, 583fracture, 588haptic fracture, 589

intraocular pressure, 582, 631intrinsic dissipation mechanisms, 320intrinsic failure criteria, 297–8intrinsic mechanisms, inherent to a material, 320intrinsic microstructural process, 320intrinsic toughening, 320, 355, 631intrusions, initiating flaws, 330investigational device exemption (IDE), 406, 408,

631Investigational Review Boards (IRBs), 406, 631investment casting, 52, 54ionic bonds, 72, 631ionization (electron disruptions), producing, 8ionized gas, deactivating biological organisms, 9ionizing radiation sterilization, deterioration of

orthopedic-grade UHMWPE due to, 20–2iron carbide, precipitating, 49iron pins, used in the mid-1800s, 447irradiation, 631

resulting in chain scission or crosslinkingmechanism, 9

resulting in cross-linking, 9using for polymeric materials, 9

irregular bone, 140Irwin corrected plane stress plastic zone size, 306Irwin Corrected Plastic Zone Size, 301Irwin Plastic Zone Size, 300Irwin, G.I.Irwin, G.R., 283, 286ISO (Organization for Standardization), 409isotropic, 631isotropic case, defined by two independent

constants, 184isotropic material, 184–6, 255isotropic pyrolytic carbon, used in mechanical heart

valves, 487Ivalon sponge, implantation of, 561

J, computing for linear elastic solids and fully plasticsolids, 314

Japan, Pharmaceutical and Medical Safety Bureau,411

jaw joint, 509, 538jaw loading, as dynamic, 538jaw sizes, accommodating, 525J-integral, 309–11, 631

approximating, 314as nonlinear energy release rate, 310at crack initiation, 316integral contour path for, 309

joint arthroplasty, 533joint replacement, implanted to restore function, 14joint surface, removal of and replacement with a

synthetic component, 152

jointslubrication in, 379most commonly replaced, 421

JR curve, 316, 317Jungle, The (Sinclair), 399

dependence on global stress and crack length, 289dependent on stress triaxiality, 297for a constant pressure applied to crack tip, 306

k values, typical, 382Kc

as a function of plastic constraint, 300–3variations in, 302

K-dominance, region of, 639Kefauver–Harris Amendments of 1962, 400Kelvin model, 214, 217, 631

as solid-like, 217chained in series, 226complex modulus of, 230equal strain in two parallel elements, 219generalized form of, 226incapable of predicting stress relaxation behavior,

220limitations of, 222, 231parallel network, 217relaxing from a highly stiff response, 220with theoretically infinite instantaneous elastic

modulus, 220Kelvin-type SLS, 224Kennedy Ligament Augmentation Device (LAD),

572keratinocytes, 577, 631keratoprostheses, currently marketed, 582kinetic barriers, preventing or limiting corrosion, 55kinetic friction, 373knee

anatomy of, 152, 435articulation of the non-conforming, 439complex anatomy with relatively low conformity,

421flexion, 437joint, 439ligaments, 150, 151, 570, 571

knee replacements, functional requirements of,442–3

knot security, 569, 631knot tie-down, 570, 631knot-pull strength, 569, 631Knowles pin, 451, 452kurtosis, 372kyphosis, 458, 631

laboratories, achieving repeatable results, 168lacunae, 141, 631LAD (Kennedy Ligament Augmentation Device),

572lamellae, 631

composition of, 142function of, 457mechanical properties changing, 142of mineralized tissue, 141


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663 Index

lamina, 457, 631Lange, Fritz, 453laser etching, 353, 631lateral screw rod systems, 454lattice atoms, element with a geometric mismatch,

47lattice structure, of ceramic materials, 72lattice substitution, 45, 47layered devices, optimal thicknesses in, 202–3LDPE, see low-density polyethylene (LDPE)lead-coated platinum post, as a dental implant, 515leaflets (or cusps), with three layers of tissue, 479leakiness, 486Leeds–Keio prosthesis, 573LEFM, see linear elastic fracture mechanics (LEFM)left ventricular assist device (LVAD), 493, 494lens

fibers, 580of the eye, 580

life-supporting or life sustaining devices, 10ligament (material ahead of the crack tip), 289Ligament Advanced Reinforcement System

(LARS), 573ligament reconstructive surgeries, 572ligament replacements, carbon fiber composites for,

587ligaments, 148–51, 631

anatomy of, 570as structures of discrete components, 151attaching femur and tibia and fibula, 435composition of, 148in unaltered state, 135of the knee, 571reconstructing, 94showing relative deformation response, 150structure of, 149transition from compliant to stiff behavior, 151tying bones together, 149

likelihood of failure, predicting, 255line defects, 39–42, 626linear chains, facilitating efficient packing of

molecules, 99linear crack growth, 350, 352linear elastic element, 216linear elastic fracture mechanics (LEFM), 77,

285–303, 349, 632based on stress and strain field solutions, 308–9COD methods as alternative approach to, 304crack tip effective in modified, 304elastic J dominating in, 314in situations where inelasticity present but limited,

299modified methods in, 299–303summary and limitations of, 298

linear elastic isotropic materials, 288linear elastic strains, 311linear individual model elements, 216linear low-density polyethylene (LLDPE), 116, 117linear polyethylene chains, packing, 118linear portion, described by Hooke’s Law, 187linear region, 134

linear relationship, between stress and strain, 181linear response, representing with complex numbers,

230linear spring, dissipating no energy, 230linear superposition, 632

invoking, 218principle of, 182properties of, 215, 292

linear viscoelastic elements, 216–17linear viscoelastic networks, 214–27linear viscoelasticity, 632linear viscous response, 216linen fibers, used as sutures, 560Linkow, Leonard, 517, 518lipoma, 561, 632liquid phase sintering, 83L-lactide form, of PLA, 124LLDPE, see linear low-density polyethylene

(LLDPE)load event, duration of, 227load-bearing devices, 483–96load-bearing human tissue constituents, values for,

137load-bearing tissues, 136–56loading, 332, 350loading Modes, independent, 291loading problems, solving variable, 343loading scenarios, 255loading situations, as three-dimensional, 168loads, in the body, 10local stresses

controlled by presence of a notch, 267exceeding strength of materials under loading,

287finding, 267

localized crack phenomena, alternative measure of,294

long bonesanatomy of, 140epiphyses and a shaft, 140

long neck lengths, resulting in increased stresses,466

longitudinal direction, as stiffer than transverse, 143longitudinal testing, of cortical bone, 142long-term creep tests, on UHWMPE, 225Lorentz/Biomet (Warsaw, IN) device, 537loss factor, 232, 632loss modulus, 228, 229, 230, 232, 632lost-wax casting, 52low-cycle fatigue, 335, 344, 345–6, 632low density polyethylene (LDPE), 116, 117low frequency, modulus of Kelvin model purely

elastic, 230low-carbon steel, heat treatment of, 49low-cycle fatigue component failure, 269lower back pain, incidence of, 458lower bound elastic modulus, 19low-friction contact, leading to appreciable wear, 369low-friction hip arthroplasty, 417lubricant layer, maximizing, 390lubricant, choice of, 389


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664 Index

lubricated articulation, in the healthy body, 369lubrication, 377–81, 632

boundary, 632elastohydrodynamic, 632hydrodynamic, 632mixed, 632squeeze film, 632types of, 377–81

lumbar spine, 456lumen, 632

machine coolant, leaking during manufacturingprocess, 467

machining, 51, 52, 632macromolecular structures mechanical behavior of,

274of polymeric materials, 94

macrophages, 7, 427, 632malleability, of metals, 28malocclusion, 511, 632mandible, 508, 632mandibular bone, schematic of, 509mandibular implants, contraindications for, 530man-made materials, versus biological materials,

14manufacturability, of polymers, 112manufacturing methods for implants, 7

of ceramic materials, 82run cost, 52utilized in polymeric materials, 114

marble breast, 561Marin factors, 346–8Marin, Joseph, 346martensite, 49, 632martensite-austenite phase transformation, 64mastication, 632

