2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)
3D Printed Carbon Fibre Composite Knee and Hip
Replacements
Bradford Milne1, Xiaowen Yuan1*, Andrew Kvalsvig1, Peng Cao2
1
School of Engineering & Advanced Technology, Massey University
2
Department of Chemical and Materials Engineering, University of Auckland
Auckland, New Zealand
*
xw.yuan@massey.ac.nz
Abstract — This paper reviews current research on the
design, processing and finite element analysis (FEA) of bone
implants for the human body. The feasibility of producing carbon
fibre composite implants, in particular knee and hip
replacements which are common bone replacements by 3D
printing, is discussed. The relationship between design and
material requirements is elaborated.
Keywords— 3D printing; bone implant; FEA analysis
I. INTRODUCTION
An increase in the number of hip and knee replacements
has been the trend in the past decade. Around twenty to thirty
years ago, the majority of hip and knee replacement patients
were older than seventy years but now it is very common for
patients to be as young as twenty-five years old. It is possible
for hip replacement surgery to be undertaken by patients under
25. So, with the increase in the demand for bone replacements,
the demand for the supply of replacement parts is also
increasing.
Technology around the world is making great advances
with 3D printing growing greatly since it was first introduced
in the 1980’s. Markforged, a 3D printing company, has made it
possible to produce fibre reinforced composite parts using
nylon as the matrix and a range of fibre materials for the fibre
reinforcement. The composite parts that this printer can create
maintain very good mechanical properties, such as high
strength-to-weight ratio and high tensile strength. These
mechanical properties make it suitable to be used for
manufacturing bone prosthetics in the human body.
The possibility arises for an improvement on current bone
implants by producing 3D printed nylon and carbon fibre
composite bone implants. There is very large market for bone
replacement, with around 773000 Americans having had hip or
knee replacement in 2009 [1]. A commercial 3D printer
capable of making carbon fibre composite parts is a very recent
piece of technology and has only been around for the past
couple of years. So, there is very little information on the
mechanical properties of such a fibre composite material. The
basis of this paper is to demonstrate the feasibility of using a
3D printed carbon fibre composite part in the human body.
Different tests such as tensile strength and FEA analysis have
been conducted to demonstrate the mechanical properties of the
material and how it may be implemented. The Mark One 3D
printer has certain fibre and nylon parameters which can
978-1-5090-6546-2/17/$31.00 ©2017 IEEE
change the structure of the part. The tests completed show the
best possible combination of parameters to produce the
strongest possible part. The strongest combination of
parameters can then be implemented into the final bone
replacement.
The bone is living and growing tissue [2] in the human
body, mostly made of collagen. The bone isn’t uniformly solid
and instead consists of a rough matrix. This rough matrix
makes up about 30% of the bone. The remaining 70%
provides strength and is made of salts. The matrix is made
from around 5% ground substance and between 90%- 95%
collagen fibres. The ground substance is an amorphous gel-
like substance surrounding the cells. The primary portion of
the bone known as osseous tissue, is quite hard and
lightweight. The matrix consists of mostly a composite
material which involves the inorganic mineral calcium
phosphate in the arrangement termed calcium hydroxyl apatite
(this mineral gives bone its rigidity) and collagen, an elastic
protein which improves fracture resistance [3]. When humans
become older and older, their bones become less dense and the
bone strength decreases. This indicates that they are more
vulnerable to fracture in the later years of life. Therefore, it is
more common that most types of bone replacement surgery
occurs in the elderly. Table I shows Young’s Modulus for
various bone constituents.
TABLE I. – Young’s Modulus of Bone [4]
Bone Material Young’s Modulus, E (GPa)
Collagen(dry) 6
Bone Mineral (Hydrooxyapatite) 80
Cortical bone, longitudinal 11-21
Cortical bone, transverse 5-13
Bones are subjected to bending moments during normal
loading. These bending moments create both tensile and
compressive stresses in different regions of the bone. Different
bones have different functions, so there is a large variation in
strength required for them to function. Table II shows the
range of tensile and compressive strength values of bone in the
human body.
In total hip arthroplasty or total hip replacement the
damaged bone and cartilage is removed and replaced by an
artificial component. The femoral head is taken out and
 2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)

