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Kurtz MA, Alaniz K, Kurtz PW, Wessinger AC, Moreno-Reyes A, Gilbert JL. Oxide degradation precedes additively manufactured Ti-6Al-4V selective dissolution: An unsupervised machine learning correlation of impedance and dissolution compared to Ti-29Nb-21Zr. J Biomed Mater Res A 2024; 112:1250-1264. [PMID: 37877770 DOI: 10.1002/jbm.a.37632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Additively manufactured (AM) Ti-6Al-4V devices are implanted with increasing frequency. While registry data report short-term success, a gap persists in our understanding of long-term AM Ti-6Al-4V corrosion behavior. Retrieval studies document β phase selective dissolution on conventionally manufactured Ti-6Al-4V devices. Researchers reproduce this damage in vitro by combining negative potentials (cathodic activation) and inflammatory simulating solutions (H2O2-phosphate buffered saline). In this study, we investigate the effects of these adverse electrochemical conditions on AM Ti-6Al-4V impedance and selective dissolution. We hypothesize that cathodic activation and H2O2 solution will degrade the oxide, promoting corrosion. First, we characterized AM Ti-6Al-4V samples before and after a 48 h -0.4 V hold in 0.1 M H2O2/phosphate buffered saline. Next, we acquired nearfield electrochemical impedance spectroscopy (EIS) data. Finally, we captured micrographs and EIS during dissolution. Throughout, we used AM Ti-29Nb-21Zr as a comparison. After 48 h, AM Ti-6Al-4V selectively dissolved. Ti-29Nb-21Zr visually corroded less. Structural changes at the AM Ti-6Al-4V oxide interface manifested as property changes to the impedance. After dissolution, the log-adjusted constant phase element (CPE) parameter, Q, significantly increased from -4.75 to -3.84 (Scm-2(s)α) (p = .000). The CPE exponent, α, significantly decreased from .90 to .84 (p = .000). Next, we documented a systematic decrease in oxide polarization resistance before pit nucleation and growth. Last, using k-means clustering, we established a structure-property relationship between impedance and the surface's dissolution state. These results suggest that AM Ti-6Al-4V may be susceptible to in vivo crevice corrosion within modular taper junctions.
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Affiliation(s)
- Michael A Kurtz
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Kazzandra Alaniz
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Peter W Kurtz
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Audrey C Wessinger
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Aldo Moreno-Reyes
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Jeremy L Gilbert
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
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2
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Fonseca D, de Tapia B, Pons R, Aparicio C, Guerra F, Messias A, Gil J. The Effect of Implantoplasty on the Fatigue Behavior and Corrosion Resistance in Titanium Dental Implants. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2944. [PMID: 38930312 PMCID: PMC11206074 DOI: 10.3390/ma17122944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/04/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Implantoplasty is a technique increasingly used to remove the biofilm that causes peri-implantitis on dental implants. This technique of mechanization of the titanium surface makes it possible to eliminate bacterial colonies, but it can generate variations in the properties of the implant. These variations, especially those in fatigue resistance and electrochemical corrosion behavior, have not been studied much. In this work, fatigue tests were performed on 60 dental implants without implantoplasty, namely 30 in air and 30 in Hank's solution at 37 °C, and 60 with implatoplasty, namely 30 in air and 30 in Hank's solution at 37 °C, using triaxial tension-compression and torsion stresses simulating human chewing. Mechanical tests were performed with a Bionix servo-hydraulic testing machine and fracture surfaces were studied by scanning electron microcopyElectrochemical corrosion tests were performed on 20 dental implants to determine the corrosion potentials and corrosion intensity for control implants and implantoplasty implants. Studies of titanium ion release to the physiological medium were carried out for each type of dental implants by Inductively Coupled-Plasma Mass Spectrometry at different immersion times at 37 °C. The results show a loss of fatigue caused by the implantoplasty of 30%, observing that the nucleation points of the cracks are in the areas of high deformation in the areas of the implant neck where the mechanization produced in the treatment of the implantoplasty causes an exaltation of fatigue cracks. It has been observed that tests performed in Hank's solution reduce the fatigue life due to the incorporation of hydrogen in the titanium causing the formation of hydrides that embrittle the dental implant. Likewise, the implantoplasty causes a reduction of the corrosion resistance with some pitting on the machined surface. Ion release analyses are slightly higher in the implantoplasted samples but do not show statistically significant differences. It has been observed that the physiological environment reduces the fatigue life of the implants due to the penetration of hydrogen into the titanium forming titanium hydrides which embrittle the implant. These results should be taken into account by clinicians to determine the convenience of performing a treatment such as implantoplasty that reduces the mechanical behavior and increases the chemical degradation of the titanium dental implant.
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Affiliation(s)
- Darcio Fonseca
- Bioengineering Institute of Technology, Medicine and Health Sciences Faculty, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain;
| | - Beatriz de Tapia
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain; (B.d.T.); (R.P.); (C.A.)
| | - Ramon Pons
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain; (B.d.T.); (R.P.); (C.A.)
| | - Conrado Aparicio
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain; (B.d.T.); (R.P.); (C.A.)
| | - Fernando Guerra
- Department Medicina Dentaire, Facultade de Medicina, Universidade de Coimbra, Palácio dos Grilos, Rua da Ilha, 3000-214 Coimbra, Portugal; (F.G.); (A.M.)
| | - Ana Messias
- Department Medicina Dentaire, Facultade de Medicina, Universidade de Coimbra, Palácio dos Grilos, Rua da Ilha, 3000-214 Coimbra, Portugal; (F.G.); (A.M.)
| | - Javier Gil
- Department Medicina Dentaire, Facultade de Medicina, Universidade de Coimbra, Palácio dos Grilos, Rua da Ilha, 3000-214 Coimbra, Portugal; (F.G.); (A.M.)
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Soleimani M, Żmudzki J, Pakieła W, Jaśkowska A, Krasny K. Dental Implant Abutment Screw Loss: Presentation of 10 Cases. J Funct Biomater 2024; 15:96. [PMID: 38667553 PMCID: PMC11050945 DOI: 10.3390/jfb15040096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Re-tightening the loosened dental implant abutment screw is an accepted procedure, however the evidence that such screw will hold sufficiently is weak. The purpose of this study was material analysis of lost dental implant abutment screws made of the TiAlV alloy from various manufacturers, which became lost due to unscrewing or damaged when checking if unscrewed; undamaged screws could be safely re-tightened. Among 13 failed screws retrieved from 10 cases, 10 screws were removed due to untightening and 3 were broken but without mechanical damage at the threads. Advanced corrosion was found on nine screws after 2 years of working time on all surfaces, also not mechanically loaded. Sediments observed especially in the thread area did not affect the corrosion process because of no pit densification around sediments. Pitting corrosion visible in all long-used screws raises the question of whether the screws should be replaced after a certain period during service, even if they are well-tightened. This requires further research on the influence of the degree of corrosion on the loss of the load-bearing ability of the screw.
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Affiliation(s)
- Maryam Soleimani
- Department of Engineering Materials and Biomaterials, Faculty of Mechanical Engineering, Silesian University of Technology, 18a Konarskiego Str., 41-100 Gliwice, Poland; (M.S.); (W.P.)
- Doctoral School, Silesian University of Technology, 2A Akademicka Str., 44-100 Gliwice, Poland
| | - Jarosław Żmudzki
- Department of Engineering Materials and Biomaterials, Faculty of Mechanical Engineering, Silesian University of Technology, 18a Konarskiego Str., 41-100 Gliwice, Poland; (M.S.); (W.P.)
| | - Wojciech Pakieła
- Department of Engineering Materials and Biomaterials, Faculty of Mechanical Engineering, Silesian University of Technology, 18a Konarskiego Str., 41-100 Gliwice, Poland; (M.S.); (W.P.)
| | - Anna Jaśkowska
- Anident Dental Clinic, 12 Belgradzka Str., 02-793 Warszawa, Poland (K.K.)
| | - Kornel Krasny
- Anident Dental Clinic, 12 Belgradzka Str., 02-793 Warszawa, Poland (K.K.)
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Kurtz MA, Alaniz K, Taylor LM, Moreno-Reyes A, Gilbert JL. Increasing temperature accelerates Ti-6Al-4V oxide degradation and selective dissolution: An Arrhenius-based analysis. Acta Biomater 2024; 178:352-365. [PMID: 38417644 DOI: 10.1016/j.actbio.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024]
Abstract
Ti-6Al-4V selective dissolution occurs in vivo on orthopedic implants as the leading edge of a pitting corrosion attack. A gap persists in our fundamental understanding of selective dissolution and pre-clinical tests fail to reproduce this damage. While CoCrMo clinical use decreases, Ti-6Al-4V and the crevice geometries where corrosion can occur remain ubiquitous in implant design. Additionally, most additively manufactured devices cleared by the FDA use Ti-6Al-4V. Accelerated preclinical testing, therefore, would aid in the evaluation of new titanium devices and biomaterials. In this study, using temperature, we (1) developed an accelerated pre-clinical methodology to rapidly induce dissolution and (2) investigated the structure-property relationship between the dissolving surface and the oxide layer. We hypothesized that solution temperature and H2O2 concentration would accelerate oxide degradation, increase corrosion kinetics and decrease experimental times. To assess this effect, we selected temperatures above (45 °C), below (24 °C), and at (37 °C) physiological levels. Then, we acquired electrochemical impedance spectra during active β dissolution, showing significant decreases in oxide polarization resistance (Rp) both over time (p = 0.000) and as temperature increased (p = 0.000). Next, using the impedance response as a guide, we quantified the extent of selective dissolution in scanning electron micrographs. As the temperature increased, the corrosion rate increased in an Arrhenius-dependent manner. Last, we identified three surface classes as the oxide properties changed: undissolved, transition and dissolved. These results indicate a concentration and temperature dependent structure-property relationship between the solution, the protective oxide film, and the substrate alloy. Additionally, we show how supraphysiological temperatures induce structurally similar dissolution to tests run at 37 °C in less experimental time. STATEMENT OF SIGNIFICANCE: Within modular taper junctions of total hip replacement systems, retrieval studies document severe corrosion including Ti-6AL-4V selective dissolution. Current pre-clinical tests and ASTM standards fail to reproduce this damage, preventing accurate screening of titanium-based biomaterials and implant designs. In this study, we induce selective dissolution using accelerated temperatures. Building off previous work, we use electrochemical impedance spectroscopy to rapidly monitor the oxide film during dissolution. We elucidate components of the dissolution mechanism, where oxide degradation precedes pit nucleation within the β phase. Using an Arrhenius approach, we relate these accelerated testing conditions to more physiologically relevant solution concentrations. In total, this study shows the importance of including adverse electrochemical events like cathodic activation and inflammatory species in pre-clinical testing.
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Affiliation(s)
- Michael A Kurtz
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, SC, USA
| | - Kazzandra Alaniz
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, SC, USA
| | - Lilliana M Taylor
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, SC, USA
| | - Aldo Moreno-Reyes
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, SC, USA
| | - Jeremy L Gilbert
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, SC, USA.