1000 chewing cycles/day, 529efficacy of, 510severe mechanical demands of, 136

masticatory loads, 529material behavior, over a range of loading

frequencies, 227material choices, for orthopedic implants, 203material development, used in medical devices, 4material failure, process of, 241material phase, as a true viscous medium, 214material properties

measuring in a uniaxial test, 187need for certain, 15processing metals for, 45–50tailoring through heat treatment, 44time-dependent, 209, 210–12

material resistance, to crack growth, 294material selection, as a multifactorial problem, 60material symmetry, utilizing, 261materials

deforming plastically, 299selecting for devices and implants, 7, 14

materials science, of medical alloys, 27Maverick implant, 461maxilla (upper jaw), 506, 508, 632

maxillary and mandibular implants,contraindications for, 530

maxillofacial, 632maxillofacial implants, 506maximum bite force (MBF), 529maximum contact pressures, experienced in clinical

total knee replacement designs, 278maximum distortional energy, 249–55maximum principal stresses, 324maximum shear stress, 38, 245

at the center of the contact area, 376criterion, 245determining using Mohr’s circle, 178finding, 179found using Tresca yield criteria, 260localized, 243occurrence of, 246planes of oriented, 246reaching yield stress, 245relationship with principal (normal) stress, 246Tresca yield criterion, 245–9

maximum stress, finding, 196Maxwell material, 221Maxwell model, 217, 633

as fluid-like, 217characteristic time as defined by, 221combined in parallel, 226generalized form of, 226imposed sinusoidal strain in, 231loss modulus, 232series network, 217storage and loss modulus, 232storage modulus of, 231

Mayan civilization, teeth implanted into livepatients, 515

McKee-Farrar prosthesis, 417mean stress, 633

effect on fatigue behavior of a material, 338effect on fatigue life of a material, 339endurance limit decreasing with increasing, 339incorporated into the life calculations, 329mechanical behavior of polymers, 109–12of loading cycle, 332of structural tissues, 129–31

mechanical failure, of Silastic implants, 534mechanical heart valve replacement, 486mechanical heart valves, 477mechanical properties commonly compared, 205

concomitant with variations in microstructure, 50describing linear elastic, isotropic deformation,

168describing ratio between stress and strain, 181for tissues, 158for trabecular bone, 147of corals, 89of e-PTFE, 120of eye tissues, 578of inert medical ceramics, 86of metals yield strength, 27sensitivity to different test parameters, 168

mechanical requirements, on an implant, 14


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665 Index

mechanical supports, 560mechanical test, for material characterization, 241mechanical variables, associated with sustained

(cyclic) loading, 331media, 155, 481, 633median, 633medical alloys

elastic modulus, yield strength and tensilestrength for most commonly used, 61

fatigue crack propagation behavior of a range,358

materials science of, 27variety of uses in the body, 60

medical ceramics, summary of, 87Medical Device Amendments of 1976, 400, 404Medical Device Report (MDR), with the FDA, 498Medical Device User Fee and Modernization Act

(2002), 400medical devices, 633

approval, 397brought under FDA control, 399complexity of, 401definition of, 401definitions and classifications, 401–4design, 4early, 3for load-bearing applications in the body, 13for which failure cannot be tolerated, 297fractures, 283long-term success of, 4multifactorial factors contributing to

performance, 6regulating advertising of, 400structural requirements of, 6, 10–13subject to pre-market approval, 400

medical implantsceramics in, 85–7designing, 3metals in, 60–4polymers in, 113–24requiring very specific properties, 11utilized in the body, 14

medical indications for subperiosteal implants, 530for TMJ replacements, 538

medical polymers, 116medium density polyethylene (MDPE), 117Medtronic catheter, bursting during an angioplasty,

401melt viscosity, scaling with molecular weight, 107melting curves, of polymers, 102melting temperature, relationship with lamellae

thickness, 103menisectomy, 533, 633Mentor Corporation, 586mers units, in polymersmeshes, made from nylon and PET, 585metal backing, added to polyethylene tibial insert,

443metal bonds, breaking and reforming, 35metal corrosion, characteristics determining, 55metal head, displacement into the polymer cup, 237

metal ions, 54metal processing, 42–53metal systems

alloying, 47defect types and sources of microstructural

features, 272utilized as medical alloys, 27yield stress saturating under sustained loading,

333metal(s)

altering structure and properties of, 42as intrinsically metastable, 53characteristics of, 241expression for theoretical strength of, 38failure mechanisms in, 271–2fatigue behavior of, 357–9fracture mechanisms in, 322high fracture toughness and resistance to crack

propagation, 330imperfections in, 38–42in medical implants, 26–64, 67limitation of using, 17making use of metallic bonding and closely

packed planes of atoms, 16mechanical properties for load-bearing medical

devices, 17plastically deformed, 35processes strengthening, 45processing for improved material properties, 45–8processing for shape-forming, 53sensitivity to corrosion, 322slip systems in, 36strengthening mechanisms in, 45theoretical shear strength of, 36–8utilizing metallic bonding, 27with limited slip systems, 270

metal/metal pairings, failed lubrication in, 382metallic bonding, 13, 633

bonding structure in, 53described, 34material behaviors, 27

metallic femoral stem, 259, 262, 354metallic implants, degradation of, 53metallic stent, schematic of, 352metal-on-metal conical taper connections, to assist

modularity, 64metal-on-metal designs, in intervertebral disk

replacement, 461metal-on-polymer articulation, implant design

employing, 439metal-oxide passive film, on the metal surface, 55metaphyseal, 633metaphyseal (trabecular) bone, 450microcrack propagation, in young and aged human

teeth, 139microcracking, 80, 633microguidewire, in an artery, 178micromechanisms, 321, 330, 633micromotion

during initial healing, 545experienced by implants, 519


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666 Index

microscopic flaw, introducing, 284microscopic sharp cracks, 287microstructure, of metals, 27microvoid coalescence, 270, 274middle zone, collagen fiber orientation, 153migration, 633Miller indices, 34, 633mineral crystals, in dentin, 136misalignment

clinical reasons for, 436of the knee, 436

mitral valve, 479mixed lubrication, 380mixed-mode condition, 633mixed-mode crack propagation, 349mixed-mode loading, 292, 293, 297mobile bearing designs, 440Mode I

crack-opening mode, 291equation, 292loading, 77opening mode, 349stress intensity factor, 349strip-yield zones in thin steel sheets in plane

stress, 305typically most critical, 297

Mode II, shear mode, 291, 349Mode III

out-of plane shear mode, 349twisting (or tearing) mode, 291

modeling packages, computing J-integral at blunt orsharp crack tips, 311

modeling techniques, predicting behavior ofpolymers, 212

modular hip stems, assembly of, 385modular implant design, trade-off in, 466modular implants

conical press-fit fixation, 65degradation, 65tapered shank, 65

modular neckadded length, 66fracture of, 465

modularity, benefits, 64, 429modulus, 623modulus of resilience, 243, 633modulus values, for alloy classes used in medical

implants, 44Mohr, Otto, 176Mohr’s circle, 176, 633

basic equations for, 260coordinate system maximizing shear stress, 178finding principal stresses, 248for uniaxial loading, 246plot for uniaxial loading, 246representation of a stress state, 178, 180representation of a two-dimensional problem, 177showing maximum shear stress, 256using to find principal stresses, 179

molding, 633molds, intricacy of, 52

molecular bonding level, of structural materials, 15molecular characteristics, limiting ability of a

polymer to form crystalline structures, 98molecular effects, in polymers, 105molecular structures, in ceramics, metals, and

materials, 18molecular variables effect on time-temperature

behavior of polymer systems, 112strengthening a polymer system, 112tailoring in polymers, 19

molecular weight, 633affecting glass transition of a polymer system,

104determination of, 108–9distribution in polymers, 106–9effect on structure, 100impeding long-range ordering, 99

molecule size distribution, in a typical polymer, 106moment area of inertia, around the neutral axis, 198monofilament, 561monomers, 95morbidity, 570, 633Morse taper, 26, 58, 65, 633

achieving junction between femoral head andneck, 429

requirements for, 424schematic illustration, 65, 430

Morse Taper cone, showing burning, fretting andintergranular attack, 66

Morse Taper junction, burnishing and fretting at, 66motion, in knee, 435Mouse Cleaver, 561multiaxial loading, 182–3, 255–61multiaxial stress state, 241multiaxial stresses, sources of, 259multiaxial testing, of a material, 187multifilament designs, increasing suppleness of a

suture, 570multiphase polymers, toughness of, 323muscle, motive action of, 149mussel shells, toughness of, 287myocardium, 479, 633myopia, 581, 633

natural corneal transplant surgeries, 581natural joints, coefficient of friction in, 386natural materials, 561natural options, for vascular grafts, 490natural sutures, 565natural tissues, see tissuesnatural tissues, dramatic increase in understanding

of, 129enabling energy dissipation, 322existing along a continuum, 136mechanical properties of, 129properties of, 158stress-strain curves in, 191–3

Naval Ordinance Laboratory (NOL), 63nearsightedness, 633near-tip stresses, maximized, 77neck-head junction, 424


