Effects of Ca and H2O2 added to RPMI on the fretting corrosion of Ti6Al4V

Nickel-free high-nitrogen austenitic steel outperforms CoCrMo alloy regarding tribocorrosion in simulated inflammatory synovial fluids

CoCrMo alloys are well-established biomaterials used for orthopedic joint replacement implants. However, such alloys have been associated with clinical problems related to wear and corrosion. A new generation of austenitic high-nitrogen steels (AHNSs) has been developed for biomedical applications. Here, we have addressed influences of hyaluronic acid, combined with inflammatory (oxidizing) conditions, on tribocorrosion of the high-nitrogen FeCrMnMoN_0.9 steel (DIN/EN X13CrMnMoN18-14-3, 1.4452), and of the low carbon CoCrMo_0.03 alloy (ISO 5832-12). We aimed to elucidate critical and clinically relevant conditions affecting the implant's performance in certain orthopedic applications. Tribocorrosion tests were conducted in triplicate, with discs under reciprocating sliding wear against a ceramic ball. Different lubricants were prepared from standardized bovine serum solution (ISO 14242-1), with variable additions of hyaluronic acid (HA) and hydrogen peroxide (H₂ O₂ ). Test conditions were: 37°C, 86,400 cycles, 37 N load (20-40 MPa after run-in phase). Volumetric wear was quantified; surfaces were evaluated by electrochemical parameters and microscopy/spectroscopy analyses (SEM/EDS). Factorial analysis of variance tests was conducted to examine the effects of HA, H₂ O₂ , and test material on wear- and corrosion-related dependent variables. Tribocorrosion performances of CoCrMo_0.03 and FeCrMnMoN_0.9 were comparable in fluids without H₂ O₂ . With higher H₂ O₂ concentrations, tribocorrosion increased for CoCrMo_0.03 , while this was not the case for FeCrMnMoN_0.9 . HA significantly enhanced wear of CoCrMo_0.03 in the absence of H₂ O₂ , while it mitigated the tribocorrosive action of 3 mM H₂ O₂ ; HA had no impact on FeCrMnMoN_0.9 . These results indicate a favorable performance of FeCrMnMoN_0.9 compared to CoCrMo_0.03 , and encourage further research on AHNS for certain orthopedic applications.

Corrosion of titanium under simulated inflammation conditions: clinical context and in vitro investigations

Titanium and alloys thereof are widely utilized for biomedical applications in the fields of orthopedics and dentistry. The corrosion resistance and perceived biocompatibility of such materials are essentially related to the presence of a thin passive oxide layer on the surface. However, during inflammation phases, the immune system and its leukocytic cells generate highly aggressive molecules, such as hydrogen peroxide and radicals, that can significantly alter the passive film resulting in the degradation of the titanium implants. In combination with mechanical factors, this can lead to the release of metal ions, nanoparticles or microscaled debris in the surrounding tissues (which may sustain chronic inflammation), bring about relevant health issues and contribute to implant loss or failure. After briefly presenting the context of inflammation, this review article analyses the state-of-the-art knowledge of the in vitro corrosion of titanium, titanium alloys and coated titanium by reactive oxygen species and by living cells with an emphasis on electrochemical and microstructural aspects. STATEMENT OF SIGNIFICANCE: Inflammation involves the production of reactive oxygen species that are known to alter the passive layer protecting titanium implants against the aggressive environment of the human body. Inflammatory processes therefore contribute to the deterioration of biomedical devices. Although review articles on biomaterials for implant applications are regularly published in the literature, none has ever focused specifically on the topic of inflammation. After briefly recalling the clinical context, this review analyses the in vitro studies on titanium corrosion under simulated inflammation conditions from the pioneer works of the 80s and the 90s till the most recent investigations. It reports about the status of this research area for a multidisciplinary readership covering the fields of materials science, corrosion and implantology.

Corrosion resistance of the nickel-free high-nitrogen steel FeCrMnMoN0.9 under simulated inflammatory conditions

Nickel-free, high-nitrogen austenitic steels (AHNS) have been introduced for biomedical applications, with encouraging results in terms of mechanical and corrosion properties. Here, we tested the corrosion resistance of a nickel-free high nitrogen steel (FeCrMnMoN0.9) in bovine serum solutions containing 0 or 3 g/L hyaluronic acid (HA), and 0, 3, or 30 mM hydrogen peroxide (H₂ O₂ ) simulating no, moderate, or strong inflammatory conditions, respectively. Nondestructive electrochemical measurements (open circuit potential [OCP], linear polarization resistance "R_P ", and electrochemical impedance spectroscopy) were run in triplicate over 10 hr. The presence of HA had no significant effect either on the stabilized OCP values, or on the corrosion resistance of FeCrMnMoN0.9. Increasing H₂ O₂ concentrations shifted the OCP to more electropositive values; the corrosion resistance decreased only at a 30 mM H₂ O₂ . Final R_P values at 0, 3, and 30 mM H₂ O₂ resulted in 1598 ± 276, 1746 ± 308, and 439 ± 47 kΩ cm² , respectively. These values were 4-14 times higher, than the R_P values measured on LC-CoCrMo in our previous study, conducted under identical conditions. While these findings are encouraging, future studies need to focus on tribocorrosive properties of the AHNS to evaluate its applicability in joint replacement.