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Mace AO, Kurtz MA, Gilbert JL. Fretting and Fretting Corrosion Behavior of Additively Manufactured Ti-6Al-4V and Ti-Nb-Zr Alloys in Air and Physiological Solutions. J Funct Biomater 2024; 15:38. [PMID: 38391891 PMCID: PMC10889821 DOI: 10.3390/jfb15020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Additive manufacturing (AM) of orthopedic implants has increased in recent years, providing benefits to surgeons, patients, and implant companies. Both traditional and new titanium alloys are under consideration for AM-manufactured implants. However, concerns remain about their wear and corrosion (tribocorrosion) performance. In this study, the effects of fretting corrosion were investigated on AM Ti-29Nb-21Zr (pre-alloyed and admixed) and AM Ti-6Al-4V with 1% nano yttria-stabilized zirconia (nYSZ). Low cycle (100 cycles, 3 Hz, 100 mN) fretting and fretting corrosion (potentiostatic, 0 V vs. Ag/AgCl) methods were used to compare these AM alloys to traditionally manufactured AM Ti-6Al-4V. Alloy and admixture surfaces were subjected to (1) fretting in the air (i.e., small-scale reciprocal sliding) and (2) fretting corrosion in phosphate-buffered saline (PBS) using a single diamond asperity (17 µm radius). Wear track depth measurements, fretting currents and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) analysis of oxide debris revealed that pre-alloyed AM Ti-29Nb-21Zr generally had greater wear depths after 100 cycles (4.67 +/- 0.55 µm dry and 5.78 +/- 0.83 µm in solution) and higher fretting currents (0.58 +/- 0.07 µA). A correlation (R2 = 0.67) was found between wear depth and the average fretting currents with different alloys located in different regions of the relationship. No statistically significant differences were observed in wear depth between in-air and in-PBS tests. However, significantly higher amounts of oxygen (measured by oxygen weight % by EDS analysis of the debris) were embedded within the wear track for tests performed in PBS compared to air for all samples except the ad-mixed Ti-29Nb-21Zr (p = 0.21). For traditional and AM Ti-6Al-4V, the wear track depths (dry fretting: 2.90 +/- 0.32 µm vs. 2.51 +/- 0.51 μm, respectively; fretting corrosion: 2.09 +/- 0.59 μm vs. 1.16 +/- 0.79 μm, respectively) and fretting current measurements (0.37 +/- 0.05 μA vs. 0.34 +/- 0.05 μA, respectively) showed no significant differences. The dominant wear deformation process was plastic deformation followed by cyclic extrusion of plate-like wear debris at the end of the stroke, resulting in ribbon-like extruded material for all alloys. While previous work documented improved corrosion resistance of Ti-29Nb-21Zr in simulated inflammatory solutions over Ti-6Al-4V, this work does not show similar improvements in the relative fretting corrosion resistance of these alloys compared to Ti-6Al-4V.
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Affiliation(s)
- Annsley O Mace
- Clemson-Medical University of South Carolina Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, SC 29464, USA
| | - Michael A Kurtz
- Clemson-Medical University of South Carolina Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, SC 29464, USA
| | - Jeremy L Gilbert
- Clemson-Medical University of South Carolina Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, SC 29464, USA
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6
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Bormann T, Kretzer JP, Jaeger S, Lohmann CH. Is taper corrosion in modular revision hip stem junctions associated with patient or implant specific factors? A retrieval analysis. J Mech Behav Biomed Mater 2024; 150:106326. [PMID: 38141361 DOI: 10.1016/j.jmbbm.2023.106326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
Implant modularity within revision total hip arthroplasty (THA) offers multiple implant configurations and allows surgeons a high intraoperative flexibility to restore functionality to the patients joint, even in complex revision cases. However, a rare but devastating complication for patients, clinicians and manufacturers presenting a breakage of the taper junction between the distal stem and the proximal implant part. Aside from implant and patient specific risk factors, corrosion and fretting at the stem junctions have been associated with taper failure. Whether corrosive processes are a precursor of failure or rather an accompaniment of material fatigue is thereby still unclear. Therefore, this study aims to investigate the incidence of taper corrosion in a collection of 17 retrievals from a single type (MRP-Titan, Peter Brehm GmbH) and on the correlation of taper corrosion to implant and patient specific factors. None of the implants was revised for problems related to the taper junction, corrosion or the implant itself. The modular stem junction of all retrievals was visually rated with respect to corrosion, fretting and surface contamination. Additionally, the stability of taper junctions of retrievals where the proximal part with the neck was still assembled to the stem was determined by measuring the loosening moment of the securing screw and the push-out-force for taper dissociation. There was no difference between the mean push-out-force of the retrievals (14 kN ± 1.2 kN) and new reference samples (12.6 kN ± 0.5 kN). Approximately one third of the investigated retrievals showed considerable taper corrosion. The extent of corrosion increased with time in vivo and contamination of the neck piece, while it decreased with the loosening moment of the locking screw. The parameters femoral head offset, neck piece length, lateralized neck pieces, obesity of patients and septic/aseptic revision were not correlated to taper corrosion. Taper corrosion seems to occur regularly in modular taper junctions and is not necessarily connected to taper failure. A correct assembly of the junction and avoiding taper surface contamination during revision surgery is mandatory.
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Affiliation(s)
- Therese Bormann
- Heidelberg University Hospital, Department of Orthopaedics, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
| | - J Philippe Kretzer
- Heidelberg University Hospital, Department of Orthopaedics, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Sebastian Jaeger
- Heidelberg University Hospital, Department of Orthopaedics, Laboratory of Biomechanics and Implant Research, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedics, University Hospital Magdeburg, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
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Li Y, Zhou Z, He Y. Tribocorrosion and Surface Protection Technology of Titanium Alloys: A Review. MATERIALS (BASEL, SWITZERLAND) 2023; 17:65. [PMID: 38203919 PMCID: PMC10779822 DOI: 10.3390/ma17010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024]
Abstract
Titanium alloy has the advantages of high specific strength, good corrosion resistance, and biocompatibility and is widely used in marine equipment, biomedicine, aerospace, and other fields. However, the application of titanium alloy in special working conditions shows some shortcomings, such as low hardness and poor wear resistance, which seriously affect the long life and safe and reliable service of the structural parts. Tribocorrosion has been one of the research hotspots in the field of tribology in recent years, and it is one of the essential factors affecting the application of passivated metal in corrosive environments. In this work, the characteristics of the marine and human environments and their critical tribological problems are analyzed, and the research connotation of tribocorrosion of titanium alloy is expounded. The research status of surface protection technology for titanium alloy in marine and biological environments is reviewed, and the development direction and trends in surface engineering of titanium alloy are prospected.
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Affiliation(s)
- Yang Li
- School of Nuclear Equipment and Nuclear Engineering, Yantai University, Yantai 264005, China;
| | - Zelong Zhou
- School of Nuclear Equipment and Nuclear Engineering, Yantai University, Yantai 264005, China;
| | - Yongyong He
- State Key Laboratory of Tribology, Tsinghua University, Beijing 100084, China
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8
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Kurtz MA, Wessinger AC, Mace A, Moreno-Reyes A, Gilbert JL. Additively manufactured Ti-29Nb-21Zr shows improved oxide polarization resistance versus Ti-6Al-4V in inflammatory simulating solution. J Biomed Mater Res A 2023; 111:1538-1553. [PMID: 37129046 DOI: 10.1002/jbm.a.37552] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Abstract
Retrieval studies in the past two decades show severe corrosion of titanium and its alloys in orthopedic implants. This damage is promoted by mechanically assisted crevice corrosion (MACC), particularly within modular titanium-titanium junctions. During MACC, titanium interfaces may be subject to negative potentials and reactive oxygen species (ROS), generated from cathodic activation and/or inflammation. Additive manufacturing (AM) may be able to produce new, corrosion-resistant titanium alloys and admixtures that are less susceptible to these adverse electrochemical events. In this study, we characterize the impedance and corrosion properties of three new AM titanium materials, including Ti-6Al-4V with added 1% nano-yttria stabilized ZrO2 , admixed Ti-29Nb-21Zr, and pre-alloyed Ti-29Nb-21Zr. We aim to elucidate how these materials perform when subjected to high ROS solutions. We include conventionally and additively manufactured Ti-6Al-4V in our study as comparison groups. A 0.1 M H2 O2 phosphate-buffered saline (PBS) solution, simulating inflammatory conditions, significantly increased biomaterial OCP (-0.14 V vs. Ag/AgCl) compared to PBS only (-0.38 V, p = .000). During anodic polarization, Ti-6Al-4V passive current density more than doubled from 1.28 × 10-7 to 3.81 × 10-7 A/cm2 when exposed to 0.1 M H2 O2 . In contrast, Ti-29Nb-21Zr passive current density remained relatively unchanged, slightly increasing from 7.49 × 10-8 in PBS to 9.31 × 10-8 in 0.1 M H2 O2 . Ti-29Nb-21Zr oxide polarization resistance (Rp ) was not affected by 0.1 M H2 O2 , maintaining a high value (1.09 × 106 vs. 1.89 × 106 Ω cm2 ), while Ti-6Al-4V in 0.1 M H2 O2 solution had significantly diminished Rp (4.38 × 106 in PBS vs. 7.24 × 104 Ω cm2 in H2 O2 ). These results indicate that Ti-29Nb-21Zr has improved corrosion resistance in ROS containing solutions when compared with Ti-6Al-4V based biomaterials.
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Affiliation(s)
- Michael A Kurtz
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Audrey C Wessinger
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Annsley Mace
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Aldo Moreno-Reyes
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
| | - Jeremy L Gilbert
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
- The Clemson University-Medical University of South Carolina Bioengineering Program, Charleston, South Carolina, USA
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9
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Kurtz MA, Yang R, Elapolu MSR, Wessinger AC, Nelson W, Alaniz K, Rai R, Gilbert JL. Predicting Corrosion Damage in the Human Body Using Artificial Intelligence: In Vitro Progress and Future Applications. Orthop Clin North Am 2023; 54:169-192. [PMID: 36894290 DOI: 10.1016/j.ocl.2022.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Artificial intelligence (AI) is used in the clinic to improve patient care. While the successes illustrate AI's impact, few studies have led to improved clinical outcomes. In this review, we focus on how AI models implemented in nonorthopedic fields of corrosion science may apply to the study of orthopedic alloys. We first define and introduce fundamental AI concepts and models, as well as physiologically relevant corrosion damage modes. We then systematically review the corrosion/AI literature. Finally, we identify several AI models that may be implemented to study fretting, crevice, and pitting corrosion of titanium and cobalt chrome alloys.
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Affiliation(s)
- Michael A Kurtz
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, Charleston, SC 29425, USA
| | - Ruoyu Yang
- Department of Automotive Engineering, Clemson University, 4 Research Drive, Greenville, SC 29607, USA
| | - Mohan S R Elapolu
- Department of Automotive Engineering, Clemson University, 4 Research Drive, Greenville, SC 29607, USA
| | - Audrey C Wessinger
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, Charleston, SC 29425, USA
| | - William Nelson
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, Charleston, SC 29425, USA
| | - Kazzandra Alaniz
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, Charleston, SC 29425, USA
| | - Rahul Rai
- Department of Automotive Engineering, Clemson University, 4 Research Drive, Greenville, SC 29607, USA
| | - Jeremy L Gilbert
- Department of Bioengineering, Clemson University, Clemson, SC, USA; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, Charleston, SC 29425, USA.