replaced with a stem-like prosthetic which is placed into the

hollow center of the femur bone [4]. TABLE III - Minima/Maxima within whole loading cycles. a/b =
highest/lowest values from all activities [6]
TABLE II.– Tensile strength of bone [4] Stand Sit Stairs Stairs
Walking Jogging
Up Down Up Down
Longitudinal direction Transverse direction Force: 472/157 442/10 379/11 329/10
265/837b 311/1241
Tensile Strength Fx (N) 8a 02 64 85
60 - 70 ~50 -
(MPa) Force: -541/- -855/-
Compressive Strength -536/24 -1222/-21 -612/70 1067a/-
70 - 280 ~50 Fy (N) 88 78
(MPa) 68
Force: - 753/348 728/27 558/ 405/36
235/2709b 229/4519
Fz (N) 0 09b 3876a 62
A total knee joint replacement or total knee arthroplasty is
an operation that removes a severely impaired knee joint and
The hip is also subjected to other loads during normal body
replaces it with an artificial replacement of that same joint.
function. There are forces which act towards the patellar and
The goal of this surgery is to restore motion and function to
the quadricep muscle of the leg as a knee flexes. These forces
the joint. A basic knee replacement is where the knee cap and
create a reaction force represented by the big arrow in Fig. 2.
all the bones around have been replaced [4].

II. MECHANICAL LOADS AND STRESSES OF A KNEE AND HIP

JOINT
Both the knee and hip joints have different applied loads
associated with normal body function. This can include
anything from walking to bending the knee. These applied
loads are vital to the development of a carbon fibre composite
substitute.

The hip has many different loads applied to it. This can be
represented in a co-ordinate system in Fig. 1 which shows that Fig. 2 - Knee Force Diagram [7]
the main bone that is involved is the femur.
Table IV demonstrates this reaction force for different
A range of tests have been done to demonstrate the forces activities. This reaction force acts as a compression force
during some common activities. This included sit down/stand against the bottom of the femur bone as you can see in Fig. 4.
up movements, knee bend squat, walking, walking up and
down stairs and jogging. The forces are shown in Table III. TABLE IV - Reaction force related to activity in knee joint [7]
These values are very useful as they represent values in which Activity Force (N) %Body Weight
a hip replacement made from a carbon fibre composite need to Walking 850 1/2 x BW
Stair Ascend 1500 3.3 x BW
withstand to be a successful implant. This table provides the Stair Descend 4000 5 x BW
loads in the X, Y and Z directions with respect to the femur Jogging 5000 7 x BW
and maximum and minimum values for loads that the femur Squatting 15000 7 x BW
experiences during such activities.

III. MATERIAL REQUIREMENTS

The material requirements of the 3D printed carbon fibre
composite part are that the material must suit the area of bone
that it is replacing. The carbon fibre composite material must
replicate the properties of the bone replaced as closely as
possible for the area to maintain its original function. The
basic mechanical properties a bone implant material must have
included:
• Biocompatibility in the human body
• Elastic Modulus
• Hardness
• Tensile strength
• Compression Strength
• Fatigue

Fig. 1 - Load and Moment Co-ordinate system [5]