Atomic Scale Origin of Metal Ion Release from Hip Implant Taper Junctions

Millions worldwide suffer from arthritis of the hips, and total hip replacement is a clinically successful treatment for end-stage arthritis patients. Typical hip implants incorporate a cobalt alloy (Co-Cr-Mo) femoral head fixed on a titanium alloy (Ti-6Al-4V) femoral stem via a Morse taper junction. However, fretting and corrosion at this junction can cause release of wear particles and metal ions from the metallic implant, leading to local and systemic toxicity in patients. This study is a multiscale structural-chemical investigation, ranging from the micrometer down to the atomic scale, of the underlying mechanisms leading to metal ion release from such taper junctions. Correlative transmission electron microscopy and atom probe tomography reveals microstructural and compositional alterations in the subsurface of the titanium alloy subjected to in vitro gross-slip fretting against the cobalt alloy. Even though the cobalt alloy is comparatively more wear-resistant, changes in the titanium alloy promote tribocorrosion and subsequent degradation of the cobalt alloy. These observations regarding the concurrent occurrence of electrochemical and tribological phenomena are vital to further improve the design and performance of taper junctions in similar environments.

Effects of bovine serum albumin and hyaluronic acid on the electrochemical response of a CoCrMo alloy to cathodic and anodic excursions

The problem of wear and corrosion of CoCrMo-implant surfaces in the human body following total joint replacement has been commonly investigated with tribocorrosion tests, using different lubricants meant to simulate the pseudo-synovial fluid. While results considering the synovial fluid components separately have highlighted their individual influence on the tribological performance of CoCrMo-alloy, an understanding about the influence of the synovial fluid components under the electrochemical point of view is missing. This work aims to investigate the effect of bovine serum albumin (BSA) and hyaluronic acid (HA) on electrochemical potential variations of CoCrMo alloys tested in a model synovial fluid. To simulate the environment inside the synovial capsule, the tests were performed inside a CO₂ incubator at 37°C. Open circuit potential, electrochemical impedance spectroscopy, cathodic and anodic potentiodynamic measurements were performed with different electrolytes, prepared with cell culture medium (RMPI-1640), BSA and HA. The final CoCrMo-surface was analyzed by SEM/EDS and infrared spectroscopy. The influence of HA on the corrosion of the CoCrMo-alloy depended on the presence of BSA proteins adsorbed on the CoCrMo-surface: EIS and anodic polarization results showed a corrosive action of HA in the absence of adsorbed proteins. In the presence of both BSA and HA, organometallic precipitates were found on the CoCrMo surface following reverse anodic polarization, which remind of corrosion products found in-vivo. These results indicate that HA affects the interaction of CoCrMo implant alloys with protein-containing model synovial fluids, and suggest that HA needs to be considered in tribocorrosion studies for more clinically relevant outcomes.

The effect of hyaluronic acid on the corrosion of an orthopedic CoCrMo-alloy in simulated inflammatory conditions

During joint inflammation, various reactive oxygen species (ROS) are present in the surrounding tissue and joint fluid. In the laboratory, hydrogen peroxide (H₂O₂) is typically used to simulate inflammatory conditions, and media containing proteins and hyaluronic acid (HA) are employed to simulate joint synovial fluid. Electrochemical interactions between H₂O₂ and HA in the presence of a CoCrMo surface are expected, since HA molecules contain redox-active moieties. We hypothesized that any redox reactions of these moieties with ROS will mitigate the oxidizing effect of H₂O₂ on the CoCrMo surface, limiting the corrosion rate of the metal. Non-destructive electrochemical measurements (open circuit potential, linear polarization resistance and electrochemical impedance spectroscopy) were used to investigate the corrosion response of CoCrMo in synovial model fluid containing physiologically relevant concentrations of albumin proteins and hyaluronic acid, with and without H₂O₂. Two different molarities of H₂O₂, 3 mM and 30 mM, were tested. While both molarities are within physiological limits, 3mM is well within the range HA could mitigate, whereas 30 mM is not. Contrary to our hypothesis, HA did not alleviate corrosion in 3 mM H₂O₂ and even caused a corrosion increase in the case of 30 mM H₂O₂. The decrease in corrosion resistance of the alloy may be attributed to the complexation of degenerated HA molecular chains with chromium ions released from the metallic surface, which are necessary to build a protective oxide film. This finding has clinical implications, suggesting that HA accelerates corrosion of CoCrMo implants in the presence of strong inflammation.

Biomaterials for craniofacial reconstruction

Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region. For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products) when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull. The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc.) does not exist. The different material types are (autogenic) bone and many alloplastics such as metals (mainly titanium), ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.