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10
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Dun S, Lim BH, Swope SW, Whitaker DR. A novel method to improve femoral head and stem taper stability intraoperatively in total hip arthroplasty - a proof of concept study. Orthop Traumatol Surg Res 2022; 108:103284. [PMID: 35470121 DOI: 10.1016/j.otsr.2022.103284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 11/29/2021] [Accepted: 01/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mechanically assisted crevice corrosion (MACC) has been associated with the compromised durability and fixation of modular total hip implants, adverse reaction of local tissue, and other undesirable clinical outcomes in total hip arthroplasty (THA). MACC is primarily caused by the relative motion between the femoral head and stem. To minimize the relative motion the taper connection between the two components must be strong enough. The current study addressed the following questions: (1) Does increasing the mass of the femoral stem improve the taper connection strength intraoperatively? (2) Does increasing the mass of the femoral stem reduce the risk of periprosthetic tissue damage intraoperatively? HYPOTHESIS Increasing the mass of the femoral stem improve the taper connection strength intraoperatively. MATERIALS AND METHODS During the experiment, femoral heads were impacted onto the stem tapers with and without an additional weight attached to the stem. The femoral heads were then pulled off to investigate the strength of the taper connection. The stem displacement and acceleration at impaction were also measured to evaluate the risk of periprosthetic tissue damage. RESULTS The results showed that the pull-off force was increased by 24% (p=0.011, n=6) when an additional weight was attached to the stem. The additional weight also reduced the maximum stem acceleration and maximum stem displacement by 37% (p<0.001, n=6) and 14% (p=0.094, n=6), respectively. DISCUSSION These findings suggest that the femoral head and stem taper connection strength can be significantly improved and the risk of periprosthetic tissue damage significantly reduced intraoperatively by attaching an additional weight to the stem to increase its mass. LEVEL OF EVIDENCE III, comparative in vitro mechanical investigation.
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Affiliation(s)
- Shouchen Dun
- DePuy Synthes Joint Reconstruction, 700 Orthopaedic Drive, Warsaw, IN 46581, USA.
| | - Boon Him Lim
- DePuy Synthes Joint Reconstruction, 700 Orthopaedic Drive, Warsaw, IN 46581, USA
| | - Stephen W Swope
- DePuy Synthes Joint Reconstruction, 700 Orthopaedic Drive, Warsaw, IN 46581, USA
| | - Dustin R Whitaker
- DePuy Synthes Joint Reconstruction, 700 Orthopaedic Drive, Warsaw, IN 46581, USA
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11
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Taper corrosion in total hip arthroplasty – How to assess and which design features are crucial? J Mech Behav Biomed Mater 2022; 133:105307. [DOI: 10.1016/j.jmbbm.2022.105307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022]
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12
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Herbster M, Harnisch K, Kriegel P, Heyn A, Krüger M, Lohmann CH, Bertrand J, Halle T. Microstructural Modification of TiAl6V4 Alloy to Avoid Detrimental Effects Due to Selective In Vivo Crevice Corrosion. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5733. [PMID: 36013867 PMCID: PMC9414096 DOI: 10.3390/ma15165733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
TiAl6V4 wrought alloy is a standard material used for endoprostheses due to its ideal characteristics in terms of osseointegration. However, the insufficient wear and crevice corrosion resistance of TiAl6V4 are limiting factors that can cause clinical problems. Therefore, the objective of this study was to analyze and identify suitable phases and microstructural states of TiAl6V4 alloy with advantageous implant properties by thermal treatments. By varying the temperature and cooling rate, four heat treatment strategies were derived that produced different microstructural states that differed in morphology, arrangement and proportions of phases present. All TiAl6V4 modifications were characterized regarding their microstructure, mechanical, corrosive and tribological properties, as well as cell adhesion. The acicular, martensitic microstructure achieves a significant hardness increase by up to 63% and exhibits improved corrosion and wear resistance compared to the forged condition. Whereas the modified microstructures showed similar electrochemical properties in polarization tests using different electrolytes (PBS with H2O2 and HCl additives), selective α or β phase dissolution occurred under severe inflammatory crevice conditions after four weeks of exposure at 37 °C. The microstructurally selective corrosion processes resemble the damage patterns of retrieved Ti-based implants and provide a better understanding of clinically relevant in vivo crevice corrosion mechanisms. Furthermore, a microstructural effect on cell attachment was determined and is correlated to the size of the vanadium-rich β phase. These key findings highlight the relevance of an adapted processing of TiAl6V4 alloy to increase the longevity of implants.
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Affiliation(s)
- Maria Herbster
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
| | - Karsten Harnisch
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
| | - Paulina Kriegel
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
| | - Andreas Heyn
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
| | - Manja Krüger
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
| | - Christoph H. Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Thorsten Halle
- Institute of Materials and Joining Technology, Otto-von-Guericke University, 39106 Magdeburg, Germany
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13
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Kurtz MA, Khullar P, Gilbert JL. Cathodic activation and inflammatory species are critical to simulating in vivo Ti-6Al-4V selective dissolution. Acta Biomater 2022; 149:399-409. [PMID: 35842034 DOI: 10.1016/j.actbio.2022.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022]
Abstract
In vivo retrievals of metallic orthopedic implants have shown selective dissolution of Ti-6Al-4V, where the vanadium-rich β phase preferentially corrodes from the surface. This damage, typically observed in crevices, is not directly caused by wear mechanics and the underlying electrochemical mechanism remains poorly understood. Previous studies show that fretting corrosion can cause negative potential drops, resulting in a decrease in surface oxide passivation resistance and the electrochemical generation of reactive oxygen species (ROS) at metallic surfaces. In this study, we combine cathodic activation and hydrogen peroxide to induce selective dissolution in vitro. After a 600 s -1 V hold and 4 h recovery in 20 °C 1 M H2O2 solution, the Ti-6Al-4V β phase was preferentially dissolved. An initial activation threshold of -0.5 V induced a significant increase in β dissolution (p = 0.000). Above this threshold, little selective dissolution occurred. In an Arrhenius-like fashion, decreasing solution concentration to 0.1 M required 72 h to generate β dissolution instead of 4 h at 1 M. Heating 0.1 M solution to body temperature (37 °C) resulted in a decrease in the time needed to replicate a similar level of β dissolution (>90%). Electrochemical impedance shows that both cathodic activation and inflammatory species are necessary to induce selective dissolution, where the combinatorial effect causes a significant drop in oxide passivation resistance from 106 to 102 (p = 0.000). STATEMENT OF SIGNIFICANCE: Though hip arthroplasties are considered a successful procedure, revision rates of 2-4% result in tens of thousands of additional surgeries within the United States, subjecting patients to increased risk of complications. Corrosion is associated with implant failure and retrieval studies show that titanium and its alloys can severely corrode in vivo in ways not yet duplicated in vitro. Here, we reproduce selective dissolution of Ti-6Al-4V β phase simulating key characteristics of in vivo degradation observed in orthopedic retrievals. We establish both cathodically activated corrosion, a relatively unexplored concept, and the presence of inflammatory species as prerequisites, furthering our understanding of this clinically relevant damage mode. We introduce an Arrhenius-based approach to assess the concentration-temperature-time interactions present.
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Affiliation(s)
- Michael A Kurtz
- Department of Bioengineering, Clemson University, Clemson, SC, United States; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, BE 325, Charleston, SC 29425, United States
| | - Piyush Khullar
- Department of Bioengineering, Clemson University, Clemson, SC, United States; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, BE 325, Charleston, SC 29425, United States
| | - Jeremy L Gilbert
- Department of Bioengineering, Clemson University, Clemson, SC, United States; The Clemson University-Medical University of South Carolina Bioengineering Program, 68 President Street, BE 325, Charleston, SC 29425, United States.
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14
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Liu MJ, Guo J, Hoffman AS, Stenlid JH, Tang MT, Corson ER, Stone KH, Abild-Pedersen F, Bare SR, Tarpeh WA. Catalytic Performance and Near-Surface X-ray Characterization of Titanium Hydride Electrodes for the Electrochemical Nitrate Reduction Reaction. J Am Chem Soc 2022; 144:5739-5744. [PMID: 35315649 DOI: 10.1021/jacs.2c01274] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The electrochemical nitrate reduction reaction (NO3RR) on titanium introduces significant surface reconstruction and forms titanium hydride (TiHx, 0 < x ≤ 2). With ex situ grazing-incidence X-ray diffraction (GIXRD) and X-ray absorption spectroscopy (XAS), we demonstrated near-surface TiH2 enrichment with increasing NO3RR applied potential and duration. This quantitative relationship facilitated electrochemical treatment of Ti to form TiH2/Ti electrodes for use in NO3RR, thereby decoupling hydride formation from NO3RR performance. A wide range of NO3RR activity and selectivity on TiH2/Ti electrodes between -0.4 and -1.0 VRHE was observed and analyzed with density functional theory (DFT) calculations on TiH2(111). This work underscores the importance of relating NO3RR performance with near-surface electrode structure to advance catalyst design and operation.
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Affiliation(s)
- Matthew J Liu
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
| | - Jinyu Guo
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
| | - Adam S Hoffman
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - Joakim Halldin Stenlid
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States.,SUNCAT Center for Interface Science and Catalysis, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - Michael T Tang
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States.,SUNCAT Center for Interface Science and Catalysis, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - Elizabeth R Corson
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
| | - Kevin H Stone
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - Frank Abild-Pedersen
- SUNCAT Center for Interface Science and Catalysis, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - Simon R Bare
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States.,SUNCAT Center for Interface Science and Catalysis, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
| | - William A Tarpeh
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States.,SUNCAT Center for Interface Science and Catalysis, SLAC National Accelerator Laboratory, Menlo Park, California 94025, United States
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15
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Sheng X, Wang A, Wang Z, Liu H, Wang J, Li C. Advanced Surface Modification for 3D-Printed Titanium Alloy Implant Interface Functionalization. Front Bioeng Biotechnol 2022; 10:850110. [PMID: 35299643 PMCID: PMC8921557 DOI: 10.3389/fbioe.2022.850110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022] Open
Abstract
With the development of three-dimensional (3D) printed technology, 3D printed alloy implants, especially titanium alloy, play a critical role in biomedical fields such as orthopedics and dentistry. However, untreated titanium alloy implants always possess a bioinert surface that prevents the interface osseointegration, which is necessary to perform surface modification to enhance its biological functions. In this article, we discuss the principles and processes of chemical, physical, and biological surface modification technologies on 3D printed titanium alloy implants in detail. Furthermore, the challenges on antibacterial, osteogenesis, and mechanical properties of 3D-printed titanium alloy implants by surface modification are summarized. Future research studies, including the combination of multiple modification technologies or the coordination of the structure and composition of the composite coating are also present. This review provides leading-edge functionalization strategies of the 3D printed titanium alloy implants.
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Affiliation(s)
- Xiao Sheng
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Ao Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Chen Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
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16
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Microstructure and electrochemical behavior of contemporary Ti6Al4V implant alloys. JOURNAL OF BIO- AND TRIBO-CORROSION 2022; 8:26. [PMID: 35911172 PMCID: PMC9328449 DOI: 10.1007/s40735-021-00623-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ti6Al4V is the most common titanium alloy within the biomaterial field. While material standards for different variations of this alloy exist, there are only minimal requirements with respect to its microstructure which is directly related to the alloy's properties. Thus, a better understanding of the Ti6Al4V microstructure of common contemporary implant components and its effect on the electrochemical behavior is needed; including additively manufactured (AM) devices. Therefore, this study aimed at characterizing the microstructures of conventional and AM total joint replacement components, and to identify the effect of microstructure on the electrochemical behavior. Thus, 22 components from conventional (surgically retrieved cast and wrought implants) and AM implants (not previously implanted) were analysed to characterize microstructure by means of electron backscatter diffraction (EBSD) and energy dispersive X-Ray spectroscopy (EDS), and tested to determine its electrochemical behavior (potentiodynamic polarization and EIS). The microstructure of the conventional implants varied broadly but could be categorized into four groups as to their grain size and shape: fine equiaxed, coarse equiaxed, bimodal, and lamellar. The AM components exhibited a fifth category: lath-type. The AM components had a network of β-phase along the α-phase grain boundaries, prior β-grains, and manufacturing voids. Finally, the electrochemical study showed that the equiaxed coarse grains and lath-type grains (AM components) had inferior electrochemical behavior, whereas cast alloys had superior electrochemical behaviour; fine-grained wrought alloys likely provide the best compromise between electrochemical and mechanical properties.