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667 Index

necking, 189, 633neck-stem junction, bending stresses, 466needle attachment force, 569, 634neoformation, 88, 634neonatal fibroblast, 577, 634nerve endings, in the cornea, 579network polymer, three-dimensional, 97neutral axis, 194, 197–9, 634Nitinol, 64, 634Nitinol Ni-T alloy, 63nitinol stent

fatigue design of, 352–3strut failure, 498–500

noble alloys, 26noble metals, in structural dentistry, 26non-conforming design, 441non-conforming surfaces, creating large Hertz

contact stress, 442non-destruction evaluation (NDE) techniques,

352non-enzymatic crosslinks, 133non-expendable mold, 52nonlinear (NL) elasticity (E), 308nonlinear creep functions, 236nonlinear elastic material, 308nonlinear elasticity, 308nonlinear models, common, 235–6nonlinear relaxation, 236–7nonlinear viscoelasticity, 235–7non-resorbable materials, 561non-resorbable polypropylene suture, used for

wound repair, 121non-resorbable sutures, currently marketed in the

US, 566non-submergible implant, 514non-thrombogenic properties, of polyesters, 121non-thrombogenic substance, 634normal strain, 171, 634normal stress, 172, 173, 244normal stress criteria, 244, 265, 279Not Significantly Equivalent (NSE), 412notch sensitivity, 267notches, 634

materials sensitive to the presence of, 267presence of, 266serving to locally concentrate stresses, 330

novel device, path to market, 406nucleation site

for dislocation pile-ups, 42, 46of critical defects, 330

nucleus, 634of each disk, 457

nucleus pulposa, 457, 634number average molecular weight, 106, 109, 634nylon, 121, 124, 337, 585, 634nylon balloon, in deployment of a vascular stent, 122nylon polymers, tensile strength of, 94

OA, see osteoarthritis (OA) object, under loadingoblique fractures, 449, 634observer invariance, 173

occipito-cervical, 634occipito-cervical junction, 454occlusal, 634occlusal forces, 529occlusal loads, 506, 516occlusal overloads, 529octahedral shear plane, 251

orientation with respect to principal stress, 251plotted in Mohr space, 252shear stress on, 251

octahedral shear stress, 251, 634octahedral shear yield criterion, 251octahedral site, 33, 634Office of Combination Products, 401oily residue, on defective implants inhibiting

osseointegration, 467one-dimensional polymers, 113one-dimensional systems (chains), 95open cell foam, 147open pore architecture, of coral, 88ophthalmic implants, 560, 561, 578–84ophthalmologic, 634ophthalmologic disorders, 580optical micrographs, 428optical properties, of eye tissues, 578optic-haptic junction, fracture of IOL at, 588oral and maxillofacial implants, demand for, 505oral implants, 505oral muscosa, 634Organization for Standardization (ISO), 409orientation factor, for resolved shear stress, 40orientation mismatch, 42, 46orthopedic biomaterials, 13orthopedic implants challenges remaining in the

development, 416corrosion in, 64–7described, 416engineering challenges and design constraints of,

462looking forward in, 470

orthotropic, 634orthotropic material, possessing symmetry, 185orthotropy, 185osmosis, recruiting lubricating fluid into tissue,

151osseointegrated implants, failure of, 520osseointegration, 634

at bone-implant interface, 63efforts to enhance, 545lack of, 519of implants, 505supporting, 86

osseointegrative ability, of titanium, 506osseointegrative potential, of ceramics, 524ossification, 448, 634ostcoclasts, eating away at surrounding bone tissue,

427osteoarthritis (OA), 423, 424, 532, 634osteoblasts, 634osteoclasts, 88, 634osteoconduction, 88, 634


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668 Index

osteoconductive properties, of coral, 88osteocytes, 141, 634osteogenesis, 88, 634osteoid, 140, 634osteoinduction, 88, 634osteolysis, 416, 427, 635

complications with, 424due to poor wear resistance, 20–2loosening associated with, 422propensity for, 455

osteonal system, 141osteons, 635

as a basic unit, 141composition of, 141in cortical bone, 323organization of cortical bone into, 143resulting from remodeling processes, 144separated by the cement line, 142

osteoporosis, 70, 448, 635osteoporosis-related fractures, increased risk, 144outer scaffold layer, 157out-of-phase component, 229overall strain response, of the SLS in creep, 223overall stress response, for Maxwell model, 231oxidation, 635

as preferable energy state for metals, 53creating structural degradation of UHMWPE, 21long-term, 9subsurface peak in, 21

oxidation-induced embrittlement, gamma radiationresulting in, 3

oxidative degradation, enhanced susceptibility ofHylamer, 445

oxidative reaction, 55

pacemaker, 635package memory, 570, 635packing density, determining, 30packing efficiency, 30Palmgren-Miner accumulated damage model, 341Palmgren-Miner’s rule, 342, 343parafunctional, 635parafunctional activities, 529parafunctional oral activity, 526Parallel Axis Theorem, 198parallel network relationship, 217Paris equation, 358Paris law, 351, 352Paris regime, 351Paris regime slope, 359particulate debris, see wear debrisparticulate debris, increased levels of, 440Pascals [Pa]passivated surface, 58passivation, 55, 635passive oxide film, 55patella, 635patellar tendon, 570, 571patency, 500, 635Patent-Fitted TMJ Reconstruction Prosthesis, 537pathways, for corrosion in metallic systems, 55

patient factors, 5, 525Pauling’s rules, 72–5, 635peak energy, 229peak stored energy, 229peak stress, 288peak stress intensity, 356peak-to-valley height, 372pearlite, 49, 635pedicle screw spinal fixation method, 469pedicle screws, 467, 468, 469pedicles as fixation points, 453

spinal fixation through, 454pelvis, foundation of, 456percutaneous, 635percutaneous procedures, implanting stents, 483percutaneous surgeries, increased, 500pericardium, 479, 635peri-implant, 635peri-implant tissues, 519periodontal, 635periodontal disease, 87, 510, 635periodontal ligaments, 508periodontal tissues, 508periodontitis, 510, 635periosteum, 635periprosthetic osteolysis, 635permanent abutment, 514permanent ACL replacements, 572permanent augmentation devices, providing support

for existing ACL, 572PET, see polyethylene terephthalate (PET) polymerPeterson equation, developed for steels, 268PGA-PLA polymers, increased resorption time,

125phase diagram, for Fe-C steel, 50phase shift, 227, 635phase toughening mechanism, for zirconia, 80phase transformation toughening, 80, 635pHEMA Poly(2-hydroxyethyl methacrylate), contact

lenses made of, 581physical crack tip, as blunted, 304physiological problems, measurement methods in,

130physiological stresses, 6, 78, 635pile-ups, 635pin-on-disk testing, 389pins, used in internal fracture fixation, 450pitting, 277, 636pitting corrosion, 58, 59planar defects, 42planar organization, of tissues, 155planar two-dimensional polymer, 97plane sections, remaining plane during bending,

195plane strain fracture toughness, 301, 636

plastic zone size, 299planes

arbitrary intersecting the y and z axes, 34describing within the lattice structure, 34of maximum principal stress, 270of the body, 420


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669 Index

plaquecardiovascular, 636dental, 636formation of, 477

Plaster of Paris, 70, 636plastic blunting, of the crack tip, 303plastic component, of the strain amplitude,

344plastic constraint

in plane stress and plane strain, 307Kc as a function of, 300–3

plastic deformationassociated with hydrostatic loading, 257increasingly severe, 313local, 266of metals, 35onset critically linked to resolved shear stresses,

42within crystal systems, 34

plastic flow, region of reversed, 268plastic strain amplitude, 344

avoiding sustained, 344resulting in permanent deformation, 243some portion of the energy lost, 243

plastic wake, 317plastic zone, 636

ahead of apparent crack tip, 305correction to, 300growing singular stress extinguished, 306in high toughness materials, 308radius, 315size, 300size affecting distribution of stresses, 304size approximation, 300

plasticity, 308, 312platelets, 482plates, 450, 636PMMA, see polymethylmethacrylate (PMMA)point defects, 33, 38Poison Squad, 398Poisson’s ratio, 181, 205, 636poly (lactic acid) (PLA), 123polyamide polymer, 636polyamides, uses of, 121polycentric implant design, 438polycentric knee, invention of, 437polycentric motion, in the knee, 438polycentric pathway, rotation about, 437polycrystalline aluminum oxide (alumina), 523polycrystalline ceramic glasses, 71polycrystalline materials, metals as, 42polycrystalline metal, 42polycrystalline solids, metals more precisely termed,

