On the Formation Mechanism of Column Damage Within Modular Taper Junctions

Has Wrought Cobalt-Chromium-Molybdenum Alloy Changed for the Worse Over Time?

BACKGROUND

Total hip arthroplasty (THA) failure due to tribocorrosion of modular junctions and resulting adverse local tissue reactions to corrosion debris have seemingly increased over the past few decades. Recent studies have found that chemically-induced column damage seen on the inner head taper is enabled by banding in the alloy microstructure of wrought cobalt-chromium-molybdenum alloy femoral heads, and is associated with more material loss than other tribocorrosion processes. It is unclear if alloy banding represents a recent phenomenon. The purpose of this study was to examine THAs implanted in the 1990s, 2000s, and 2010s to determine if alloy microstructure and implant susceptibility to severe damage has increased over time.

METHODS

Five hundred and forty-five modular heads were assessed for damage severity and grouped based on decade of implantation to serve as a proxy measure for manufacturing date. A subset of heads (n = 120) was then processed for metallographic analysis to visualize alloy banding.

RESULTS

We found that damage score distribution was consistent over the time periods, but the incidence of column damage significantly increased between the 1990s and 2000s. Banding also increased from the 1990s to 2000s, but both column damage and banding levels appear to recover slightly in the 2010s.

CONCLUSION

Banding, which provides preferential corrosion sites enabling column damage, has increased over the last 3 decades. No difference between manufacturers was seen, which may be explained by shared suppliers of bar stock material. These findings are important as banding can be avoidable, reducing the risk of severe column damage to THA modular junctions and failure due to adverse local tissue reactions.

Do total shoulder arthroplasty implants corrode?

BACKGROUND

Total shoulder arthroplasty (TSA) has become the gold-standard treatment to relieve joint pain and disability in patients with glenohumeral osteoarthritis who do not respond to conservative treatment. An adverse reaction to metal debris released due to fretting corrosion has been a major concern in total hip arthroplasty. To date, it is unclear how frequently implant corrosion occurs in TSA and whether it is a cause of implant failure. This study aimed to characterize and quantify corrosion and fretting damage in a single anatomic TSA design and to compare the outcomes to the established outcomes of total hip arthroplasty.

METHODS

We analyzed 21 surgically retrieved anatomic TSAs of the same design (Tornier Aequalis Pressfit). The retrieved components were microscopically examined for taper corrosion, and taper damage was scored. Head and stem taper damage was quantitatively measured with a non-contact optical coordinate-measuring machine. In selected cases, damage was further characterized at high magnifications using scanning electron microscopy. Energy-dispersive x-ray spectroscopy and metallographic evaluations were performed to determine underlying alloy microstructure and composition. Comparisons between groups with different damage features were performed with independent-samples t tests; Mann-Whitney tests and multivariate linear regression were conducted to correlate damage with patient factors. The level of statistical significance was set at P < .05.

RESULTS

The average material loss for head and stem tapers was 0.007 mm3 and 0.001 mm3, respectively. Material loss was not correlated with sex, age, previous implant, or time in situ (P > .05). We observed greater volume loss in head tapers compared with stem tapers (P = .002). Implants with evidence of column damage had larger volumetric material loss than those without such evidence (P = .003). Column damage aligned with segregation bands within the alloy (preferential corrosion sites). The average angular mismatch was 0.03° (standard deviation, 0.0668°), with negative values indicating distal engagement and positive values indicating proximal engagement. Implants with proximal engagement were significantly more likely to have column damage than those with distal engagement (P = .030).

DISCUSSION

This study has shown not only that the metal components of TSA implants can corrode but also that the risk of corrosion can be reduced by (1) eliminating preferential corrosion sites and (2) ensuring distal engagement to prevent fluid infiltration into the modular junction.