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17
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Herbster M, Rosemann P, Michael O, Harnisch K, Ecke M, Heyn A, Lohmann CH, Bertrand J, Halle T. Microstructure-dependent crevice corrosion damage of implant materials CoCr28Mo6, TiAl6V4 and REX 734 under severe inflammatory conditions. J Biomed Mater Res B Appl Biomater 2022; 110:1687-1704. [PMID: 35174958 DOI: 10.1002/jbm.b.35030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 11/10/2022]
Abstract
Fretting corrosion is associated with increased risk of premature implant failure. In this complex in vivo corrosion system, the contribution of static crevice corrosion of the joined metal alloys is still unknown. The aim of this study was to develop a methodology for testing crevice corrosion behavior that simulates the physiological conditions of modular taper junctions and to identify critical factors on corrosion susceptibility. Samples of medical grade CoCr28Mo6 cast and wrought alloy, TiAl6V4 wrought alloy and REX 734 stainless steel were prepared metallographically and the microstructure was investigated using scanning electron microscopy (SEM). Crevice formers that mimic typical geometries of taper junctions were developed. Crevice corrosion immersion tests were performed in different physiological fluids (bovine serum or phosphate buffered saline with additives of 30 mM H2 O2 at pH = 1) for 4 weeks at 37°C. SEM with energy dispersive X-ray spectroscopy as well as focused ion beam were used to characterize the surface morphology, investigate present damages and identify the chemical composition of residues. Macroscopic inspection showed increased crevice corrosion susceptibility of TiAl6V4 and REX 734 under severe simulated inflammatory conditions. CoCr28Mo6 cast alloy exhibited degraded areas next to Cr- and Mo-rich precipitations that were located within the opposed crevices. The results indicate that aggressive electrolyte composition and crevice heights of 50-500 μm are critical influencing factors on crevice corrosion of biomedical alloys. Furthermore, manufacturing-related microstructure of common implant alloys determines the deterioration of corrosion resistance. The developed method should be used to enhance the corrosion resistance of common implant biomaterials by an adapted microstructure.
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Affiliation(s)
- Maria Herbster
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany.,Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Paul Rosemann
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany.,Institute of Technology and Production in Mechanical Engineering, HTWK University of Applied Sciences, Leipzig, Germany
| | - Oliver Michael
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Karsten Harnisch
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Martin Ecke
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Andreas Heyn
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Thorsten Halle
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
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18
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Wade A, Webster F, Beadling AR, Bryant MG. Importance of surgical assembly technique on the engagement of 12/14 modular tapers. Proc Inst Mech Eng H 2022; 236:158-168. [PMID: 34693823 PMCID: PMC8688978 DOI: 10.1177/09544119211053066] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/19/2021] [Indexed: 11/30/2022]
Abstract
Fretting-corrosion at the modular taper junction in total hip replacements (THR), leading to implant failure, has been identified as a clinical concern and has received increased interest in recent years. There are many parameters thought to affect the performance of the taper junction, with the assembly process being one of the few consistently identified to have a direct impact. Despite this, the assembly process used by surgeons during THR surgery differs from a suggested 'ideal' process. For example, taper junctions of cutting tools should be pushed together rather than impacted, while ensuring as much concentricity as possible between the male and female taper and loading axis. This study devised six simple assembly methodologies to investigate how surgical variations affect the success of the compressive fit achieved at the taper interface compared to a controlled assembly method, designed to represent a more 'ideal' scenario. Key findings from this study suggest that a more successful and repeatable engagement can be achieved by quasi-statically loading the male and female taper concentrically with the loading axis. This was shown by a greater disassembly to assembly force ratio of 0.626 ± 0.07 when assembled using the more 'ideal' process, compared to 0.480 ± 0.05 when using a method closer to that used by a surgeon intraoperatively. Findings from this study can be used to help inform new surgical instrumentation and an improved surgical assembly method.
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Affiliation(s)
- A Wade
- School of Mechanical Engineering, Institute of Functional Surfaces, University of Leeds, Leeds, UK
| | - F Webster
- School of Mechanical Engineering, Institute of Functional Surfaces, University of Leeds, Leeds, UK
| | - AR Beadling
- School of Mechanical Engineering, Institute of Functional Surfaces, University of Leeds, Leeds, UK
| | - MG Bryant
- School of Mechanical Engineering, Institute of Functional Surfaces, University of Leeds, Leeds, UK
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19
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Chauhan P, Koul V, Bhatnagar N. Critical Role of Etching Parameters in the Evolution of Nano Micro SLA Surface on the Ti6Al4V Alloy Dental Implants. MATERIALS 2021; 14:ma14216344. [PMID: 34771869 PMCID: PMC8585160 DOI: 10.3390/ma14216344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 01/12/2023]
Abstract
The surface of dental implants plays a vital role in early and more predictable osseointegration. SLA (sandblasted large grit and acid-etched) represents the most widely accepted, long-term clinically proven surface. Primarily, dental implants are manufactured by either commercially pure titanium (CP-Ti) or Ti6Al4V ELI alloy. The acid etch behavior of CP-Ti is well known and its effects on the surface microstructure and physicochemical properties have been studied by various researchers in the past. However, there is a lack of studies showing the effect of acid etching parameters on the Ti6Al4V alloy surface. The requirement of the narrow diameter implants necessitates implant manufacturing from alloys due to their high mechanical properties. Hence, it is necessary to have an insight on the behavior of acid etching of the alloy surface as it might be different due to changed compositions and microstructure, which can further influence the osseointegration process. The present research was carried out to study the effect of acid etching parameters on Ti6Al4V ELI alloy surface properties and the optimization of process parameters to produce micro- and nanotopography on the dental implant surface. This study shows that the Ti6Al4V ELI alloy depicts an entirely different surface topography compared to CP-Ti. Moreover, the surface topography of the Ti6Al4V ELI alloy was also different when etching was done at room temperature compared to high temperature, which in turn affected the behavior of the cell on these surfaces. Both microns and nano-level topography were achieved through the optimized parameters of acid etching on Ti6Al4V ELI alloy dental implant surface along with improved roughness, hydrophilicity, and enhanced cytocompatibility.
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Affiliation(s)
- Pankaj Chauhan
- Mechanical Engineering Department, Indian Institute of Technology, Delhi 110016, India;
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi 110016, India;
| | - Veena Koul
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi 110016, India;
| | - Naresh Bhatnagar
- Mechanical Engineering Department, Indian Institute of Technology, Delhi 110016, India;
- Correspondence:
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20
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Nanostructured Coatings (Ti,Zr)N as a Barrier to Hydrogen Diffusion into Ti0.16Pd (wt.%) Alloy. METALS 2021. [DOI: 10.3390/met11091332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The results of a study of structure, phase, and chemical compositions of nanostructured (Ti,Zr)N coatings formed by vacuum arc deposition on Ti0.16Pd (wt.%) alloy substrates are reported. The coating composition was varied depending on the quasi-binary system δ—TiN—δ—ZrN. The coatings were formed in two modes: without (mode 1) and with (mode 2) rotation of the substrates in a plasma flow. It was shown that irrespective of the deposition regime, the coatings have a single-phase nanograined (grain size ≤ 20 nm) structure of δ-nitrides TiN, (Ti,Zr)N, and ZrN. It is found out that the coatings deposited in accordance with modes 1 and 2 significantly differ in their microstructure. It is demonstrated that in the case of electrolytic hydrogenation in a physiological saline solution (0.9% NaCl), the barrier properties of the coatings deposited via mode 2 are substantially better than those deposited via mode 1 (irrespective of the chemical coating compositions). In the coatings with a regular columnar structure (mode 1), there is a high concentration of hydrogen homogeneously distributed over the coating thickness. In the coatings formed via mode 2 (without columnar microstructure), a high concentration of hydrogen was observed in the subsurface area only. It is found out that there is no hydrogen diffusion into the substrate of these coating both immediately after hydrogenation and after storing for 430 h at room temperature. It was shown that the highest barrier properties were exhibited by the (Ti,Zr)N coatings with the least correlation of spatial distribution of nanograins and Zr/Ti ≤ 1. The hydrogen absorption in the coating based on zirconium nitride increases by a factor of 2.
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21
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Dorovskikh SI, Vikulova ES, Chepeleva EV, Vasilieva MB, Nasimov DA, Maksimovskii EA, Tsygankova AR, Basova TV, Sergeevichev DS, Morozova NB. Noble Metals for Modern Implant Materials: MOCVD of Film Structures and Cytotoxical, Antibacterial, and Histological Studies. Biomedicines 2021; 9:biomedicines9080851. [PMID: 34440054 PMCID: PMC8389635 DOI: 10.3390/biomedicines9080851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
This work is aimed at developing the modification of the surface of medical implants with film materials based on noble metals in order to improve their biological characteristics. Gas-phase transportation methods were proposed to obtain such materials. To determine the effect of the material of the bottom layer of heterometallic structures, Ir, Pt, and PtIr coatings with a thickness of 1.4-1.5 μm were deposited by metal-organic chemical vapor deposition (MOCVD) on Ti6Al4V alloy discs. Two types of antibacterial components, namely, gold nanoparticles (AuNPs) and discontinuous Ag coatings, were deposited on the surface of these coatings. AuNPs (11-14 nm) were deposited by a pulsed MOCVD method, while Ag films (35-40 nm in thickness) were obtained by physical vapor deposition (PVD). The cytotoxic (24 h and 48 h, toward peripheral blood mononuclear cells (PBMCs)) and antibacterial (24 h) properties of monophase (Ag, Ir, Pt, and PtIr) and heterophase (Ag/Pt, Ag/Ir, Ag/PtIr, Au/Pt, Au/Ir, and Au/PtIr) film materials deposited on Ti-alloy samples were studied in vitro and compared with those of uncoated Ti-alloy samples. Studies of the cytokine production by PBMCs in response to incubation of the samples for 24 and 48 h and histological studies at 1 and 3 months after subcutaneous implantation in rats were also performed. Despite the comparable thickness of the fibrous capsule after 3 months, a faster completion of the active phase of encapsulation was observed for the coated implants compared to the Ti alloy analogs. For the Ag-containing samples, growth inhibition of S. epidermidis, S. aureus, Str. pyogenes, P. aeruginosa, and Ent. faecium was observed.
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Affiliation(s)
- Svetlana I. Dorovskikh
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
| | - Evgeniia S. Vikulova
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
| | - Elena V. Chepeleva
- E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, 15 Rechkunovskaya Str., 630055 Novosibirsk, Russia; (E.V.C.); (M.B.V.); (D.S.S.)
| | - Maria B. Vasilieva
- E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, 15 Rechkunovskaya Str., 630055 Novosibirsk, Russia; (E.V.C.); (M.B.V.); (D.S.S.)
| | - Dmitriy A. Nasimov
- Rzhanov Institute of Semiconductor Physics, Siberian Branch, Russian Academy of Sciences, 15 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia;
| | - Eugene A. Maksimovskii
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
| | - Alphiya R. Tsygankova
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
| | - Tamara V. Basova
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
| | - David S. Sergeevichev
- E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, 15 Rechkunovskaya Str., 630055 Novosibirsk, Russia; (E.V.C.); (M.B.V.); (D.S.S.)
| | - Natalya B. Morozova
- Nikolaev Institute of Inorganic Chemistry, Siberian Branch, Russian Academy of Sciences, 3 Acad. Lavrentiev Ave., 630090 Novosibirsk, Russia; (S.I.D.); (E.S.V.); (E.A.M.); (A.R.T.); (T.V.B.)