42polydimethylsiloxane (PDMS), 123polydisperity index (PDI), 107, 109, 636polyester polymers, tensile strength of, 94polyesters, 121, 636polyetheretherketone (PEEK) polymer, 636

carbon fiber reinforced, 19uses of, 123

polyethylene (UHMWPE), as acetabular linear in amodular total hip replacement, 118

polyethylene fossa, 536polyethylene polymer, 636polyethylene polymer systems, 99polyethylene terephthalate (PET) polymer, 121,

636dynamic scan of, 231flexible tubes of, 478mechanical properties for, 229meshes made from, 585no endurance limit, 337

polyethylenesmolecular weight of, 116uses of, 116–17

polyglycolic acid (PGA), 94, 113, 125in sutures, 19polymer, 636

polylactic acid (PLA) polymer, 94, 113, 485, 636polymer chains

accommodating through chain folding, 102foldering into ordered structures, 95increased length of, 107segments overcoming activation barriers to move,

110polymer composites, 19polymer crystals, thickness of, 102polymer resorption, rate of, 125polymer structure, density of, 102polymer synthesis, result of basic, 106polymer systems

crystallinity of, 101elastic modulus, 16

polymer(s), 636as viscoelastic materials, 212bonding and crystal structure of, 95–106characteristics of, 241deforming elastically under small stresses, 109ethylene oxide sterilization used in, 9failure mechanisms in, 274–6fatigue behavior of, 330, 357, 360–2fracture mechanisms in, 322improvement of, 93in load-bearing applications in medical devices,

93in medical implants, 92, 113–24low elastic modulus values, 16mechanical behavior of, 109–12melting rather than fracturing, 361melting temperature of, 102molecular weight distribution in, 106–9offering lower elastic modulus, 13porous by design, 113processing, 83, 112properties of, 19requiring low temperature methods, 9structural properties of, 95susceptible to creep and strain rate effects, 360tensile loading versus compression loading, 276time-dependent crack propagation in, 305toughening with addition of a second phase, 323


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670 Index

polymer(s) (cont.)tribological behavior, 387uses of, 94varying greatly in molecular weight, crystallinity,

and density, 99with high glass transition temperature, 103

polymeric biomaterials, 19polymeric coatings, 94polymeric implant, modified yield criteria for, 263–4polymeric materials highly dependent upon local

stress states, 361primary advantage of, 94softening, 333susceptible to irradiation damage, 9

polymeric tibial insert, 263polymethylmethacrylate (PMMA), 118, 636

as load transfer medium and grouting agent, 119biodegradation in, 19button pressed into a two-piece interface grasping

a corneal graft, 581condylar head, 534IOLs, 583transparency of, 119uses of, 92

polyp, 636polypropylene (PP) polymer, 120, 636polytetrafluoroethylene (PTFE) polymer, 636

as a bearing surface, 93cup, 417flexible tubes of, 478in a low-friction bearing pair, 390in dental implants, 93materials for orthopedic implants, 543slippery during handling, 585

polyurethane (PU) foam disintegration of, 586susceptible to chronic inflammatory response,

93polyurethane polymer, 636polyurethanes, 94, 122polyvinyl chloride (PVC) balloon catheters, 483pontics, 511, 636pore spaces mineralization spreading into,

140reduction in, 83

pores, 132poroelastic behavior, 637porosity

of cortical bone, 145of trabecular bone, 145, 147

porous coatings, 425, 431porous components, 561porous meshes, 560positive values, for stresspost-amendment devices, 400posterior cruciate ligament-retaining design,

441posterior cruciate ligament-substituting design, 441posterior implants, less success, 526post-market surveillance, of a device, 498potential energy, 310pounds per square inch [psi], 172

powder metallurgy, 83powder sintering, 637power-law correlation, 236power-law deformation plasticity material, 312power-law empirical correlation scheme, 235power-law plasticity, near the crack tip, 312power-law time-dependent compliance, 319power-law viscoplasticity, 236PP Polyflex, 570precipitates, 48precipitation hardening, 47, 620, see also age

hardeningpredicate creep, 412predicate device, 404, 637Pre-Market Approval (PMA), 404, 637Pre-Market Notification (510(k)), 637

device path to market, 406examining approval of and subsequent FDA

internal review, 411–13for a device, 404using surgical meshes as predicate devices,

412primary body planes (cross-sections), describing

anatomical positioning, 420primary slip systems, 35principal directions, 179, 637principal material coordinate system, 145principal stresses, 179, 637processing of the implant, 7

polymers, 112Pro-Disk intervertebral implant, 460ProFemur Z hip stem, 463profilometer, ID curve taken using, 372profilometry measurements, 388propagation process, of a critical flaw, 333Proplants, interpositional implants made of, 534Proplast, 536, 570, 637

carbon fiber composites, 587coating, 536

Proplast I, 543Proplast Interpositional Implant, 536Proplast-Teflon (PT) as TMJ implant material, 506

TMJ implants, 536Proplast-Teflon Temporomandibular Joint

Replacements, 542–4prosthesis, see specific typesprosthesis, assessing amount of wear, 237

views of Flot’s, 536prosthetic heart valves, need for, 486proteins, in the body’s structural tissues, 131proteoglycans, 148, 152, 637proximal, 637proximal-distal slipping, 65pterygoid muscles, 509, 637PU foam, see polyurethane (PU) foampulmonary valve, 479pulp, interior of, 507pulsatile fatigue, 500Pure Food and Drug Act of 1906, 399pure shear loading, 256pyrogenicity, 637


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671 Index

pyrolytic carbon, 83, 637fatigue crack propagation rates, 360properties of, 86replacement of Delrin by, 487structural arrangement of carbon in, 84

pyrolytic carbon coating, 83pyrolytic carbon heart valves, fracture of, 284

quenching, 49, 637

R curve shape, sensitive to stress triaxiality, 296R curves, 295

for monotonic (quasi-static) loading, 320radians, measuring shear strain, 170radiation chemistry, of specific polymer systems, 9radicular pulp, 508radiopacity, for post-surgical monitoring, 489radius ratio, 72ramus blade, 519ramus blade-form implant, schematic of, 519ramus frame, 519Rankine, 244rapid crack growth, 351rapid prototyping, 83, 637rate sensitivity, of polymer mechanical behavior, 212ratio of maximum stresses, 298R-curve (resistance curve) behavior, resistance curve

behavior, 360reactions, when metals corrode, 55real area of contact, 371, 637recrystallization, 48, 621, 637recrystallization temperature, 46rectangular and circular cross-sections, area

moments of inertia for, 196red blood cells, 481red bone marrow, 144reduced time, 236, 637reduction reaction, 55reference temperature, for WLF equation, 234ReGen Menaflex Collagen Scaffold (MCS), 411region of material breakdown, 289regulatory affairs, 397regulatory issues, 7, 9regurgitation, 486, 637rehabilitation period, after surgery, 570relative strength, of viscous component of the

spectral response, 229relative time scale, of relaxation and loading event,

211relaxation spectrum, 227, 233relaxation time, 208, 210, 637

for Silly Putty, 212relaxation transitions, in polymers, 233remodeling, 140, 637removable dentures illustration of, 512

primary components, 511repeatable data, accumulating large amounts of, 346resecting, 533, 637residual compression, 269residual stresses, developing at notch tip, 268residual tensile stress, zone of, 268

residual tension, created upon unloading, 269resilience

of polymer structures, 106of polymers, 19

resolved shear stress, 40resorbable, 638resorbable (biodegradable) ceramics, 84resorbable materials, 71, 561resorbable sutures, 11, 124–5

made from polymers, 567materials, structures and absorption times, 568

restenosis, 483, 638retrieval studies, providing insight into adverse

reactions or complex problems, 10retrodiscal, 638retrodiscal tissues, 510rheopectic, 638

as synovial fluid, 380rheumatoid arthritis, 532, 638

as source of damage in articular cartilage, 424in the knee, 436

Ridley IOLs, 583Ridley, Harold, 561, 583Riegel v. Medtronic (2008), 401Riegel, Charles, 401Ringer’s solution, 389RMS roughness, 378Roberts, Ralph and Harold, 519rods, used in internal fracture fixation, 450rolling, 51rolling contact fatigue, see contact fatigueRoosevelt, Theodore, 399root, 638

of a tooth, 136root canal, 508root mean squared (RMS) roughness, 371root-form endosteal dental implants, 513,

520–9root-form implants

failures during healing, 526geometries for, 524overtaking bladeform implants in popularity,