 2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)
Biocompatibility – This is the capability of the carbon
fibre composite material being implanted without the human
body reacting to it and causing any kind of harm biologically.
Elastic Modulus – This would be a value given to the
carbon fibre composite to represent its stiffness.
Hardness – is a measure of how resistant a carbon fibre
composite implant would be to permanent shape change due to
a compressive force being applied.
Tensile strength – is the capacity of a material or a
structure to withstand loads that tend to elongate it. In context,
the elongation properties of the carbon fibre composite
material as it fails.
Compression Strength – is the capacity of a material or a
structure to withstand loads that are of compressive nature
reducing the materials size. In context, the compressive
capabilities of the carbon fibre composite material.
Fatigue – A material fatigue is a phenomenon where the
structures fails when subjected to a cyclic load. In context, the
period until a bone implant made from the carbon fibre
composite part fails due to fatigue.
A. Knee Replacement
The replacement knee joint is made up of a flat metal plate
and a stem implanted in the tibia, a polyethylene bearing
surface and a contoured metal implant fit around the end of the
femur. Materials which are used for knee implants are:
Stainless Steel - Stainless steel has a very limited ability to
withstand corroding in the human body for a long period.
Therefore, it is not often used. That is why it is normally used
as a temporary implant with fracture plates and screws[8].
Cobalt-chromium alloys - This material demonstrates hard,
tough, corrosion resistant, biocompatible qualities. Alongside
titanium, cobalt chrome is one of the most widely used
materials used in knee implants. There are a very small
number of patients that have allergic reactions related to the
use of cobalt-chromium. One area of concern is the problem of
small particles (metal ions) that may be released into the body
because of joint movement [8].
Titanium and Titanium alloys - Pure titanium is typically
used only where high strength is not necessary. Titanium
alloys are bio-compatible and are very corrosion resistant,
making them inert biomaterials (which means they will not
change after being implanted in the human being). Acts more
like a natural joint due to its lower elastic nature [8].
Uncemented implants - Knee implants are either cemented
or cement less. This depends on the type of fixation used to
hold the implant in place. Uncemented designs rely on bone
growth into the surface of the implant to keep it in place [8].
Polyethylene - The tibial and patellar components in knee
replacements are made of polyethylene. Standard polyethylene
surfaces traditionally suffer from wear in hip replacements,
wear is less of a problem in knee replacements as the bearing
surfaces are flatter and do not result in the same kind of wear
[8].
B. Hip replacement
Currently, there are several hip implants that are made
from different materials. Each manufacturer creates different
styles of models. These styles can be put into one of the
following categories:
• metal on plastic (polyethylene or UHMWPE)
• metal on metal (MoM)
• ceramic on plastic (UHMWPE)
• ceramic on ceramic (CoC)
The stem and ball fit into and articulate against the cup.
Each component can be made of one of several materials:
Metal on Plastic (Polyethylene) - This type of hip
replacement is the longest tried and tested. The convex
femoral stem is constructed of metal (usually cobalt chrome
alloy) and the concave socket liner is made of a plastic called
polyethylene. It is very durable and has been used since early
hip replacements in 1960 [9].
Metal on Metal - This type of hip replacement has been
used longer than metal on plastic. Metal on Metal bearings
(cobalt chromium alloy, titanium alloy or sometimes stainless
steel) were in use as far back as 1955. They offer the potential
for greatly reduced wear and less bone inflammation [9].
Ceramic on Ceramic - This is good for very active patients.
Ceramic on ceramic is a good combination with longevity and
reliability. There have been issues with the ceramics shattering
and squeaking [9]. This hip replacement type has been
improved and has eliminated this problem. Ceramic is the
hardest material used in the body and has the lowest wear rate
[9].
Ceramic on Plastic - This is the most expensive type of hip
replacement. It has the best wear rate, about 50% less than
metal on plastic due to the interaction between ceramic socket
and metal stem [9].
IV. DESIGN OF HIP REPLACEMENT AND KNEE REPLACEMENT
The hip replacement consists of a socket part and a ball
and stem part. In Fig. 3, a hip replacement has been designed
for this research. The hip replacement needs to follow some
specific rules. The neck to shaft angle needs to be around 130
degrees and the ante version angle needs to be around 12
degrees [10]. This is important to the motion of the hip and the
muscles around it. The size of the replacement depends on the
patient.
 2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)
Fig. 3 - Created Hip Replacement Design
The knee replacement consists of three typical parts, a
femoral component, plastic spacer and a tibial component. The
femoral component is made to curve around the end of the
femur, the tibial component is slotted into the tibia bone and
the plastic spacer holds both parts together allowing the
femoral component to slide across its surface for knee like
motion. The dimensions depend on the patient’s original bone.
The curvature of the top femoral component is designed to
produce the same knee bend as before. This is demonstrated in
a design for a knee replacement shown in Fig. 4.
Fig. 4 - Created Knee Replacement Design
FEA analysis shows the areas of the bone and bone
implants that are weakest. This will be significant in setting
the parameters for the bone implants printed because it shows
the exact areas which require strengthening.
In Fig. 5 the analysis of young modulus on a femur bone is
exhibited. It demonstrates that the bone is more rigid in red
areas of the femur bone in the figure. It demonstrates that a
bone implant needs to be designed stronger in these areas.
Fig. 5 - Young’s Modulus Analysis of Femur Bone [4]
Fig. 6 shows that the most force or strain is applied to the
yellow areas for the hip replacement. These areas must be
strengthened to produce a stronger and more durable part.
Fig. 6 – Hip Replacement strain diagram
In Fig. 7 the most strain is demonstrated in red areas of the
knee replacement. These red areas will require more
strengthening.
Fig. 7 - Knee Replacement Strain diagram
V. 3D PRINTING OF COMPOSITE BONE IMPLANTS
Based on the previous research [11], carbon fibre
reinforced nylon composites can be 3D printed to produce
composite hip and knee replacements. To make such a
composite part, there are certain parameters which can be set
to acquire the desired properties of a part that is printed. In this
context, a carbon fibre composite bone implant needs to be
strengthened in areas where the original bone experiences the
most force. There are parameters for both the fibre and plastic
of the composite, such as [12]:
For Nylon:
• Nylon fill pattern – the geometric shapes repeated
inside of a part to add strength. There are three
different types: triangular, rectangular and hexagonal.
• Fill density – Fill density controls the density of the
internal structure. Different fill patterns may have
different minimum and maximum densities.
• Roof & Floor Layers – Layers of solid plastic used on
the top and bottom of the part; usually 4 layers.
• Wall Layers – the wall thickness of the part. More
walls will make a pure plastic part stronger but will
also reduce the area that fibre will be able to fit into.
 2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)