- Correspondence: ; Tel.: +73-833-309-556
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22
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Stockhausen KE, Riedel C, Belinski AV, Rothe D, Gehrke T, Klebig F, Gebauer M, Amling M, Citak M, Busse B. Variability in stem taper surface topography affects the degree of corrosion and fretting in total hip arthroplasty. Sci Rep 2021; 11:9348. [PMID: 33931680 PMCID: PMC8087796 DOI: 10.1038/s41598-021-88234-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 03/19/2021] [Indexed: 12/29/2022] Open
Abstract
Degradation at the modular head-neck interface in total hip arthroplasty (THA) is predominately expressed in the form of corrosion and fretting, potentially causing peri-prosthetic failure by adverse reactions to metal debris. This retrieval study aimed to quantify variations in stem taper surface topographies and to assess the influence on the formation of corrosion and/or fretting in titanium alloy stem tapers combined with metal and ceramic heads. Four hip stem designs (Alloclassic, CLS, Bicontact and SL-Plus) were characterized using high-resolution 3D microscopy, and corrosion and fretting were rated using the Goldberg scoring scheme. Quantification of the taper surface topographies revealed a high variability in surface characteristics between threaded stem tapers: Alloclassic and CLS tapers feature deeply threaded trapezoid-shaped profiles with thread heights over 65 µm. The sawtooth-shaped Bicontact and triangular SL-Plus taper are characterized by low thread heights below 14 µm. Significantly lower corrosion and fretting scores were observed in lightly threaded compared to deeply threaded tapers in ceramic head combinations. No significant differences in corrosion or fretting scores with thread height were found in pairings with metal heads. Understanding the relationship between stem taper surface topography and the formation of corrosion and fretting could help to improve the performance of modern THAs and lead to longer-lasting clinical results.
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Affiliation(s)
- Kilian Elia Stockhausen
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany
| | - Christoph Riedel
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany
| | - Alex Victoria Belinski
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany.,Department of Mechanical Engineering, University of California, 6141 Etcheverry Hall, Berkeley, CA, USA
| | - Dorothea Rothe
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany
| | - Thorsten Gehrke
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany
| | - Felix Klebig
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany
| | - Matthias Gebauer
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany
| | - Mustafa Citak
- Department of Orthopedic Surgery, Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 55a, 22529, Hamburg, Germany. .,Interdisciplinary Competence Center for Interface Research (ICCIR), Martinistr. 52, 20251, Hamburg, Germany. .,Forum Medical Technology Health Hamburg (FMTHH), Butenfeld 34, 22529, Hamburg, Germany.
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23
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Eichler D, Barry J, Lavigne M, Massé V, Vendittoli PA. No radiological and biological sign of trunnionosis with Large Diameter Head Ceramic Bearing Total Hip Arthroplasty after 5 years. Orthop Traumatol Surg Res 2021; 107:102543. [PMID: 32276843 DOI: 10.1016/j.otsr.2019.12.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Trunnionosis of large diameter (LDH) metal-on-metal total hip arthroplasty (THA) was linked to high systemic chromium (Cr) and cobalt (Co) ion levels and local adverse reactions to metal debris (ARMD). The safety of CoC LDH THA is not yet available at mid-term. Measuring whole blood Ti level of ceramic on ceramic (CoC) LDH THA with a titanium (Ti) stem is an indirect way to assess the performance of its head-neck taper modular junction. Therefore, we wanted to determine: (1) if the whole blood Ti ion levels in patients with LDH CoC THA after a minimum of 5 years of implantation is within the expected values for similar well performing Ti THA, (2) if Ti level scientifically increases over time, which would suggest the presence of a progressive modular head/neck junction wear process, (3) if clinical or radiographical manifestations of implant dysfunction are present? HYPOTHESIS Ti blood levels of LDH CoC THA will indirectly reflect the expected levels due to passive corrosion of the implants and will be stable over time. PATIENTS AND METHODS We report the whole blood Ti, Cr, and Co levels at 5years minimum for 57 patients with unilateral primary LDH CoC THA with head sizes ranging from 36 to 48mm using Ti stem and acetabular component. To compare Ti ion levels modification over time, in 25 patients were a previous measurement (1-3years) was available, we compared it to their last follow-up results (>5 years). Mean Ti level in well performing Ti THAs is recognized to be around 2.0 ug/L. Although, there are no universally accepted Ti levels associated with problematic implant, we used safety threshold of 10 ug/L. Clinical and radiological outcomes were recorded at last follow-up. RESULTS At 79 months mean follow-up, all mean Ti levels were 1.9μg/L (min 1.2, max 4.4) and all subject had values below the safety threshold of 10ug/L. In the subgroup of 25 cases with a previous measurement, there was a decrease in mean Ti levels between 20 months and 78 months follow-up (2.2μg/L (1.6-3.9) versus 2.0μg/L (1.4-2.8), p=0.007). No statistically significant relation was observed between Ti level at last FU and bearing diameter (rho=0.046, p=0.0734) or the presence or absence of a Ti adaptor sleeve (p=0.454): 1.94ug/L (min 1.20, max 2.80) versus 1.90ug/L (min 1.20, max 4.40). At last follow up, no patients presented osteolysis signs on radiographs, clinical signs of ARMD or were reoperated. Most patients had excellent clinical with 98% of them reporting minor (29%) or no functional limitation (69%) and 44% perceive their THA as a natural hip joint. However, 3/57patients (5%) temporarily experienced hip squeaking and 18/57 (31%) reported clicking sound. CONCLUSION With the tested LDH CoC THA, Ti levels were low and related the uneventful and unavoidable passive corrosion of implant surfaces. Mid-term measurement of Ti in subjects with LDH CoC did not reveal any indirect signs of trunnionosis, which should already be observable by this time. LEVEL OF EVIDENCE IV, retrospective study.
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Affiliation(s)
- David Eichler
- Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415, boulevard de l'Assomption, Montréal, QC H1T2M4, Canada
| | - Janie Barry
- Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415, boulevard de l'Assomption, Montréal, QC H1T2M4, Canada
| | - Martin Lavigne
- Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415, boulevard de l'Assomption, Montréal, QC H1T2M4, Canada
| | - Vincent Massé
- Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415, boulevard de l'Assomption, Montréal, QC H1T2M4, Canada
| | - Pascal-André Vendittoli
- Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415, boulevard de l'Assomption, Montréal, QC H1T2M4, Canada.
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24
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Romanos GE, Fischer GA, Delgado-Ruiz R. Titanium Wear of Dental Implants from Placement, under Loading and Maintenance Protocols. Int J Mol Sci 2021; 22:1067. [PMID: 33494539 PMCID: PMC7865642 DOI: 10.3390/ijms22031067] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/05/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
The objective of this review was to analyze the process of wear of implants leading to the shedding of titanium particles into the peri-implant hard and soft tissues. Titanium is considered highly biocompatible with low corrosion and toxicity, but recent studies indicate that this understanding may be misleading as the properties of the material change drastically when titanium nanoparticles (NPs) are shed from implant surfaces. These NPs are immunogenic and are associated with a macrophage-mediated inflammatory response by the host. The literature discussed in this review indicates that titanium NPs may be shed from implant surfaces at the time of implant placement, under loading conditions, and during implant maintenance procedures. We also discuss the significance of the micro-gap at the implant-abutment interface and the effect of size of the titanium particles on their toxicology. These findings are significant as the titanium particles can have adverse effects on local soft and hard tissues surrounding implants, implant health and prognosis, and even the health of systemic tissues and organs.
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Affiliation(s)
- Georgios E. Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA;
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, Johann Wolfgang Goethe University, 60590 Frankfurt, Germany
| | - Gerard A. Fischer
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, 106 Rockland Hall, Stony Brook, NY 11794-8700, USA;
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794-8700, USA;
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25
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Çiloglu O, Karaali E. The Role of Stem Modularity in the Failure of Internal Fixation in Geriatric Patients With Distally Fixed Hemiarthroplasty. Orthopedics 2021; 44:e119-e124. [PMID: 33089337 DOI: 10.3928/01477447-20201007-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/20/2020] [Indexed: 02/03/2023]
Abstract
The aim of this study was to compare the radiological and clinical outcomes of the same make of modular and monoblock tapered fluted stems in patients with failure of internal fixation following osteoporotic intertrochanteric fracture. This retrospective, comparative study included patients older than 65 years who underwent hemiarthroplasty with a modular or monoblock distally fixed fluted stem and had failed treatment with proximal femoral nailing between 2012 and 2017, with at least a 2-year follow-up period. Radiographic and clinical evaluations of the groups were compared. The modular group comprised 22 males and 18 females with a mean age of 85.05±7.1 years, and the monoblock group comprised 27 males and 17 females with a mean age of 83.27±7.0 years. No significant difference was observed between the groups regarding the preoperative and final-visit Harris Hip Score and Parker and Palmer Mobility Score values (P>.05 for both). More patients showed osseous restoration in the monoblock group, but not to a significant level. The groups were similar regarding mortality rates. Stem length was greater in the modular group, but the proximal femoral part and stem size were similar in the groups (P<.05 for all). Canal filling at levels A, B, and C was negatively correlated (weak) with the proximal femoral bone restoration (P<.001 for all). Canal filling at level B was negatively correlated (weak) with the stress shielding of the femur (P<.05 for all). When comparing the modularity of the stem by minimizing the variations of both prostheses, such as brand and geometric design, there was no significant difference in either clinical or radiological evaluations. [Orthopedics. 2021;44(1):e119-e124.].
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26
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Kobayashi K, Kidera K, Itose M, Motokawa T, Chiba K, Osaki M. Higher incidence of aseptic loosening caused by a lower canal filling ratio with a modified modular stem in total hip arthroplasty. J Orthop Surg Res 2020; 15:568. [PMID: 33256767 PMCID: PMC7706283 DOI: 10.1186/s13018-020-02101-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/19/2020] [Indexed: 11/14/2022] Open
Abstract
Purpose Although a cementless modular prosthesis has shown reliable results, cases of unstable fixation and revision due to aseptic loosening were observed in our institute. The purpose of this study was to clarify the causes of unstable fixation of the prosthesis. Methods A total of 144 patients (154 hips) who underwent total hip arthroplasty using the modular prosthesis were retrospectively investigated. For the cohort study, 97 patients (104 hips) were included. The femoral component survival rate and sleeve fixation were assessed at a minimum follow-up of 5 years. Patients were divided into 2 groups, including stable and unstable fixation groups, by sleeve fixation. Clinical and radiographic outcomes were compared. Results The Kaplan-Meier survival rate at 9 years was 93% with revision for any reason as the endpoint in study cohort. The reasons for revision were recurrent dislocation (1 hip) and aseptic loosening of the stem (5 hips). A total of 88 hips (84.6%) showed stable fixation, and 16 hips (15.4%) showed unstable fixation at final follow-up. There was no significant difference in clinical outcomes between the 2 groups at final follow-up. The canal flare index was significantly higher, and the canal filling ratio was significantly lower in the unstable fixation group. Conclusion Although the modified modular prosthesis was useful for treating anatomically difficult patients, we need to pay attention to both proximal/distal mismatch of the intramedullary canal and the canal filling ratio to achieve stable fixation and good long-term results.