528reclassified by the FDA as Class II devices, 528regions of, 514requiring a healthy, intact vertical column of

alveolar bone, 514success of, 526susceptible to early bone loss, 527with surfaces roughened, 522

rough surfaces, coming into contact, 371roughened surfaces, particularly in cylindrical

bodies, 523roughness, 371

average, 638calculating, 372–3root mean squared, 638

roughness measurement methods, 388R-ratio, 332, see also stress ratio rubber disk,

embedded between two titanium endplates,455


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672 Index

rubber particles, nucleating multiple crazes, 277rubbery plateau, 210, 638rubbery polymers, 104, 638

S.E. Massengill Co., 399Sabins, Gary, 467sacrum, 456Safe Medical Devices Act, 641Safe Medical Devices Act (1990), 400, 640safety factor, as proximity to yield boundary, 253safety-critical applications, defect-tolerant approach

used in, 348sagittal plane, 638saline, 389saline-filled breast implants, 585, 586Sandhaus, S., 523saphenous vein, 490, 638sapphire implant, 524sapphire, more favorable survival rates, 524saturation crack length, effect of load ratio on, 279SB Charite intervertebral disk, 455scaffold, creating for tissue engineering, 156–8Schulte, Heyer, 585scission, 9, 638scoliosis, 453, 458, 638screw dislocations, 39, 40, 271, 638screw type designs, 524screw(s), 638

types of, 450used in internal fracture fixation, 450

screw-plate construction, for stabilization of a spine,454

screw-rod system, 454screw-type implants, 514screw-type root-form implant, 520sea coral, see coral secant modulus, 188, 638second degree burns, 576, 638second moment of molecular weight, 107second-order imperfections, 39second phase additions, 80,

638second phase particle strengthening mechanism, 48second phase particles, 45, see also precipitatessecond phase particles, strengthening achieved with,

48second-phase particles, 45self-expanding stent delivery, 483, 484self-interstitial atom, 38self-interstitial point defect, 38self-similarity, 288, 638self-tapping implants designs, 522semi-brittle, 638semi-brittle processes, of polymerssemi-brittle solid, cleavage mechanisms in, 273semi-brittle system, 241, 269semi-constrained dynamic plates, 454semi-crystalline polymer, 98

having crystalline and amorphous domains, 98prediction of shift factors, 235schematic illustration depicting, 103uses of, 106

with glass transition temperatures well belowbody temperature, 105

semilunar valves, 479septal defects, 638septal occluders, 495, 496series network relationship, 217series representations, for relaxation behavior, 226sesamoid bone, 140severe stress, 287shape memory behavior, 63, 64, 634sharp cracks, 273, 288sharp fatigue crack, in UHMWPE, 279sharp flaws, central role of, 283sharp notches, 266shear banding, 275, 276shear cavitational fracture processes, 257shear forces, repetitive high-magnitude, 530shear modulus, 182, 638

of human dentin, 139relating strain, shear stress, and shear strain, 37solute atom locally altering, 47

shear plane, 41shear processes, deforming metals, 245shear strain, 169, 171shear stresses, 172, 173

common at interfaces, 291necessary to force dislocations between particles,

48plane of greatest, 247relationship with normal stresses, 179required for continued deformation, 45

shear, as mechanism for plastic deformation, 257shearing mode (Mode II), 291shift factor, 233, 234, 639short bone, 140short fibers, 202short implant survival, 525sigmoidal fatigue crack propagation plot, 351Significant Risk Study Protocol, 407Significantly Equivalent (SE), 510(k) application,

412Silastic (silicone rubber), 639

as TMJ implant material, 506compared to Proplast, 544introduction of, 534

Silastic HP sheeting, 534Silastic implants, widespread failure, 534Silastic TMJ disk, temporary, 534silica glass, 72, 74silicone breast implants, 561

more realistic feel and not prone to collapse, 586re-approved, 586removed from the biomaterials market, 93utilizing crosslinked form of silicone, 123

silicone elastomer, in place of a rubber one, 455silicone implant design, 123silicone polymersilicone, slippery during handling, 585silicones, 93, 122, 639silk, as suture materials, 124, 560Silly Putty, 212, 213


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673 Index

siloxane hydrogels, in contact lenses, 581siloxanes, see siliconessimilitude, see self-similaritySinclair, Upton, 399single craze, in a polymersingle crystal aluminum oxide (sapphire), 523single crystal orientation, regions of, 42single-stage surgery, 514single tooth crowns, cemented to the abutment, 525single-root implants, less likely to fail, 526singular region, 289singularity dominated zone, 289singularity stresses, extending beyond crack tip, 288singularity-dominated zone, 639sintering, 83, 639sinusoidal deformation, over a wide range of

frequencies, 227–30sinusoidal strain input, resulting stress response, 227sinusoidal stress displacement curve, 36skeletal fractures, incidence of, 446skeletal regeneration, of fractured bone tissue, 447skeleton, principal structural material of, 140skewness, 372skin, see artificial skinskin and blood vessel walls, 154–6skin

as largest organ in the body, 575cellular structure of the epidermis, 154functions of, 576layers of, 154, 575, 576mechanical properties of, 156

sleep away implant, 522slip, 639

atomic movement denoted as, 35defined, 28due to grain orientation mismatch, 45

slip plane, capturing motion of the dislocation, 39slip systems, 35, 36, 639slow crack growth, 351small-scale plasticity, 299–300, 312, 313, 639small-scale yielding, see small-scale plasticitysmall-scale yielding, conditions of 348S-N curve, generating, 335S-N fatigue data, for several polymer systems, 337S-N plots

for several polymer systems used in medicaldevices, 337

on linear-logarithmic scale, 336sodium chloride (NaCI) structure, as lattice of

sodium atoms, 72soft tissue biomaterials, 13soft tissue devices, future of, 588soft tissue repair, polymetric suture anchor

providing, 124soft tissue replacements

classifying materials used, 561in facial augmentation, 506materials used classified by chemical makeup,

562materials used classified by structure and device

area, 564

method for keeping them in place, 560schematics of material structures used in, 563types of, 560

soft tissueselastically blunting, 323exhibiting an initially low stiffness, 323

solid blocks, 561solid-solution strengthening, 45, 47, 639solute atom size, 47solution jet, stretched into a thin fiber, 157sp3 hybridization

facilitating four bonds, 95in carbon, 96

space fillers, 560spatial configuration in polymers, 95specific volume, as a function of temperature, 104spectrum loading, 331, 341, 639spheres, contact between two elastic, 376spherulite development, illustration of, 100spherulites, 99, 639spinal arthroplasty, clinical success of, 454spinal canal, 457, 639spinal column, composition of, 456spinal fixation designs, contemporary, 454spinal function, restoring, 459spinal fusion, 459spinal fusion procedure, performing, 453spinal implants, 453–62

clinical reasons for, 458cycles to failure for, 338–40design concerns in, 462designs, 460–1functional requirements, 459materials used in, 461Tresca stress, 248–9

spinal instrumentation, failure of pedicle screws,467–9

spinal rods, 639spine, 456

anatomy of, 456–7biomechanics of, 460degrees of freedom in kinematics of, 459medical devices used in, 453post-operative stabilization of, 469regions of, 456stresses of, 454

spine disorders, 458spinous processes, 453, 639spiral fractures, 449, 639spiral implant, schematic of, 521splint, 639splinted restoration, to a healthy adjacent tooth,

528split-thickness skin graft (STSG), 577, 639spongiosa, 479, 639spring, 217spring and damper elements, 230spring and dashpot, schematic showing, 216spring constant, of the bond, 11squeeze film lubrication, 379stability, addressing for knee replacement, 440


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674 Index

stabilization, of spine disorders and fractures, 453stabilized zirconia, fracture toughness test, 303stable crack propagation, 295, 316stable equilibrium, 295stainless steel alloys as material for fracture fixation

devices, 59used medical devices, 61

stainless steel total hip replacement stem, 347stainless steel(s) as implant materials, 26

chromium added to facilitate passivation, 57elastic modulus, yield strength and tensile

strength for, 61in medical implants for corrosion resistance, 61strengthening by cold working, 61

standard engineering materials, 169, 639standard linear solid (SLS), 639

as an improved Kelvin model solid, 222model, 222, 232

standard metal processing, categories of, 51standards development organizations (SDOs), 409,

639standards, defined, 408STARR Surgical IOL, 583Starr-Edwards Silastic Ball Valve, 486state of plane stress, 252static driving force (mean stress), 340static friction, 373statics, problems of, 130steam, high pressure, 8steel plates, as internal fixation devices, 26steel rods, in combination with wire to stabilize the

spine, 453steel(s)

concentration of interstitial carbon, 38having near identical elastic modulus values, 44heat treatment of low-carbon, 49

