PubMed · 9769060
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M A Ritter. 1998. Common litigation problems: dueling with the devil.. https://doi.org/10.3928/0147-7447-19980901-44
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An autopolymerizing fracture-toughened acrylic lute was developed utilizing a toughened prepolymer and a gel-polymerization method. Samples for mechanical and chemical characterization were molded from this material and from untoughened controls. Mechanical testing showed that the mode I fracture toughness (K(IC)) of the toughened lute was increased by 163% over that of the untoughened acrylic controls while the compressive strength and modulus were decreased by 36% and 34%, respectively. The flexural properties of the experimental material were not adversely affected. Analysis of molecular weight and residual monomer data for the experimental and control materials demonstrated that the increase in toughness was due to the presence of the toughened prepolymer. The use of the gel polymerization process gave excellent homogeneity with very low porosity for the experimental polymer, but it resulted in a significant increase in the residual monomer concentration due to the absence of a dispersed phase of prepolymer remnants. This raises questions concerning tissue response to the experimental system.
Advances in our knowledge of multifactorial host-biomaterial interactions have improved the outcome of joint replacement surgery. Fixation and aseptic loosening are the principal foci of research. Wear debris from articulating parts is a major cause of prosthetic loosening. Tri-biological analysis, and the development of new materials and surface finishes have reduced wear particle production. The use of modular implants increases flexibility and facilitates surgical fit, but also introduces new problems such as dissociation of components, corrosion and wear. In the future, as design, biomaterials and surgical technique become further optimized, arthroplasty may also become an alternative for use in younger patients.
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