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Affiliation(s)
- Kyosuke Kobayashi
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.
| | - Kenichi Kidera
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Masaru Itose
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Tetsuhiko Motokawa
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Ko Chiba
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Makoto Osaki
- Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
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27
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Kheir MM, Drayer NJ, Chen AF. An Update on Cementless Femoral Fixation in Total Hip Arthroplasty. J Bone Joint Surg Am 2020; 102:1646-1661. [PMID: 32740265 DOI: 10.2106/jbjs.19.01397] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Michael M Kheir
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nicholas J Drayer
- Department of Orthopaedic Surgery, Madigan Army Medical Center, Tacoma, Washington
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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28
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Zhu D, Liu Y, Gilbert JL. In vitro fretting crevice corrosion damage of CoCrMo alloys in phosphate buffered saline: Debris generation, chemistry and distribution. Acta Biomater 2020; 114:449-459. [PMID: 32771589 DOI: 10.1016/j.actbio.2020.07.052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022]
Abstract
Fretting crevice corrosion in modular tapers of total hip replacements has become a major concern in orthopedic medical devices. Solid and ionic debris arising from fretting crevice corrosion have been implicated in device failure and revision surgery. This study aims to use a 2D pin-on-disk fretting corrosion test system to visualize damage progression and debris generation during fretting corrosion of CoCrMo alloys in phosphate buffered saline (PBS). The results provide direct evidence of rapid debris generation during fretting corrosion (after only 12 min of testing). Debris was generated and either extruded from the contact region or impacted into adjacent crevice sites as long as fretting continued. After testing, the fretting region consisted of a damaged and plastically deformed contact region surrounded by a halo of fretting debris consisting entirely of oxides and phosphates within the crevice region. Evidence of pitting corrosion and grain boundary corrosion was observed. Solid debris consisted of chromium (Cr), phosphate (P) and oxygen (O). X-ray photoelectron spectroscopy analysis of the near-fretted metal surface area showed a thicker oxygen (O1s) containing film with the depth profile of O1s above 10% penetrating up to 5.75 nm while the O1s concentration on the unfretted area fell to below 10% after 1 nm depth. Ion concentration in the PBS, measured using inductively coupled mass spectrometry, showed cobalt (Co) ions were most prevalent (1.46 ppm) compared to chromium (Cr) (0.07 ppm) and molybdenum (Mo) (0.05 ppm) (p <0.05). All of these results are consistent with the analysis of in vivo modular taper corrosion processes. STATEMENT OF SIGNIFICANCE: CoCrMo alloys has been widely used as a metallic biomaterial for implant devices and can lose their durability and reliability due to wear, corrosion and tribocorrosion. Debris, as one of the major products of these reactions, is associated with implant device failure. In the first time, we developed a fretting corrosion testing system to visualize the debris generation process in real-time between CoCrMo alloy pin and disk samples. Debris was generated rapidly during fretting corrosion and some of the debris egressed from the crevice site while also accumulating within the crevice area as fretting continued. Our study opens a new method for future studies to advance understanding of debris generation processes during wear and tribocorrosion phenomenon.
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Affiliation(s)
- Dongkai Zhu
- Syracuse Biomaterials Institute, Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, United States; Clemson - MUSC Bioengineering Program, Department of Bioengineering, Clemson University and the Medical University of South Carolina, 68 Presidents Street, Charleston, SC 20425, United States
| | - Yangping Liu
- Syracuse Biomaterials Institute, Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, United States; Clemson - MUSC Bioengineering Program, Department of Bioengineering, Clemson University and the Medical University of South Carolina, 68 Presidents Street, Charleston, SC 20425, United States
| | - Jeremy L Gilbert
- Syracuse Biomaterials Institute, Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, United States; Clemson - MUSC Bioengineering Program, Department of Bioengineering, Clemson University and the Medical University of South Carolina, 68 Presidents Street, Charleston, SC 20425, United States.
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29
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Barrak FN, Li S, Muntane AM, Jones JR. Particle release from implantoplasty of dental implants and impact on cells. Int J Implant Dent 2020; 6:50. [PMID: 32918144 PMCID: PMC7486360 DOI: 10.1186/s40729-020-00247-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/29/2020] [Indexed: 01/01/2023] Open
Abstract
Background With increasing numbers of dental implants placed annually, complications such as peri-implantitis and the subsequent periprosthetic osteolysis are becoming a major concern. Implantoplasty, a commonly used treatment of peri-implantitis, aims to remove plaque from exposed implants and reduce future microbial adhesion and colonisation by mechanically modifying the implant surface topography, delaying re-infection/colonisation of the site. This in vitro study aims to investigate the release of particles from dental implants and their effects on human gingival fibroblasts (HGFs), following an in vitro mock implantoplasty procedure with a diamond burr. Materials and methods Commercially available implants made from grade 4 (commercially pure, CP) titanium (G4) and grade 5 Ti-6Al-4 V titanium (G5) alloy implants were investigated. Implant particle compositions were quantified by inductively coupled plasma optical emission spectrometer (ICP-OES) following acid digestion. HGFs were cultured in presence of implant particles, and viability was determined using a metabolic activity assay. Results Microparticles and nanoparticles were released from both G4 and G5 implants following the mock implantoplasty procedure. A small amount of vanadium ions were released from G5 particles following immersion in both simulated body fluid and cell culture medium, resulting in significantly reduced viability of HGFs after 10 days of culture. Conclusion There is a need for careful evaluation of the materials used in dental implants and the potential risks of the individual constituents of any alloy. The potential cytotoxicity of G5 titanium alloy particles should be considered when choosing a device for dental implants. Additionally, regardless of implant material, the implantoplasty procedure can release nanometre-sized particles, the full systemic effect of which is not fully understood. As such, authors do not recommend implantoplasty for the treatment of peri-implantitis.
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Affiliation(s)
- Fadi N Barrak
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Siwei Li
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Albert M Muntane
- School of Dentistry, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK.
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30
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Wilson TG. Bone loss around implants-is it metallosis? J Periodontol 2020; 92:181-185. [PMID: 32729118 DOI: 10.1002/jper.20-0208] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/02/2020] [Accepted: 06/07/2020] [Indexed: 12/28/2022]
Abstract
Most would agree that the etiology of dental implant failure is related to oral biofilm. At present one group of scientists and clinicians feel that biofilm is solely responsible for bone loss around the devices. However, there is strong evidence that particles and ions of titanium released into the surrounding tissues by the action of biofilm and/or mechanical forces, a process termed metallosis, can be responsible for bone loss around some dental implants. These findings are reinforced by similar responses found around failed metal on metal joint prostheses. Both possible etiologies are discussed in detail in this commentary.
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31
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Cohn MR, Tetreault MW, Li J, Kunze KN, Nahhas CR, Michalski JF, Levine BR, Nam D. Is There a Benefit to Modularity for Femoral Revisions When Using a Splined, Tapered Titanium Stem? J Arthroplasty 2020; 35:S278-S283. [PMID: 32067894 DOI: 10.1016/j.arth.2019.12.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/26/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Proposed benefits of modularity for femoral revisions in total hip arthroplasty (THA) include more precise biomechanical restoration and improved stability, but this has not been proven with use of a splined, tapered design. This study's purpose is to compare (1) complication rates, (2) functional outcomes, and (3) radiographic measures of subsidence, offset, and leg length discrepancy with the use of modular vs monoblock splined, tapered titanium stems in revision THA. METHODS We retrospectively reviewed 145 femoral revisions with minimum 2-year follow-up (mean, 5.12 years; range, 2-17.3 years). Patients receiving a modular (67) or monoblock (78) splined, tapered titanium stem for femoral revision were included. RESULTS There were no statistically significant differences in rates of reoperation (22.3% vs 17.9%; P = .66), intraoperative fracture (9.0% vs 3.8%; P = .30), postoperative fracture (3.0% vs 1.3%; P = .47), dislocation (11.9% vs 5.1%; P = .23), or aseptic loosening (4.5% vs 6.4%; P = .73) between the modular and monoblock cohorts, respectively. There were similar results regarding subsidence >5 mm (10.4% vs 12.8%; P = .22), LLD >1 cm (35.8% vs 38.5%; P = .74), restoration of hip offset (-5.88 ± 10.1 mm vs -5.07 ± 12.1 mm; P = .67), and Harris Hip Score (70.7 ± 17.9 vs 73.9 ± 19.7; P = .36) between groups. Multivariate regression showed no differences in complications (P = .44) or reoperations (P = .20) between groups. CONCLUSION Modular and monoblock splined, tapered titanium stems demonstrated comparable complication rates, functional outcomes, and radiographic parameters for femoral revisions. However, a limited number of patients with grade IIIB or IV femoral bone loss received a monoblock stem. Future investigations are required to determine whether modularity is beneficial for more complex femoral defects.
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Affiliation(s)
- Matthew R Cohn
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Matthew W Tetreault
- Capital Region Orthopaedics and Department of Orthopaedics, Albany Medical Center, Albany, NY
| | - Jefferson Li
- Department of Orthopaedic Surgery, University of California San Francisco-Fresno, Fresno, CA
| | - Kyle N Kunze
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Cindy R Nahhas
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Joseph F Michalski
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Brett R Levine
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Denis Nam
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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32
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McGrory BJ, Jacobs JJ, Kwon YM, Fillingham Y. Standardizing terms for tribocorrosion-associated adverse local tissue reaction in total hip arthroplasty. Arthroplast Today 2020; 6:196-200. [PMID: 32577461 PMCID: PMC7303482 DOI: 10.1016/j.artd.2020.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 02/08/2023] Open
Abstract
Recognizing and adopting standardized terms for adverse local tissue reaction associated with tribocorrosion in total hip arthroplasty are essential for clear scientific discourse and clinical communication. Our goal was to develop terms that can be broadly applied to characterize the local tissue response to tribocorrosion debris, based on current evidence regarding the etiology of this failure mode and its consequences. The proposed standardized terms will improve the understanding and interpretation of analytical tests, advance diagnostic and treatment algorithms, and reduce confusion in research by maintaining consistent nomenclature.
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Affiliation(s)
- Brian J. McGrory
- Corresponding author. Department of Orthopaedic Surgery, Tufts University School of Medicine, Boiston, MA, USA; Maine Medical Center Division of Joint Replacements, Portland, ME, USA. Tel.: +1 207 781 1551.
| | - Joshua J. Jacobs
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, MA, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Young-Min Kwon
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, MA, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Yale Fillingham
- Department of Orthopaedic Surgery, Tufts University School of Medicine, Boston, MA, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
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Wheelis SE, Biguetti CC, Natarajan S, Guida L, Hedden B, Garlet GP, Rodrigues DC. Investigation of the early healing response to dicationic imidazolium-based ionic liquids: a biocompatible coating for titanium implants. ACS Biomater Sci Eng 2020; 6:984-994. [PMID: 32656316 DOI: 10.1021/acsbiomaterials.9b01884] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dicationic Imidazolum-based ionic liquids with amino acid anions (IonL) have been proposed as a multifunctional coating for titanium dental implants, as their properties have been shown to address multiple early complicating factors while maintaining host cell compatibility. This study aims to evaluate effects of this coating on host response in the absence of complicating oral factors during the early healing period using a subcutaneous implantation model in the rat. IonLs with the best cytocompatibility and antimicrobial properties (IonL-Phe, IonL-Met) were chosen as coatings. Three different doses were applied to cpTi disks and subcutaneously implanted into 36 male Lewis rats. Rats received 2 implants: 1 coated implant on one side and an uncoated implant on the contralateral sides (n=3 per formulation, per dose). Peri-implant tissue was evaluated 2 and 14 days after implantation with H&E staining and IHC markers associated with macrophage polarization as well as molecular analysis (qPCR) for inflammatory and healing markers. H&E stains revealed the presence of the coating, blood clots and inflammatory infiltrate at 2 days around all implants. At 14 days, inflammation had receded with more developed connective tissue with fibroblasts, blood vessels in certain doses of coated and uncoated samples with no foreign body giant cells. This study demonstrated that IonL at the appropriate concentration does not significantly interfere with and healing and Ti foreign body response. Results regarding optimal dose and formulation from this study will be applied in future studies using an oral osseointegration model.