Steffee, Arthur, 469stem-neck design (modularity), contributing to

corrosion-induced fracture, 464stenosis, 486, 639stent characterization, non-clinical tests for, 486stent delivery, methods for, 483stent device, made of Nitinol, 352stent fracture, 499stent grafts, 491, 497–8stent(s), 483–6, 639

composition of, 485fully absorbable, 500improved testing, 500keeping arteries open better and longer, 483marketed in the United States, 485representative sample of, 485sizing as crucial, 483structural requirements of, 485

sterility, 8–9sterilization, 8, 639

methods, 3, 9, 10options, 8–9procedure, 126protocols, 7

stiff tissues, 323

stiffness evolution, in a viscoelastic biomaterial,224–6

storage modulus, 228, 229, 230, 231, 640stored energy component, 229strain

amplitude, 333complete equations for, 171definition of, 169–71definitions, 170enabling, 110equation, 171imposing equal across each element, 217in cortical bone, 186normal (ε), 640parameters used in defining types of, 170shear (γ ), 640types of normal (or extensional) strain, 169

strain energy, 250, 310basic form or, 250obtaining the total change in, 229

strain hardening, 640activated as dislocations interact, 45adding line defects, 45of metals and alloys, 40simple demonstration of, 46source of, 42

strain rate, 109, 640deceleration with increasing deformation, 236effect of increasing on stress-strain behavior, 111

strain response, of the Maxwell model, 218strain to failure, 27, 187, 640strain-based loading, 343–6strain-based tests, 334, 343strain-based total life philosophy, 344strength described, 284

designing for, 284strength of materials, 284, 640strengthening behavior, as a measure of strain

hardening, 272stress amplitude, 640

determining, 338increasing or decreasing, 333of loading cycle, 332relationship with number of cycles to failure,

337stress amplitude cycle (S-N) fatigue plots, 334stress and strain, local fluctuations in, 189stress concentration factor, 266, 267, 287, 640stress concentrations

cracks as extreme, 287–8in a ceramic system, 273locations of occurrence, 266

stress corrosion cracking, 640in a medical grade alloy, 59–60in device components, 59in metals, 17metals susceptible to, 330stainless steel susceptible to, 62

stress criteria, for crazing, 276stress distribution, in a total joint replacement, 276–9stress intensity, 357


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675 Index

calculating values of, 60for an embedded penny-shaped flaw, 293reaching critical value for material, 58

stress intensity factor (K), 60, 77, 288–91, 348, 640for a flaw, 78formula, 289of an edge-notched crack, 298overall, 293range, 351rewriting for individual loading modes, 292

stress intensity parameter, 349stress invariants used to describe the yield surface,

245utilized in fundamental failure theories, 245

stress matrix, components of, 259, 260stress power law, governing strain rate, 236stress range, 332, 640stress ratios, 279, 640stress relaxation, 210

accounting for, 19for the Maxwell model, 219in a polymeric implant, 221Maxwell model illustrating, 218

stress relaxation response, of the SLS, 224stress response, of the SLS, 232stress shielding, 167, 640

bone loss due to, 416Co-Cr prone to, 63defined, 329leading to bone resorption, 203

stress statescomplicated, 291components of, 173contained within the ellipse as safe, 253for pure shear, 258of an object, 173reduced to two dimensions, 259

stress tensor, 173–81, 640stress transformation, 173, 640stress triaxiality, 301stress(es), 640

ahead of plastic zone, 301at which plastic deformation begins, 36complex states of, 243decomposition of, 249definition of, 171–3distributing in the singularity region, 288finding the highest, 179imposing equal across each element, 217in several different sets of coordinate axes, 175in the Maxwell arm of the SLS during creep, 223loads resolved into, 10localization of, 266measured in Pascals [Pa] or pounds per square

inch [psi],partitioning into the Maxwell arm of the SLS, 223peak intensity of, 77sharing over time, 222–30upper limit of, 243versus cycles to failure (N) data, 335

stress-based loading, 334–7

stress-based test, 334stress-corrosion data, 59stress-induced transformation, of crystal structure,

80stress-strain behavior

of several polymers, 109, 110of the human artery, 193showing modulus of resilience, 243

stress-strain curves, 187–90area under, 626finding elastic, 189for a material undergoing necking, 189for brittle and elastomeric materials, 188for brittle and rubbery materials, 188for cortical bone, 193for skin and artery, 155, 194for tendon and ligament, 149in natural tissues, 191–3plotted data given, 190toe and heel regions of, 323traditional, 187

stress-strain response, 188, 228striation markings, 357Stribeck curve, 380, 384Stribeck, Richard, 380strip-yield zone diagram, 306strip-yield crack tip cohesive zones, 305–8strip-yield models, 308strip-yield shape, of the plastic zone, 307strip-yield zones, 307Strock brothers, 520stroma, 580, 640structural analysis, presuming implant materials to

be unflawed, 283structural aspects

of dental implants, 529–30of TMJ replacements, 538

structural components, as intrinsically flawed, 348structural discontinuity, magnitude of stress near,

266structural factors, determining elastic interaction

with a dislocation, 47structural implants examples of, 14

sustained loading of, 329structural layers, separated by a soft interspersed

phase, 323structural materials

fatigue behavior of, 354–7fracture mechanisms, 322–3under sustained loading, 333

structural medical ceramics, comparison ofmechanical properties of, 76

structural properties, for materials used in implants,14

structural relaxation effects, 210structural requirements, of medical devices, 6, 10–13structure-property relationships, 16–17strut fracture, 487

in a mechanical heart valve, 496in a stent, 498

Styker-Dacron implant, 572


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676 Index

submergible, 640submergible implant, 514submissions, types for medical devices, 404–8subperiosteal, 640subperiosteal dental implants, 513, 514, 515–18, 529subperiosteal framework, design of metal in, 516subperiosteal implant strut configurations, 517substantially equivalent, 640substantially equivalent device, 404substitutional solid solution, 47, 640sulcus, 511, 641Sulzer Inter-Op cupSulzer Orthopedics, recall, 467super saturated solid solution, creating, 48superelastic behavior, 63, 634superelastic traits, 64superficial tangent zone, 153superior, 641superposition

determining stresses individually, 291of G, 296–7

supersaturated solid solution, 47, 641Supramid, 585surface coatings, for fixation, 433surface contact mechanics, 375–7surface contact, in biomaterials, 386–7surface damage, for crosslinked UHMWPE used in

the hip, 463surface energy, 117, 641surface factor, as a function of ultimate tensile

strength, 347surface features, relative sizes of, 374surface finish, 641surface properties, 371surface roughness

controlled through processing, 372curve illustrating, 371of components, 346resulting from conventional machining, 347

surface topography, 371surface treatments, as a protective mechanism, 55surgeon, role of a good, 5surgeon’s knot, 569, 570surgical biomaterials, 13surgical interventions, for TMJ disorders, 533surgical meshes, reinforcing natural tissue, 412surgical tools, sterilizing, 8sustained loading, 331sustained loading cycle, mean stress of, 338suture anchors, 92, 124–5, 221, 641suture materials employed in biomedical implants,

230examples of, 124

sutures, 565–70, 641among earliest recorded medical devices, 560as Class II devices, 565clinical uses of, 565current designs, 565–8functional requirements of, 568–70physical characteristics of, 568polymers in, 94

properties of, 11with attached needle, 565with structures and suggested indications, 567

suturing, 560switchboard model, 100symmetric stress tensor, 249symmetry, special cases of, 185synovial fluid, 422

as example of a lubricant, 380drawing into tissue, 153penetrating articular cartilage, 379

synovial joint, 422, 641synovial membrane (capsule), covering the knee, 435synthetic biomaterials attributes and limitations of,