For carbon fibre filaments:

• Number of concentric fibre rings – The number of
rings of concentric fibre fill added per layer. The
more rings, the stronger the part.
• Fibre fill type – The fibre fill type chooses the Fig. 9 - Specimen Dimensions (Side View)
algorithms which control how fibre will be used to
reinforce the part. Concentric is good for reinforcing B. Taguchi Method
the walls of a part while isotropic makes a part
The Taguchi method is used to define the optimized
relatively stiff in all directions.
processing parameters of the experiment. Taguchi is a robust
• Layers of fibre – The total number of layers filled and efficient statistical method for experimental design. It
with fibre in the part. requires less experiments to achieve the same amount of
• Location of fibre layers – The location in the part information selecting the minimum required combinations of
layers of fibre are applied for reinforcement. variables that yield the desired information which can be used
determine the optimal combination of processing parameters
VI. TENSILE TESTING [13]. The Taguchi method was applied to the original array of
test specimens and has resulted in the array in Table V. Three
Tensile tests have been carried out on multiple specimens specimens were tested for each sample group.
to determine the optimum parameters for the structure of a
carbon fibre composite. Multiple procedures have taken place
in order to get the most efficient and best possible results. TABLE V - Taguchi Design Orthogonal Array
A. Specimen characterisation Sample Type Nylon Fill Number of Number of
Pattern Concentric Rings Fibre Layers
The ASTM standard D638 (Standard Test Method for Tensile A A1 B1 C1
Properties of Plastics) was used for guidelines to determine the B A1 B2 C2
dimensions and the shape of the specimen. Their actual C A1 B3 C3
dimensions are to suit the dimensions of the Instron machine’s D A2 B1 C2
E A2 B2 C3
jaws used for tensile testing. The dimensions and structure of F A2 B3 C1
the specimens were modified and redesigned because G A3 B1 C3
specimens with the original dimensions would fracture at the H A3 B2 C1
grips failing to obtain reliable results. (Specimens would fail I A3 B3 C2
prematurely due to the grippers damaging the fibre Level Information
reinforcement within parts). Therefore fillets were applied to A1 Hexagonal
the edges instead of rectangular corners to ensure specimen A2 Triangular
fractured within the gauge length as required. The alterations A3 Rectangular
for the testing specimens were done based on previous B1 2
B2 3
research [11]. The dimensions of the structure of the specimen
B3 4
are shown in Fig. 8 and Fig 9. C1 2 layers
C2 4 layers
C3 6 layers