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Affiliation(s)
| | - Claudia C Biguetti
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.,Bauru School of Dentistry, Department of Biological Sciences, University of São Paulo São Paulo, Brazil
| | - Shruti Natarajan
- Department of Biological Sciences, University of Texas at Dallas
| | - Lidia Guida
- Deparment of Bioengineering, University of Texas at Dallas
| | - Brian Hedden
- Deparment of Bioengineering, University of Texas at Dallas
| | - Gustavo P Garlet
- Bauru School of Dentistry, Department of Biological Sciences, University of São Paulo São Paulo, Brazil
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Sivan S, Rahman E, Weaver JD, Di Prima M. Comparison of ASTM F2129 and ASTM F746 for Evaluating Crevice Corrosion. JOURNAL OF TESTING AND EVALUATION 2019; 47:2497-2511. [PMID: 37680964 PMCID: PMC10483512 DOI: 10.1520/jte20180585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Crevice corrosion is one of the major mechanisms that drives implant failure in orthopedic devices that have modular interfaces. Despite the prevalence of crevice corrosion in modular interfaces, very little is known with regards to the susceptibility of different material combinations to participate in crevice corrosion. In this study, we compare two electrochemical methods, ASTM F2129, Standard Test Method for Conducting Cyclic Potentiodynamic Polarization Measurements to Determine the Corrosion Susceptibility of Small Implant Devices, and a modified version of ASTM F746, Standard Test Method for Pitting or Crevice Corrosion of Metallic Surgical Implant Materials, in their ability to induce crevice corrosion. Four commonly used metals, 316 stainless steel, commercially pure titanium (Ti grade 2), Ti-6Al-4V (Ti grade 5), and cobalt-chromium-molybdenum per ASTM F1537, Standard Specification for Wrought Cobalt-28Chromium-6Molybdenum Alloys for Surgical Implants (UNSR31537, UNSR31538, and UNSR31539), were used to form crevices with a rod and washer combination. As a control, the metal rod materials were tested alone in the absence of crevices using ASTM F2129 and the modified ASTM F746 method. As another control to determine if crevices formed with polymeric materials would influence crevice corrosion susceptibility, experiments were also conducted with metal rods and polytetrafluorethylene washers. Our results revealed more visible corrosion after ASTM F2129 than ASTM F746. Additionally, ASTM F746 was found to falsely identify crevice corrosion per the critical pitting potential when visual inspection found no evidence of crevice corrosion. Hence, ASTM F2129 was found to be more effective overall at evaluating crevice corrosion compared to ASTM F746.
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Affiliation(s)
- Shiril Sivan
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, USA
| | - Elnaz Rahman
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, USA
| | - Jason D Weaver
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, USA
| | - Matthew Di Prima
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, USA
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Design, Material, and Seating Load Effects on In Vitro Fretting Corrosion Performance of Modular Head-Neck Tapers. J Arthroplasty 2019; 34:991-1002. [PMID: 30827717 DOI: 10.1016/j.arth.2019.01.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/03/2019] [Accepted: 01/17/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The short-term corrosion and micromechanical behavior of 32 unique head-neck taper design/material/assembly conditions was tested using an incremental cyclic fretting corrosion (ICFC) test method previously developed. METHODS Seven materials, design, and simulated surgical parameters were evaluated, each being assigned 2 conditions for testing, using a 27-2 (7 factor, quarter factorial) design of experiments test matrix. The factors explored were (1) seating load, (2) head-neck offset, (3) material combination, (4) taper diameter, (5) taper roughness, (6) angular mismatch/engagement, and (7) taper length. Each sample underwent assembly, ICFC testing, pull off. RESULTS Low seating load and high head offset correlated with increased fretting corrosion (P < .05). High head offset also contributed to a lower onset load for fretting current and higher micromotion (P < .05). Head subsidence measured over the ICFC test for samples seated at 100 N was significantly higher than samples seated at 4000 N. Micromotion for 12-mm head offsets was statistically higher than samples with a 1.5-mm head offset. A number of interactive effects were observed. For example, samples seated at 4000 N were less sensitive to head offset than samples seated at 100 N in terms of the resulting fretting current. CONCLUSION Taper locking position, material combination, taper engagement length, taper roughness, and taper dimensions all had weak or no correlation with fretting current and taper micromotion. This test method and experimental design is a versatile means of assessing potential new taper designs in the future.
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DeRogatis MJ, Wintermeyer E, Sperring TR, Issack PS. Modular Fluted Titanium Stems in Revision Hip Arthroplasty. J Bone Joint Surg Am 2019; 101:745-754. [PMID: 30994593 DOI: 10.2106/jbjs.18.00753] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Michael J DeRogatis
- Department of Orthopaedic Surgery, New York - Presbyterian Hospital, New York, NY
| | - Elke Wintermeyer
- Department of Orthopaedic Surgery, New York - Presbyterian Hospital, New York, NY.,Department of Trauma and Reconstructive Surgery, BG Trauma Center, Tuebingen, Germany
| | - Thomas R Sperring
- Department of Orthopaedic Surgery, New York - Presbyterian Hospital, New York, NY
| | - Paul S Issack
- Department of Orthopaedic Surgery, New York - Presbyterian Hospital, New York, NY
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Sridhar S, Wang F, Wilson TG, Palmer K, Valderrama P, Rodrigues DC. The role of bacterial biofilm and mechanical forces in modulating dental implant failures. J Mech Behav Biomed Mater 2019; 92:118-127. [PMID: 30685725 DOI: 10.1016/j.jmbbm.2019.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/27/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
Currently many assume that bacteria are the primary etiological factor associated with failure of titanium dental implants. However, emerging data indicates a possible role for mechanical forces in implant failure. This study is based on the hypothesis that the synergistic effect of mechanical forces and bacterial biofilm can lead to surface damage resulting in in vivo release of metallic particles. The primary aim of the study was to develop a dynamic fatigue test method for dental implants immersed in wet environments such as; (i) 0.01 M phosphate buffer saline (PBS); (ii) lactic acid (pH = 5); (iii) bacterial polyculture. Four dental implants each were subjected to fatigue loading from 45 N to 450 N at 4 Hz for 2 million cycles while immersed in (i) PBS (negative control); (ii) bacterial culture (test); and (iii) lactic acid (positive control). Post-testing, optical microscopy, x-ray photoelectron spectroscopy, and electrochemical corrosion tests were performed to evaluate the surface morphology, chemistry, and potential, respectively, of titanium implants. Post-testing, surface discoloration was evident in all three groups. However, the surface damage was further established in XPS analyses of test specimens, which showed that the interplay of bacterial biofilm and mechanical forces resulted in thinning of the TiO2. Lower corrosion potential (Ecorr) of the test specimens compared to positive and negative controls also illustrated damage to the oxide layer. However, other electrochemical parameters such as linear polarization resistance (LPR) and corrosion rate (CR) were comparable among the groups indicating the corrosion resistance post-testing. The synergistic effect of cyclic occlusal loading and bacteria biofilm could negatively affect the surface of titanium dental implants.
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Affiliation(s)
- Sathyanarayanan Sridhar
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, United States.
| | - Frederick Wang
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, United States.
| | - Thomas G Wilson
- Private Practice of Periodontics, Dallas, TX 75231, United States.
| | - Kelli Palmer
- Department of Biological Sciences, University of Texas at Dallas, Richardson, TX 75080, United States.
| | - Pilar Valderrama
- Private Practice of Periodontics, Dallas, TX 75231, United States.
| | - Danieli C Rodrigues
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, United States.
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Harrel SK, Wilson TG, Pandya M, Diekwisch TGH. Titanium particles generated during ultrasonic scaling of implants. J Periodontol 2018; 90:241-246. [PMID: 30312471 DOI: 10.1002/jper.18-0230] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/23/2018] [Accepted: 07/16/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is growing concern that titanium particles may play a role in peri-implant breakdown. Ultrasonic scalers are routinely used in the debridement of peri-implant lesions. This in vitro study is designed to evaluate if titanium particles are produced when an ultrasonic scaler is used on an implant. METHODS New sandblasted, large grit, acid etched (SLA) coated implants were subjected to ultrasonic scaling with stainless steel, titanium, and PEEK plastic tips. The implants were placed in a holding device and the ultrasonic scaler was positioned on the SLA surface under 25 grams of pressure. The implants were subjected to 30 scaling motions. The ultrasonic coolant water was collected and the number of metallic particles were counted under a light microscope. The particles were confirmed to be titanium via elemental analysis. The implants were visually evaluated for damage to the SLA coating. RESULTS No metallic particles were detected in the water supplied to the ultrasonic scalers (passive control). Metallic particles were detected when implants were subjected to the ultrasonic coolant water only without the scaler tip touching the implant (active control). All implants that were scaled produced metallic particles and showed easily detectable damage to the SLA layer. CONCLUSIONS All ultrasonic scaling caused the production of titanium particles and caused damage to the SLA coating of the implant. Ultrasonic scalers should be used with great caution in the treatment of peri-implant conditions and care should be taken to not touch the SLA surface of the implant.
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Affiliation(s)
- Stephen K Harrel
- Periodontal Department, Texas A&M College of Dentistry, Dallas, TX
| | | | - Mirali Pandya
- Periodontal Department, Texas A&M College of Dentistry, Dallas, TX
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Delgado-Ruiz R, Romanos G. Potential Causes of Titanium Particle and Ion Release in Implant Dentistry: A Systematic Review. Int J Mol Sci 2018; 19:E3585. [PMID: 30428596 PMCID: PMC6274707 DOI: 10.3390/ijms19113585] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/09/2018] [Accepted: 11/11/2018] [Indexed: 01/03/2023] Open
Abstract
Implant surface characteristics, as well as physical and mechanical properties, are responsible for the positive interaction between the dental implant, the bone and the surrounding soft tissues. Unfortunately, the dental implant surface does not remain unaltered and changes over time during the life of the implant. If changes occur at the implant surface, mucositis and peri-implantitis processes could be initiated; implant osseointegration might be disrupted and bone resorption phenomena (osteolysis) may lead to implant loss. This systematic review compiled the information related to the potential sources of titanium particle and ions in implant dentistry. Research questions were structured in the Population, Intervention, Comparison, Outcome (PICO) framework. PICO questionnaires were developed and an exhaustive search was performed for all the relevant studies published between 1980 and 2018 involving titanium particles and ions related to implant dentistry procedures. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for the selection and inclusion of the manuscripts in this review. Titanium particle and ions are released during the implant bed preparation, during the implant insertion and during the implant decontamination. In addition, the implant surfaces and restorations are exposed to the saliva, bacteria and chemicals that can potentially dissolve the titanium oxide layer and, therefore, corrosion cycles can be initiated. Mechanical factors, the micro-gap and fluorides can also influence the proportion of metal particles and ions released from implants and restorations.
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Affiliation(s)
- Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
| | - Georgios Romanos
- Department of Periodontics, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA.
- Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, 60323 Frankfurt, Germany.