17–20designing an implant using, 130in load-bearing medical devices, 14

synthetic grafts, 490synthetic hydroxyapatities, elastic moduli of, 136synthetic ligament replacements concerns associated

with development of, 573search for a suitable, 561

synthetic ligaments, 570–5Class III devices, 574functional requirements of, 573not yet a good solution, 589

synthetic materials, 561categories based on structure, bonding, and

inherent properties, 13synthetic non-resorbable sutures, materials used, 565synthetic scaffolds, 573synthetic sutures, 565synthetic vascular grafts, 491

tailbone (coccyx), 456tan (δ), see loss factortangent modulus, 187, 641tartar, 641tartar-induced inflammation, of the gums, 510tearing instability, 316teeth, see toothTeflon, 478, 543Teflon products, 543temperatures, methods withstanding high, 9tempered martensite, 49tempering, 49, 641temporomandibular joint (TMJ), 509, 641

anatomy of, 509ankylosis, box-like stainless steel fossa for

relieving, 534articular surfaces, 538as weight-bearing joint, 542devices, refinements in surgical placement of, 545disorder (NIDCR), 532, 533functions of, 533implants, reclassification as Class III devices, 537in the OA, 532loading, 545malocclusion generating super-physiologic loads

on, 511mechanics, 506


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677 Index

prosthesis, Christensen’s early, 528registry, 545resultant forces on from masticatory loads, 538

temporomandibular joint (TMJ) replacements, 506,532–9, 545–6

clinical reasons for, 532–3contraindications for, 538disorders necessitating, 532first permanent, 534functional requirements for, 538historical development of, 533–8history of, 506medical indications for, 538placement of a partial or total, 533structural aspects of, 538

tendon(s), 148–51, 641as assemblies of bundled collagen fibers, 129as structures of discrete components, 151composition of, 148hierarchical structure of, 149high load-carrying ability, 149high proportion of Type I collagen in, 133protection from abrasion and wear, 149schematic showing relative deformation response,

150structurally in parallel with muscles, 151structure of, 149transition from compliant to stiff behavior, 151

tennis players, bone strength of the dominant arm,167

tensile force, 201tensile strength, 641

for elastic fibers, 134of a brittle material, 286of ceramics, 18of Co-Cr alloys, 63of collagen fibers, 133of cortical bone, 142of enamel, 138of human dentin, 139of most ceramic structures, 75

tensile stress, 172tensile stress-strain curve, for articular cartilage, 153tensile test, metrics derived from, 168tensile testing configuration, 242tension-compression stress-strain curve, 192test methodology, reporting all aspects of, 169test specimen, dimensions, 301testing standards anatomy of, 408–9

development of, 409–10from international standards development

organizations, 168tetrahedral site, 33, 641tetrahedron, geometry of, 31Thalidomide disaster, 400theoretical cohesive strength, 75, 641theoretical shear strength, 36–8, 75theoretical strength, for small displacements, 75theoretical value of strength, 75thermal expansion coefficient, 81, 82, 641thermal strains, 81

thermal stresses, 81–2thermal treatments, controlling grain size, 49thermal variation, experienced by dental implants,

81thermodynamic driving forces, 55thermoplastic polymer, 641thermoplastics, characteristics of, 113thermosetting plastics, 113thermosetting polymers, 112, 641thick specimen, plane strain and plane stress, 302thin-walled cylindrical pressure vessel, 257third degree burns, 576, 641third-order imperfections, 42thoracic spine, 456, 641three-dimensional Tresca yield envelope, 248three-dimensional hydrostatic stress, 257three-dimensional polymer networks, 95threshold regime, 351threshold stress intensity factor, 353thrombosis, in synthetic grafts, 491thrombus, 483, 641tibial, 641tibial components, in total knee arthroplasty, 241tibial plateau, 183, 184time power law, 235time, under a constant load, 319time-dependence, associated with a characteristic

time scale, 208time-dependent, 641time-dependent creep component, 361time-dependent fracture mechanics (TDFM),

318–20, 641time-dependent material behavior, 210time-dependent material properties, 210–12

describing viscoelastic materials, 208making design process more challenging, 209

time-dependent vanishing yield strengths, 318time-temperature equivalence, 233time-temperature superposition, 233–4, 642time-temperature-transformation (TTT) plot, for

steel, 50, 51time-varying stress, in the Maxwell element during

creep of SLS, 223tissue drag, 570, 642tissue engineering, creating a scaffold, 156–8tissue ingrowth, assuring valve placement is secure,

488tissue integration, available in ceramic systems, 85tissue microstructure, as predictive of material

response, 131tissue valves, 486

currently marketed in the United States, 489vulnerable to calcification, 487

tissue-engineering solutions, for TMJ disorders, 545tissues, see natural tissuestissues as viscoelastic solids, 213–14

building blocks of, 131–6characteristics of, 241fracture mechanisms in, 323hydrated to maintain function, 214load-bearing, 136–56


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678 Index

titaniumas a surgical material, 27elastic modulus compared to Co–Cr, 63forming an outer oxide layer, 18natural propensity for integration with bone, 63offering exceptional strength, 63osseointegrative properties of, 522pure existing as HCP structure, 63susceptible to corrosive wear, 383

titanium alloyselastic modulus, yield strength and tensile

strength for, 61in the fracture fixation industry, 453introduced into orthopedics, 418offering exceptional strength, 63specials surface treatments with, 18

Ti-6Al-4V, 63, 432titanium endplate-rubber core interface, failures

occurring at, 455titanium implant, Branemark’s original, 522titanium nitride, in an investigational device, 537TMJ, see temporomandibular joint (TMJ)toe regime behavior, 151toe region, 134, 149, 642tolerance, 642tooth

anatomically distinct regions, 507diagram indicating enamel and dentin, 138mineral responsible for stiffening, 135sections of, 136

tooth crown, 507, 508tooth enamel, see enameltooth loss, 510, 511tooth root

below the gum margin, 508schematic of, 508

Toronto Conference for Osseointegration in ClinicalDentistry, in 1982, 522

torsional loading, 256total artificial heart (TAH), 495total condylar knee

illustration of, 440in 1974, 439knee design founded upon, 439

total damage, 342total hip arthroplasty, 422–33, 435total hip replacements

components of, 424constituents of contemporary, 419design of, 429elements of a contemporary, 418endurance limit error, 347–8functional properties of components in, 425historical evolution, 416material properties summarized, 432path to market, 407–8showing porous coating in, 431utilizing an UHMWPE acetabular cup, 117

total joint arthroplasty (TJA), 421total joint replacements, 421–2, 642

causes for, 422

evolution in design and materials, 419failure rate, 422polymer sleeve assisting with bone ingrowth in,

202stress distribution in, 276–9use of composites in, 390

total knee arthoplasty, 435–46design concerns, 446materials used in contemporary, 443–6

total knee reconstruction, in mid-20th century, 437total knee replacements design of, 443

functional properties of components, 444functional requirements of components, 443

total life approximation for a femoral stem, 340–1using the Goodman equation, 341–2

total life design methodology, 333total life philosophy, 334–7, 642total life tests, specimens utilized in, 335total strain amplitude, of the fatigue cycle, 344toughening ceramics, in engineering applications,

322toughening mechanisms classifications of, 354

types of, 320utilized in ceramic structures, 80utilized in ceramics, 79

toughness, of polymer structures, 106trabeculae

arrangement of, 144beam or plate-like behavior of, 146excessive remodeling of in old age, 144in vertebrae, 145orientation coordinated, 145

trabecular bone, 143–8, 642architecture of, 130cellular structure of, 144composition of, 144coral as a substitute for, 89dependence on porosity and trabecular

architecture, 147dominant orientation of architecture of, 145exhibiting different architectures, 145increased surface area of, 144macroscopic mechanical performance of, 148mechanical behavior of, 145network structure of, 145open network structure of, 146relationship between ultimate tensile strength and

porosity, 148structural performance of, 148structure, schematic of, 144

traction vector, defining, 172Transcyte silicon membrane, 577transformation toughened ceramic, 80transition region, 210transition time, viscoelastic transition around, 233transmucosal, 642transmucosal abutments, 513transparency, of PMMA, 119transverse fracture, 449transverse isotrophy, 185, 186, 642transverse plane, 642


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679 Index

transverse processes, 457, 642transverse testing, of cortical bone, 142Trapeziodal-28 (T-28) hip stem design

failure mechanisms of, 362failures of, 426

trauma, 424, 642trephine, 520, 642Tresca stress, 248–9Tresca yield criterion, 293

determining effective stress, 338developed for a plane stress state, 247expression for, 248for a stress state, 256shear stress needed for plastic deformation,

258Tresca yield surface, 247Tresca, Henri, 243Trevira/Hochfest ligament augmentation device,

572, 573triaxial stress state, 258tribology, 369, 642tricuspid valve, 479tripod blade-form ramus frame implant, 519tripodal subperiosteal implants, 517trobocollagen, 642tropocollagen molecules, 132true EPFM conditions, 314true material properties, 320true strain, 191, 642true stress, 191, 642true stress and strain compared to engineering stress

and strain, 192realistic picture of deformation behavior, 205

true stress–strain behavior, 242trunnion, of femoral shaft, 429truss-like frameworks, with strategically placed

struts, 516turbostratic carbon, 84, 642turbulent flow, reduction of, 488twisting or tearing mode (Mode III), 291two-dimensional polymer systems, weak van der