Pre-clinical evaluation of fretting-corrosion at stem-head and stem-cement interfaces of hip implants using in vitro and in silico models

Prior to clinical use, the corrosion resistance of new prosthesis system must be verified. The fretting-corrosion mechanisms of total hip arthroplasty (THA) implants generate metal debris and ions that can increase the incidence of adverse tissue reactions. For cemented stems, there are at least two interfaces that can be damaged by fretting-corrosion: stem-head and stem-cement. This investigation aimed to evaluate, through in vitro and in silico analyses, fretting-corrosion at the stem-head and stem-cement interfaces, to determine which surface is most affected in pre-clinical testing and identify the causes associated with the observed behavior. Unimodular stems and femoral heads of three different groups were evaluated, defined according to the head/stem material as group I (SS/SS), group II (CoCr/SS), and group III (CoCr/CoCr). Seven pairs of stems and heads per group were tested: three pairs were subjected to material characterization, three pairs to in vitro fretting-corrosion testing, and one pair to geometric modeling in the in silico analysis. The absolute area of the stem body degraded was more than three times higher compared with the trunnion, for all groups. These results were corroborated by the in silico analysis results, which revealed that the average micromotion at the stem-cement interface (9.65-15.66 μm) was higher than that at the stem-head interface (0.55-1.08 μm). In conclusion, the degradation of the stem-cement interface is predominant in the pre-clinical set, indicating the need to consider the fretting-corrosion at the stem-cement interface during pre-clinical implant evaluations.

Corrosion properties of low carbon CoCrMo and additively manufactured CoCr alloys for dental applications

OBJECTIVES

Additive manufacturing (AM) is being applied to metallic biomaterials and dental alloys, including CoCrMo. CoCrMo mechanical properties and corrosion resistance are vital to the structural integrity of implants and dental appliances. The goal of this work is to assess the resistivity of AM cobalt chromium alloys by comparing them with traditional CoCrMo, regarding electrochemical properties resulting from microstructural and oxide film differences.

METHODS

In this work, selective laser melting (SLM), was used to manufacture CoCrMoW. The corrosion characteristics of AM alloy were compared to that of wrought LC CoCrMo (ASTM F-1537) in both phosphate buffered saline (PBS) and PBS with 10 mM H₂O₂ to simulate increased inflammatory conditions. Anodic polarization and electrochemical impedance spectroscopy (EIS) were performed.

RESULTS

Both alloys were substantially similar in corrosion behavior in both solutions. They exhibited changes with the different solutions. Polarization resistances were statistically lower (R_p^AM = 1.4 MΩcm² (PBS) vs. 0.72 MΩcm² (H₂O₂), R_p^LC = 1.86 MΩcm² (PBS) vs. 0.55 MΩcm² (H₂O₂)), and open circuit potentials (OCP's) were statistically higher in 10 mM H₂O₂ for both alloys (0.20 V (in H₂O₂) vs. - 0.09 V in PBS). Chemistry variations were revealed by the corrosion tests indicating that wrought LC CoCrMo retained its casting-based chemical heterogeneity, while AM CoCrMoW had sub-cell structures within the solidified grains.

SIGNIFICANCE

As novel production methods like AM arise, it is necessary to understand any microstructural differences that may diminish the corrosion resistance properties. AM CoCrMoW alloys hold significant promise for use in dentistry where complex geometries are required.

Microstructure and electrochemical behavior of contemporary Ti6Al4V implant alloys

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.

Nontribological corrosion modes dominate wrought CoCrMo acetabular taper corrosion: A retrieval study

Corrosion of modular metal-on-metal acetabular tapers in total hip arthroplasty (THA) systems is often attributed to mechanically driven processes. Recent findings suggest that mechanically assisted crevice corrosion (MACC) might not be the dominant cause of corrosion in shell-liner tapers. This study aims to document and present the corrosion modes observed in metal-metal acetabular liners. Twenty-one retrieved wrought CoCrMo liners were examined using digital optical microscopy (DOM), scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS). Corrosion-related damage was documented in nonengagement taper regions, outside of direct taper contact. Within engagement regions, nonmechanically driven corrosion features (pitting, intergranular corrosion) were observed adjacent to fretting and material transfer, which rely on mechanical contact; corrosion independent of MACC was observed even in contact regions. Corrosion types observed included intergranular corrosion (IGC), pitting attack, phase boundary dissolution, all both outside and inside of taper junctions, and MACC within contact regions of the taper. Typical fretting scars associated with MACC were mostly absent, and were not always associated with corrosion damage where present. Finally, hard phase particles (Mo-Si-O) released from the wrought CoCrMo microstructure had redeposited within regions with material loss. Acetabular taper corrosion modes differ significantly from those in head-neck tapers and are dominated by electrochemically driven processes, not mechanical processes, as indicated by corrosion in noncontact regions. With greater prevalence of dual mobility hip implants, acetabular taper corrosion processes must be understood in order to limit their impact on device performance.