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Multifaceted roles of environmental factors toward dental implant performance: Observations from clinical retrievals and in vitro testing. Dent Mater 2018; 34:e265-e279. [DOI: 10.1016/j.dental.2018.08.299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/16/2018] [Accepted: 08/29/2018] [Indexed: 12/27/2022]
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Abstract
INTRODUCTION Metal ion release from wear and corrosion at the femoral head-stem taper junction can evoke local adverse reactions to metal debris (ARMD). In a specific large-diameter head (LDH) total hip arthroplasty (THA) system, ceramic femoral heads of 44 to 48 mm are available with a titanium (Ti) adaptor sleeve, while heads of 36- to 40-mm come without sleeves. The hypothesis of this study is that the Ti adaptor sleeve with LDH ceramic-on-ceramic (CoC) bearings will not cause wear or corrosion at the taper junction and, thus, will not generate high whole blood Ti ion levels. METHODS We compared whole blood Ti levels at minimum 1-year follow-up in 27 patients with unilateral primary LDH CoC THA with head sizes ranging from 36 to 48 mm using a Ti stem and acetabular component. RESULTS Although Ti ion levels in patients with 36- to 40-mm head diameters without Ti sleeve were found to be statistically significantly higher (2.3 μg/l: 1.6-3.1, SD 0.44) compared to those with a Ti sleeve (1.9 μg/l: 1.6-2.2, SD 0.19) (p = 0.020), the found difference has no clinical importance. No patients presented clinical signs of ARMD, and the clinical results in both groups were similar. CONCLUSIONS LDH CoC THA Ti levels were low and probably related to unavoidable passive corrosion of implant surfaces. Measurement of Ti in subjects with ceramic LDH, with or without Ti adaptor sleeve, did not disclose undirected signs of trunnionosis.
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Royhman D, Patel M, Jacobs JJ, Wimmer MA, Hallab NJ, Mathew MT. In vitro simulation of fretting-corrosion in hip implant modular junctions: The influence of pH. Med Eng Phys 2018; 52:1-9. [DOI: 10.1016/j.medengphy.2017.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 10/25/2017] [Accepted: 10/29/2017] [Indexed: 11/26/2022]
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Ramesh D, Sridhar S, Siddiqui DA, Valderrama P, Rodrigues DC. Detoxification of Titanium Implant Surfaces: Evaluation of Surface Morphology and Bone-Forming Cell Compatibility. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40735-017-0111-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Oskouei RH, Barati MR, Farhoudi H, Taylor M, Solomon LB. A new finding on the in-vivo crevice corrosion damage in a CoCrMo hip implant. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017. [DOI: 10.1016/j.msec.2017.05.086] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Saba JN, Siddiqui DA, Rodriguez LC, Sridhar S, Rodrigues DC. Investigation of the Corrosive Effects of Dental Cements on Titanium. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40735-017-0083-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Bryant M, Neville A. Fretting corrosion of CoCr alloy: Effect of load and displacement on the degradation mechanisms. Proc Inst Mech Eng H 2017; 231:114-126. [PMID: 28233505 DOI: 10.1177/0954411916680237] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fretting corrosion of medical devices is of growing concern, yet, the interactions between tribological and electrochemical parameters are not fully understood. Fretting corrosion of CoCr alloy was simulated, and the components of damage were monitored as a function of displacement and contact pressure. Free corrosion potential (Ecorr), intermittent linear polarisation resistance and cathodic potentiostatic methods were used to characterise the system. Interferometry was used to estimate material loss post rubbing. The fretting regime influenced the total material lost and the dominant degradation mechanism. At high contact pressures and low displacements, pure corrosion was dominant with wear and its synergies becoming more important as the contact pressure and displacement decreased and increased, respectively. In some cases, an antagonistic effect from the corrosion-enhanced wear contributor was observed suggesting that film formation and removal may be present. The relationship between slip mechanism and the contributors to tribocorrosion degradation is presented.
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Affiliation(s)
- Michael Bryant
- Institute of Functional Surfaces (iFS), School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Anne Neville
- Institute of Functional Surfaces (iFS), School of Mechanical Engineering, University of Leeds, Leeds, UK
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Properties and Corrosion Performance of Self-reinforced Composite PEEK for Proposed Use as a Modular Taper Gasket. Clin Orthop Relat Res 2016; 474:2414-2427. [PMID: 27146655 PMCID: PMC5052187 DOI: 10.1007/s11999-016-4861-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fretting corrosion in medical alloys is a persistent problem, and the need for biomaterials that can effectively suppress mechanically assisted crevice corrosion in modular taper junctions or otherwise insulate metal-on-metal interfaces in mechanically demanding environments is as yet unmet. QUESTIONS/PURPOSES The purpose of this study is to characterize a novel material, self-reinforced composite polyetheretherketone (SRC-PEEK) and to evaluate its ability to inhibit fretting corrosion in a pin-on-disk metal-on-metal interface test. METHODS SRC-PEEK was fabricated by hot compaction of in-house-made PEEK fibers by compacting uniaxial layups at 344°C under a load of 18,000 N for 10 minutes. SRC-PEEK, bulk isotropic PEEK, and the in-house-made PEEK fibers were analyzed for thermal transitions (Tg, Tm) through differential scanning calorimetry, crystallinity, crystal size, crystalline orientation (Hermanns orientation parameter) through wide-angle x-ray scattering, and modulus, tensile strength, yield stress, and strain to failure through monotonic tensile testing. SRC-insulated pin-on-disk samples were compared with metal-on-metal control samples in pin-on-disk fretting corrosion experiments using fretting current and fretting mechanics measurements. Fifty-micron cyclic motion at 2.5 Hz was applied to the interface, first over a range of loads (0.5-35 N) while held at -0.05 V versus Ag/AgCl and then over a range of voltages (-0.5 to 0.5 V) at a constant contact stress of 73 ± 19 MPa for SRC-PEEK and 209 ± 41 MPa for metal-on-metal, which were different for each group as a result of changes in true contact area due to variations in modulus between sample groups. Pins, disks, and SRC samples were imaged for damage (on alloy and SRC surfaces) and evidence of corrosion (on alloy pin and disk surfaces). SRC specimens were analyzed for traces of alloy transferred to the surface using energy dispersive spectroscopy after pin-on-disk testing. RESULTS SRC-PEEK showed improved mechanical properties to bulk PEEK (modulus = 5.0 ± 0.3 GPa, 2.8 ± 0.1 GPa, respectively, p < 0.001) and higher crystallinity to bulk PEEK (44.2% ± 3%, 39.5% ± 0.5%, respectively, p = 0.039), but had comparable crystalline orientation as compared with the initial PEEK fibers. SRC-PEEK reduced fretting currents compared with metal-on-metal controls by two to three orders of magnitude in both variable load (4.0E-5 ± 3.8E-5 μA versus 2.9E-3 ± 7.1E-4 μA, respectively, p = 0.018) and variable potential (7.5E-6 ± 4.7E-6 μA versus 5.3E-3 ± 1.4E-3 μA, respectively, p = 0.022) fretting corrosion testing. Minimal damage was observed on surfaces insulated with SRC-PEEK, whereas control surfaces showed considerable fretting corrosion damage and metal transfer. CONCLUSIONS The SRC-PEEK gaskets in this study demonstrated higher crystallinity and crystalline orientation and improved monotonic tensile properties compared with bulk PEEK with the ability to effectively insulate Ti6Al4V and CoCrMo alloy surfaces and prevent the initiation of fretting corrosion under high contact-stress conditions. CLINICAL RELEVANCE This novel SRC-PEEK material may offer potential as a thin film gasket material for modular tapers. Pending further in vitro and in vivo analyses, this approach may be able to preserve the advantages of modular junctions for surgeons while potentially limiting the downside risks associated with mechanically assisted crevice corrosion.
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Ciolko AA, Tobias M, Ehrensberger MT. The effect of fretting associated periodic cathodic potential shifts on the electrochemistry and in vitro biocompatibility of commercially pure titanium. J Biomed Mater Res B Appl Biomater 2016; 104:1591-1601. [PMID: 26305857 DOI: 10.1002/jbm.b.33499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/06/2022]
Abstract
This study explored how periodic cathodic polarization of commercially pure titanium (cpTi) alters its electrochemical properties and biocompatibility. MC3T3-E1 preosteoblast cells were cultured directly on cpTi samples and maintained at open circuit potential (OCP) for 24 h followed by an additional 24-h sequence of periodic cathodic polarization to -1000 or -750 mV (vs. Ag/AgCl) for 1 s followed by a 5-s recovery at OCP. Control experiments were performed where the samples were maintained at OCP throughout the entire test. Subsequent electrochemical impedance spectroscopy revealed both of the periodic cathodic polarization conditions significantly reduced the polarization resistance (Rp ), while only the -1000 mV condition significantly increased the capacitance (C) as compared to the controls. Scanning electron micrographs showed that the cells were fragmented and balled up on the samples periodically shifted to -1000 mV as compared to the cells that were well spread on the controls and samples periodically shifted to -750 mV. Additionally, live/dead fluorescence microscopy revealed that periodic polarizations to -1000 mV reduced cell viability to around 12% as compared to the greater than 95% cell viability observed on the controls and samples periodically polarized to -750 mV. This work showed that periodic cathodic potential shifts can notably alter the electrochemical behavior of cpTi and the viability and morphology of cells seeded directly onto its surface. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1591-1601, 2016.
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Affiliation(s)
- Alexandra A Ciolko
- Department of Biomedical Engineering, State University of New York at Buffalo, Buffalo, New York
| | - Menachem Tobias
- Department of Orthopaedic Surgery, University of New York at Buffalo, Buffalo, New York
| | - Mark T Ehrensberger
- Department of Biomedical Engineering, State University of New York at Buffalo, Buffalo, New York. .,Department of Orthopaedic Surgery, University of New York at Buffalo, Buffalo, New York.
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Royhman D, Patel M, Runa MJ, Wimmer MA, Jacobs JJ, Hallab NJ, Mathew MT. Fretting-corrosion behavior in hip implant modular junctions: The influence of friction energy and pH variation. J Mech Behav Biomed Mater 2016; 62:570-587. [DOI: 10.1016/j.jmbbm.2016.05.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 02/24/2016] [Accepted: 05/18/2016] [Indexed: 11/30/2022]
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Laurençon J, Augsburger M, Faouzi M, Becce F, Hassani H, Rüdiger HA. Systemic Metal Ion Levels in Patients With Modular-Neck Stems: A Prospective Cohort Study. J Arthroplasty 2016; 31:1750-5. [PMID: 26880329 DOI: 10.1016/j.arth.2016.01.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/05/2016] [Accepted: 01/18/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Recent registry data reveal that modular-neck hip prostheses are associated with increased revision rates compared to fixed-neck stems. Poor implant survival has been associated to corrosion at the neck-stem junction, inducing metal ion release and subsequently adverse local tissue reactions. Data on metal ion release on the neck-stem junction of such stems are scarce. The purpose of this study was to evaluate corrosion at this interface by determining metal ion release. METHODS Serum and whole blood metal ion levels of 40 patients after 1 year of implantation of a modular-neck stem (titanium stem and cobalt-chromium neck) were compared with 10 patients with a monobloc version of the stem (all titanium) and 10 patients having no implant at all. RESULTS Seven of 40 patients (18%) with a modular-neck stem had cobalt or chromium concentrations >2 μg/L. These patients underwent magnetic resonance imaging using metal artifact reduction sequences, which revealed a pseudotumor in 1 patient. CONCLUSION Corrosion at the neck-stem junction of modular-neck stems is a reported phenomenon, which is in part reflected by elevated systemic ion levels. The use of such implants should be restricted to a minimum, and screening algorithms of patients with such implants must be developed.
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Affiliation(s)
- Jonathan Laurençon
- Department of Orthopaedics, Lausanne University Hospital, Lausanne, Switzerland
| | - Marc Augsburger
- Forensic Toxicology and Chemistry Unit, Centre Universitaire Romand de Médecine Légale CURML, Lausanne, Switzerland
| | - Mohamed Faouzi
- Department of Biostatistics, University of Lausanne, Lausanne, Switzerland
| | - Fabio Becce
- Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Hassen Hassani
- Department of Orthopaedics, Lausanne University Hospital, Lausanne, Switzerland
| | - Hannes A Rüdiger
- Department of Orthopaedics, Lausanne University Hospital, Lausanne, Switzerland; Department of Orthopaedics, Schulthess Clinic, Zürich, Switzerland
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