Fracture of Ni-Ti superelastic alloy under sustained tensile load in physiological saline solution containing hydrogen peroxide

The fracture of Ni-Ti superelastic alloy has been investigated by a sustained tensile-loading test in physiological saline solution containing hydrogen peroxide (0.15M NaCl + 0.3M H(2)O(2)). The fracture always occurs when the applied stress exceeds the critical stress for martensite transformation. In contrast, under a low applied stress, the fracture does not always occur within 1000 h. The fracture is probably mainly caused by localized corrosion associated with the preferential dissolution of nickel ions. In 0.3M H(2)O(2) solution without NaCl, the fracture does not occur even under a high applied stress. The results of the present study imply that one reason for the fracture of the Ni-Ti superelastic alloy in vivo is localized corrosion due to the synergistic effects of hydrogen peroxide and sodium chloride under applied stress.

Effects of hydrogen peroxide solutions on artificial hip joint implants

This study was designed to elucidate the erosive effect of hydrogen peroxide solutions on the materials used for total-hip arthroplasty (THA). As test materials, cross-linked polyethylene, Ti-6Al-4V alloy, and thermal sprayed hydroxyapatite (HA) were used. Changes upon soaking in 3% hydrogen peroxide, before soaking, 1 minute after soaking, 10 minutes after soaking, and 180 minutes after soaking were examined. Scanning electron microscope, Fourier transform infrared analysis, and x-ray diffraction were used for this examination. Hydrogen peroxide did not affect polyethylene, although notable changes in the Ti-6Al-4V alloy and HA did occur. These results indicate that caution should also be exercised to minimize erosion of prosthesis consisting of HA and Ti alloy when hydrogen peroxide solutions are used during total-hip arthroplasty.

Differences in the fretting corrosion of metal-metal and ceramic-metal modular junctions of total hip replacements

The use of modular interlocking components is a central design feature of total joint replacements. In this investigation we hypothesized that clinically available ceramic-metal modular connections used in total hip arthroplasty release more metal through fretting corrosion than traditional metal-metal modular connections. This was investigated using an in vitro comparison of ceramic (zirconia, ZrO2) and metal (Co-alloy) femoral-head fretting upon Co-alloy stem components. In vitro fretting corrosion testing consisted of potentiodynamic monitoring and analysis of metal release from zirconia and Co-alloy 28 mm femoral heads with similar surface roughnesses (Ra=0.46 microm) on identical Co-alloy stems at 2.2 kN for 1x10(6) cycles at 2 Hz. In contrast to our original hypothesis, we found greater metal release (approximately 11-fold increase in Co and 3-fold increase in Cr) and potentiodynamic fretting of metal-metal modular junctions when compared to ceramic-metal. Potentiodynamic testing demonstrated that lower initial voltages (-266<153 mV), greater maximum voltage changes (116>56 mV, p<0.05, t-test) and voltage variability (3>0.5 mV, p<0.05, t-test) were associated with the open circuit potentials of Co-alloy on Co-alloy junctions when compared to zirconia on Co-alloy junctions. In this study of a single total hip replacement stem and head design, zirconia heads mated with Co-alloy stems produced less fretting than Co-alloy heads mated with Co-alloy stems. Although further studies are necessary with a variety of implant designs and under different experimental conditions, the evidence presented here should, in part, alleviate concerns of increases in fretting corrosion at modular junctions of ceramic-metal coupled components.

The fretting corrosion resistance of PVD surface-modified orthopedic implant alloys

The objective of this study was to evaluate the fretting corrosion resistance of both modified and unmodified Ti6Al4V flats fretted against CoCr-alloy spheres in a buffered Hank's solution at 37 degrees C using an original fretting apparatus. A physical vapor deposition (PVD) cathodic arc evaporation technique was used to deposit 3-4 microm thick titanium nitride (TiN), zirconium nitride (ZrN), or amorphous carbon (AC) coatings onto the Ti6Al4V substrates. The fretting behavior of the nitride films (TiN and ZrN) was characterized by the absence of surface damage and the deposition of a Cr-rich oxide transferred from the CoCr-alloy spheres to the modified surfaces. This oxide led to a slight increase in surface roughness. Three of the six multilayered AC coatings tested exhibited extensive fretting damage and generated large, deep, wear scars. Cohesive failure of the AC coating was observed in the low contact stress areas of the fretting scars. The remaining AC-coated specimens experienced only slight polishing wear. The reason for the different behavior within the AC-coated specimens is not clear at the present time. The unmodified Ti6Al4V surfaces experienced severe surface damage consistent with the adhesive galling mechanism to which these alloys are susceptible.

Metal ion release from titanium with active oxygen species generated by rat macrophages in vitro

The release of metal ions due to active oxygen species generated by macrophages (Mphi) phagocytosing high-density polyethylene (HDPE) particles was studied in vitro to investigate the mechanism behind the release of metal ions from titanium implants into nearby tissues in the absence of wear and fretting in vivo. To determine the effects of Mphis on metal ion release, titanium disks were immersed in different solutions and the titanium ions released from the titanium disks into each solution were quantified. The results revealed that active oxygen species generated by Mphis induced the metal ion release. In particular, the ion release was accelerated with HDPE because the Mphis that phagocytosed HDPE generated more active oxygen species than Mphis that did not phagocytose any HDPE. Metal ions were also released by organic species in the absence of Mphis. These are some of the causes for metal ion release from titanium implants in the absence of wear and fretting in vivo.