C. Results and Discussion

Fig.8 - Specimen Dimensions (Top View)
Fig. 10 shows the average specimen strains and stresses of
samples A through to I. Sample A shows the highest tensile
strain along with the lowest tensile stress. Sample H maintains
lowest possible tensile stress of all the specimens. Sample C is
the best option as it maintains both good tensile stress and
strain compared to the other samples. It also maintains the
highest tensile stress and the second highest tensile strain.
Sample C maintained Hexagonal Nylon fill pattern with 6
concentric rings and 6 fibre layers.
 2017 24th International Conference on Mechatronics and Machine Vision in Practice (M2VIP)
Average Stress vs Strain
140
120
Tensile Stess (MPa)
100
80
60
40
20
0
0 0.005 0.01 0.015 0.02 0.025
Tensile Strain
A B C D E F G H
Fig. 10 – Average stress vs strain for samples A to I
Further, a 3D printed carbon fibre composite material has been
found to be biocompatible, X-Ray permeable, high strength to
weight ratio and corrosion resistant which are very important
characteristics of a bone implant [14].
VII. CONCLUSION
This carbon fibre composite material also maintains
similar properties to that of bone which is very useful in the
healing and function of the hip or knee replacement.
In conclusion, a carbon fibre composite bone implant has
been shown to be quite viable as it has some of the desirable
characteristics such as X-Ray permeability and high strength-
to-weight ratio when compared to other materials used in bone
implants. Additionally, the carbon fibre composite material
also maintains comparable properties to that of bone and aids
in the recovery of a patient healing from hip or knee
replacement surgery. The results showed that a carbon fibre
composite is sufficiently strong for normal human movement
and usage. The results showed that a carbon fibre composite
material has lower strength than titanium but remains adequate
for knee and hip replacements. In addition, a 3D printed
carbon fibre composite material can be more readily custom
made for individuals.
Using the optimized processing parameters obtained from
this research, the future work will be to design, manufacture
and test hip and knee implants made from the carbon fibre
composite material. The data gathered from the FEA analysis
will be useful in designing hip and knee implants, identifying
the areas of the implants that undergo high stress, and
furnishing these areas with extra reinforcement.
REFERENCES
[1] H. Maradit Kremers, D. R. Larson, C. S. Crowson,
W. K. Kremers, R. E. Washington, C. A. Steiner, et
al., "Prevalence of Total Hip and Knee Replacement
in the United States," J Bone Joint Surg Am, vol. 97,
pp. 1386-97, 2015.
[2] Introduction to Bone Biology: All About our Bones
International Osteoporosis Foundation, 2017.
https://www.iofbonehealth.org/introduction-bone-
biology-all-about-our-bones
[3] J. E. Hall, Guyton and Hall Textbook of Medical
Physiology, 13th Edition, Philadelphia, PA : Elsevier,
2016.
[4] J. Griffith and H. Genant, " New Imaging Modalities
0.03 0.035 0.04 0.045 in Bone", Curr Rheumatol Rep. 13(3):241-50, 2011
(doi: 10.1007/s11926-011-0174-x).
[5] Joints - Orthoload Wiki. 2017.
I http://www.wiki.orthoload.com/index.php/Joints
[6] G. Bergmann, A. Bender, F. Graichen, J. Dymke, A.
Rohlmann, A. Trepczynski, et al., "Standardized
loads acting in knee implants," PLoS One, vol. 9, p.
e86035, 2014.
[7] M. Reinold, Biomechanics of Patellofemoral
Rehabilitation, 2009.
https://mikereinold.com/biomechanics-of-
patellofemoral/
[8] Knee Replacement Implant Materials, 2017.
https://bonesmart.org/knee/knee-replacement-
implant-materials/
[9] Hip Replacement Implant Materials, 2017.
https://bonesmart.org/hip/hip-replacement-implant-
materials/
[10] S. B. Mirza, D. G. Dunlop, S. S. Panesar, S. G.
Naqvi, S. Gangoo, and S. Salih, "Basic science
considerations in primary total hip replacement
arthroplasty," Open Orthop J, vol. 4, pp. 169-80,
2010.
[11] A. Kvalsvig, X. W. Yuan, J. Potgieter, and P. Cao,
"3D printing of fibre reinforced honeycomb
structured composite materials," presented at the 23rd
International Conference on Mechatronics and
Machine Vision in Practice (M2VIP), Nanjing,
China, 2016.
[12] Eiger, Mark One operation Manual, MarkForged,
2017.
[13] S. Saravanan, G. Nagarajan, and S. Sampath,
"Application of Taguchi’s Orthogonal Array in Multi
Response Optimization of NOx Emission of Crude
Rice Bran Oil Methyl Ester Blend as a CI Engine
Fuel," Open Journal of Optimization, vol. 01, pp. 25-
33, 2012.
[14] R. Hillock and S. Howard, " Utility of Carbon Fiber
Implants in Orthopedic Surgery: Literature Review",
JISRF Reconstructive Review, 4 (1), 2014.