Waals forces, 95two-stage surgeries, adoption of, 522two-stage surgery, 514Type I collagen, 132Type II collagen, 132Type III collagen, 132Type IV collagen, 133Type IX collagen, 132Type V collagen, 133Type VII collagen, 132Type XI collagen, 133Type XII collagen, 133Type IX collagen, 133

UHMWPE, see ultra-high molecular weightpolyethylene (UHMWPE)

ultimate strainfor elastic fibers, 134of tendon and ligament, 150

ultimate strength, of metals, 27

ultimate tensile strength (UTS), 150, 187, 642ultra-high molecular weight polyethylene

(UHMWPE), 117, 642acetabular cup, delamination of highly

cross-linked, 462–3as bearing material, 417as polymer of choice for acetabular cups, 432bearing components in total hip replacements,

284bearings, wear in total joint arthroplasty, 237components sterilizing with EtO or gas plasma

methods, 21delamination wear of, 21fatigue crack propagation data for, 361good wear properties, 390highly crosslinked form of, 428in a constraining frame of Co–Cr, 183in total joint joint reconstruction, 225in total joint replacements, 93master curve correction factors for, 225master curve for, 236, 237material properties, 432mechanical characterization of, 361medical grade, 117poor oxidation resistance of, 20, 22subsurface fatigue fracture (delamination) of,

442tibial knee component, oxidation of, 21

uniaxial yield strength of, 254MPa, 254

umbilical vein, 478, 490, 642umbilical vein homograft, 490unhealthy contact, leading to pain and tissue

damage, 369uniaxial elastic deformation, of an isotropic

material, 181uniaxial fibers, 201uniaxial load, bar placed under, 171uniaxial loading analysis of, 175

as not a typical stress state, 255uniaxial stress, 12uniaxial stress state, in an isotropic ductile material,

256uniaxial tensile test, 241uniaxial tension, bar under, 172uniaxial yield strength, 249, 251uniaxial yield stress, 241, 255unicompartmental designs, 438unicondylar, 642unicondylar knee arthroplasty, 437unicondylar knee implants, 437unidirectional composite, example, 19unidirectional fiber composite, 20uniform attack, 643uniform attack mode of corrosion, 55, 56United Kingdom, Medicines and Healthcare

products Regulatory Agency (MHRA),410

upper bound elastic modulus, 19upper thoracic spine, 454US Pharmacopeia, 569


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680 Index

vacancies, 39vacant lattice site, 38VADs (ventricular assist devices), 495valence state, increase of during corrosion, 55valgus, 643valgus (knock-kneed) alignment, 436valleys, as lubricant reservoirs, 372valve design, requirements in, 488valves, in the heart, 479valvular disease, 477, 643van der Waals forces, 95, 643vanadium steel, 417, 643variable amplitude loading, Palmgren–Miners rule

for, 343varus, 643varus (bow-legged) knees, 436vascular, 643vascular grafts, 489–91

evolution of materials selection for, 478options, 490representative sample of, 492showing a range of diameters, 492

vascular implants, development of, 156vascular replacement, creating a trilaminate, 157vascularization, 88, 643vasculature, interruption of the local, 447vector components, within the lattice, 34veins, 481, 643venous homografts, 490venous ulcers, 575, 643vent-plant implants, 522ventricles, 479, 480, 643ventricular assist devices (VADs), 495ventricularis, 479vertebra

constituents in individual, 457individual illustration of, 457stacked upon each other, 456

Vesalius, Andreas, 129viscoelastic, 233, 643viscoelastic (glass) transition temperature, 210viscoelastic behavior, 210, 214viscoelastic bodyviscoelastic fracture mechanics (VEFM), 319–20,

643viscoelastic materials, 208, 212viscoelastic model, 214viscoelastic nature, of most polymersviscoelastic response, 223viscoelastic solids, 209, 213–14viscoelastic transition, 210, 643viscoelasticity, 109, 643

described, 209introduction to, 209–14of polymers, 19

viscous (fluid) behavior, 109viscous dissipation, 229, 318viscous loss component, 229viscous solids, differing from inelastic solids, 318Vitek, failed in responsibilities to rigorously test, 543Vitek-Kent PT prostheses, 537, 542

Vitek-Proplast I prostheses, failure rate, 544Vitredent (company), 540Vitredent Tooth Replacement System, 542Vitredent vitreous carbon root-form dental implant,

541vitreous carbon

as a potential dental material, 540biocompatibility of implant materials, 540forming, 540

vitreous carbon implantsdismal performance of, 542failure of, 540–2

vitreous carbon Tooth Replacement System, 541VK glenoid fossa component, 536VK implants, showing particulate debris, 544Volkmann’s canals, 141, 643volumetric expansion, for dental implants, 82volumetric thermal expansion, estimating, 82von Helmholtz, 130von Meyer, 130von Meyer, Herman, 146von Mises effective stressvon Mises ellipse yield surface, schematic of, 252von Mises ellipse, circumscribing the Tresca

hexagon, 253von Mises stress effective, 251, 253–5, 260, 290

finding, 254large sub-surface, 442

von Mises yield criteria, 251, 260better matching experimental data, 253capturing complete loading, 261for stress state, 256, 258indicating required shear stress, 258modified, 264modifying, 263writing in general stress component terms, 252

von Mises yield envelope, 253, 254von Mises yield spacevon Mises, Richard, 243vulcanizing, to the titanium plates, 455

water, in articular cartilage, 151wax prototype, 52wear, 381–6, 643

abrasive, 643adhesive, 643as situational, 391contact fatigue, 643corrosive, 643delamination, 643erosive, 643for any long-term implant problem, 370fretting, 643in a clinical setting, 237mechanism resulting in lamellar alignment in

UHMWPE, 427properties at expense of fracture properties, 429rates, 237stages of, 381types of, 381

wear bearings, highly resistant, 424


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681 Index

wear debris, see also particulate debris, see alsocorrosion debris

wear debrisfrom fretting wear, 385generation of, 369particles invoking inflammation response, 381setting off inflammatory cascade, 370

wear resistanceimproved by enhanced lubrication schemes, 237paramount for kneereconstruction, 11

wear simulators, 389wear testing, standardization of, 370

wide variety of test methods, 389wear-induced osteolysis, associated with loosening,

427wedge-shaped cohesive zone, for a propagating

crack in UHMWPE, 305wedge-shaped plastic zone crack in tip zone, 305weight average molecular weight, 107, 109, 643wet precipitation techniques, 84Wetherill, Charles M., 398white blood cells, 482Wiles, Phillip, 417Wilkes, Clyde, 534Williams, Landel, and Ferry (WLF) equation, 234–5wire methods, of fixation, 453wires, 450, 644WLF equation, 234, 644wound healing technologies, 575woven or knitted materials, 561wrought cobalt-chromium based steels, used in

orthopedic bearings, 47wrought Co-Cr, in hip arthroplasty, 432wrought steel, 47, 644

xenografts, using bovine vasculature, 478xenograft, see heterograftXL-UHMWPE acetabular liners, fracturedx–y plane, of an infinitesimal element, 175

yield behavior, of polymer systems, 274yield criteria, 243, 261, 263

yield envelope, for the plane stress case, 253yield strain, occuring under uniaxial yielding, 345yield strength, 15, 36, 187, 644

higher, 42information given by, 205normalizing with effective stress, 255of a material, 243of cobalt-chromium, 62of Co-Cr alloys, 63value for a metal, 38

yield stress, 243as a function of grain size, 44as failure criteria, 340calculated for uniaxial loading, 256for 316L stainless steel, 363in compression, 263in tension, 263increasing with increasing strain rate and

decreasing temperature, 111measured in uniaxial tension, 251

yield surfaces, 244–5, 644boundary of, 247for a planar (two-dimensional), 245overlay of von Mises and Tresca, 253

yield, in multiaxial loading conditions, 255–61yielding

criterion in metals based on shear stresses, 42occurring with maximum distortional energy, 249occurrence of, 249onset of, 243

Young, Thomas, 130Young’s modulus, 134, 181yttria-stabilized zirconium oxide, 523

z-direction, neglecting stresses acting in, 259Ziegler-Natta catalysts, 99, 644zirconia

properties of, 86used as a bearing material, 80

zirconia implants, manufacturers of, 524zirconium oxide, newer devices adopting, 506zone of HRR singularity, 312zone shielding, 320, 355


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