By Harry Skinner
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Additional resources for Current orthopedics
However, it is well known that muscles immobilized in a lengthened position increase the number of sarcomeres in series, leading to the longitudinal growth of the fiber. In contrast, immobilization in a shortened position reduces the number of sarcomeres in series and results in a shorter muscle fiber. Hence, such manipulations have the potential for influencing the overall lengthâ tension relationships of muscle fibers and whole muscles. Clearly, contractures may have a large effect on the number of sarcomeres in series and result in various clinical complications such as equinus contractures.
For instance, ceramics are characterized by a high elastic modulus but are extremely brittle. In contrast with ceramics, metals have a lower elastic modulus but demonstrate increased ductility. Figure 1â 22. 37 38 Representative stressâ strain curves for the classes of materials used in orthopedic implants. The most commonly used biomaterial combinations for orthopedic joint replacement are metals and metal alloys articulating with ultrahigh-molecular-weight polyethylene (UHMWPE). Stainless steel, an iron-based alloy, was used in Charnley's original hip prosthesis and is the material most commonly used for internal fixation plates, rods, and screws.
Titanium-based alloys have an adherent oxide passive film layer that provides their corrosion resistance. The surfaces of all metallic implants are passivated (made passive to corrosion) with nitric acid to form an oxide surface layer that increases corrosion resistance. Fatigue corrosion may occur, however, if this passive film layer on the implant surface was scratched or cracked and does not self-passivate in vivo. The ability to self-passivate may be hindered by wear processes or micromovement between modular components, a process called fretting.