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Background The probability of in vivo failure of ceramic hip joint implants is very low (0.004-0.05%). In addition to material flaws and overloading, improper handling during implantation can induce fractures of the ceramic ball head in the long term. Identifying the causes of an in vivo fracture contributes to improved understanding and potentially to further reduction of the fracture probability for patients. Asymmetric metal markings on the cone surface of in vivo ball head fractures have been reported. The question, therefore, is whether asymmetric loading is the sole cause or whether additional factors, specifically contamination entrapped in the taper fit, also contribute or are even the main cause. Methods The influence of the asymmetric physiological load configuration on resulting metal markings in the cone surface of an alumina femoral ball head with and without biological contaminants was investigated. Static and cyclic tests on ball heads were carried out in a load configuration of 0° (axisymmetric) and 40° in a physiological environment. The analysis of the metal marking was carried out to gain a better understanding of the processes that contribute to the generation of metal marking. Fractography was carried out to determine the fracture initiation of failed ball heads. Results Different types and sizes of residuals entrapped in the conical surface are shown to yield strongly asymmetric metal marking patterns. All heads tested without contaminants exhibited an almost homogenous distribution of residual metal markings around the circumference of the ceramic cone surface at the proximal end of the bore hole. The failure of ball heads that contained entrapped contaminants revealed a common fracture pattern. The site of fracture initiation on two of the failed heads was in the entrance region of the bore hole on the superior half of the head. Conclusion Asymmetric metal markings observed on the ball heads tested in this investigation are most probably caused by the presence of contaminants entrapped in the taper fit. Homogenous metal mark distributions around the circumference indicate proper assembly of the ball head without entrapped contaminants. It should, however, be noted that different taper designs may possibly result in different marking patterns.

PurposeConventional press-fit technique for anterior cruciate ligament reconstruction (ACLR) is performed with extraction drilling of the femoral bone tunnel and manual shaping of the patellar bone plug. However, the disadvantages of this technique include variation in bone plug size and, thus, the strength of the press-fit fixation, bone loss with debris distribution within the knee joint, potential heat necrosis, and metal wear debris due to abrasion of the guide wire. To overcome these disadvantages, a novel technique involving punching of the femoral bone tunnel and standardized compression of the bone plug was introduced. In this study, the fixation strength and apparent stiffness were tested and compared to that of the gold-standard interference screw fixation technique in three flexion angle configurations (0°/45°/90°) in a porcine model. We hypothesized that the newly developed standardized press fit fixation would not be inferior to the gold standard method.MethodsSixty skeletally mature porcine knees (30 pairs) were used. Full-thickness central third patellar tendon strips were harvested, including a patellar bone cylinder of 9.5 mm in diameter. The specimens were randomly assigned to 10 pairs per loading angle (0°, 45°, 90°). One side of each pair was prepared with the press-fit technique, and the contra-lateral side was prepared with interference screw fixation. Equivalent numbers of left- and right-sided samples were used for both fixation systems. A three-way multifactor ANOVA was carried out to check for the influence of (a) fixation type, (b) flexion angle, and (c) side of the bone pair.ResultsThe primary fixation strength of femoral press-fit graft fixation with punched tunnels and standardized bone plug compression did not differ significantly from that of interference screw fixation (p = 0.51), which had mean loads to failure of 422.4 ± 134.6 N and 445.4 ± 135.8 N, respectively. The flexion angle had a significant influence on the maximal load to failure (p = 0.01). Load values were highest in 45° flexion for both fixations. The anatomical side R/L was not a statistically significant factor (p = 0.79).ConclusionThe primary fixation strength of femoral press-fit graft fixation with punched femoral tunnels and standardized bone plug compression is equivalent to that of interference screw fixation in a porcine model. Therefore, the procedure represents an effective method for ACL reconstruction with patellar or quadriceps tendon autografts including a patellar bone plug.

Empa’s research efforts in the 1990s provided evidence that a considerable increase of the fatigue strength of welded aluminum beams can be achieved by externally bonding pultruded carbon fiber reinforced polymer (CFRP) laminates using rubber-toughened epoxies over the fatigue-weak welding zone on their tensile flange. The reinforcing effect obtained is determined by the stiffness of the unidirectional CFRP laminate which has twice the elastic modulus of aluminum. One can therefore easily follow that an unstressed CFRP laminate reinforcement of welded beams made of steel will not lead to a substantial increase in fatigue strength of the steel structure. This consideration led to the idea of prestressing an external reinforcement of the welded zone. The present investigation describes experimental studies to identify the adhesive system suitable for achieving high creep and fatigue strength of the prestressed CFRP patch. Experimental results (Wöhler-fields) of shear-lap-specimens and welded steel beams reinforced with prestressed CFRP laminates are presented. The paper concludes by presenting a field application, the reinforcement of a steel pendulum by adhesively bonded prestressed CFRP laminates to the tensile flanges of the welded box girder. Inspections carried out periodically on this structure revealed neither prestress losses nor crack initiation after nine years of service.