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Fraunhofer Develops a Ceramic Resurfacing Prosthesis for the Hip Joint

Friday, February 12, 2021

Hip joint operations are one of the most common procedures at German hospitals. In fact, according to Germany’s Federal Statistical Office, approximately 220 000 artificial hip joints are implanted each year, generally due to accidents and the wear typically experienced by older people.

An alloy consisting of cobalt, chromium and molybdenum is one of the most common materials used. However, metal abrasion often leads to issues such as the dreaded condition metallosis, with the patient ultimately suffering from irritation, allergic reactions, infections or even pseudotumors. Metal ions can also be detected in blood and tissue. If worst comes to worst, the patient may have to undergo another operation and have the prosthesis removed. An innovative resurfacing prosthesis based on ceramic is much more biocompatible, as ceramic does not cause any allergic reactions or infections. The prosthesis was developed by the Fraunhofer Institute for Ceramic Technologies and Systems IKTS as part of the Ceramic Bonepreserver joint project, a collaboration with medical devices manufacturer Mathys Orthopädie GmbH. In addition to high biocompatibility, the metal-free resurfacing prosthesis also offers further benefits. “The ceramic resurfacing prosthesis enables bone-preserving endoprosthetic reconstruction of the hip joint,” explained Project Manager Martina Johannes of Fraunhofer IKTS at the Hermsdorf location.
This innovative resurfacing prosthesis is a combination of femoral cap and monobloc acetabulum. During the surgery, the femoral cap is implanted into the femur, and its counterpart, the acetabulum, anchored in the hip bone. The surfaces that will ultimately be enclosed by bone are structured to improve bone cell adherence. In contrast, the contact area of the artificial joint between the acetabulum and ball element of the femoral cap is completely smooth to enable effortless and seamless movement of the leg.
Fraunhofer IKTS has many years of experience in the production and processing of ceramic materials, including the forming process used in medical engineering, where requirements in terms of precision and reliability are especially high. Martina Johannes’s team has further optimised the process steps for the Ceramic Bonepreserver project. In the first step, the procured ceramic materials – aluminium oxide and zirconium dioxide – are finely dispersed. Using this as a basis, the researchers create an ultrapure suspension. The particles need to be evenly distributed in the suspension to ensure the quality of the final product, which needs to be entirely free of any pores, impurities or other defects. Medical implants must be free of any flaws. The acetabulum is then formed using the slip casting process, a method that is common in traditional porcelain production and was further developed at Fraunhofer IKTS.
The products achieve their final properties during the sintering process, which is the last step. With sintered Alumina-Toughened Zirconia (ATZ) dispersion ceramic, a structure featuring a grain size between 310–320 nm was achieved. By comparison, the very fine coffee grounds used for espresso have a grain size of 250 μm, which is around 1000 times larger. Martina Johannes’s Working Group is certified in accordance with the EN ISO13485 standard for the production and development of medical engineering materials and components and thus undergoes stringent testing by on a regular basis. Fraunhofer researchers have conducted a range of tests to determine just how robust and stable the material is. “Bending, pressure and load tests have revealed that the ceramic prostheses are at least as stable and robust as a product made from metal. The result is resurfacing prostheses that demonstrate longer usability and are well tolerated by people,” said Martina Johannes. The Ceramic Bonepreserver joint project was completed in September 2020 and supported by the German State of Thuringia with EUR 800 000.