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Improving the Endoprosthesis Design and the Postoperative Therapy as a Means of Reducing Complications Risks after Total Hip Arthroplasty. LUBRICANTS 2022. [DOI: 10.3390/lubricants10030038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
One of the most high-tech, efficient and reliable surgical procedures is Total Hip Arthroplasty (THA). Due to the increase in average life expectancy, it is especially relevant for older people suffering from chronic joint disease, allowing them to return to an active lifestyle. However, the rejuvenation of such a severe joint disease as osteoarthritis requires the search for new solutions that increase the lifespan of a Total Hip Replacement (THR). Current trends in the development of this area are primarily focused on the creation of new materials used in THR and methods for their processing that meet the requirements of biocompatibility, long-term strength, wear resistance and the absence of an immune system response aimed at rejection. This study is devoted to the substantiation of one of the possible approaches to increase the reliability and durability of THR, based on the improvement of the implant design and postoperative rehabilitation technology, potentially reducing the risk of complications in the postoperative period.
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Cadel ES, Topoleski LDT, Vesnovsky O, Anderson CR, Hopper RH, Engh CA, Di Prima MA. A comparison of metal/metal and ceramic/metal taper-trunnion modular connections in explanted total hip replacements. J Biomed Mater Res B Appl Biomater 2021; 110:135-143. [PMID: 34164932 PMCID: PMC9292311 DOI: 10.1002/jbm.b.34897] [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: 01/22/2021] [Revised: 04/28/2021] [Accepted: 06/13/2021] [Indexed: 12/27/2022]
Abstract
Corrosion and wear are commonly found at the taper-trunnion connection of modular total hip arthroplasty (THA) explanted devices. While metal/metal (M/M) modular taper-trunnion connections exhibit more wear/corrosion than ceramic/metal (C/M) modular taper-trunnion connections, damage is present in both, regardless of material. This study used a combination of assessment techniques including clinical data, visual scoring assessment, optical imaging, profilometry, and x-ray photoelectron microscopy (XPS), to investigate wear mechanisms and damage features at the modular taper-trunnion connection of 10 M/M and 8 C/M explanted THAs. No correlation was found between any demographic variable and corrosion wear and assessment scores. All assessment techniques demonstrated that the stem trunnions had more damage than head tapers for both explant groups and agreed that C/M explants had less corrosion and wear compared to M/M explants. However, visual assessment scores differed between assessment techniques when evaluating the tapers and trunnions within the two groups. Profilometry showed an increase (p <.05) in surface roughness for stem trunnions compared to head tapers for both explant groups. X-ray photoelectron spectroscopy performed on deposits from two M/M explants found chromium and molybdenum carbides beneath the surface while chromium sulfate and aged bone mineral were found on the surface suggesting that the debris is a result of corrosion rather than wear. These results indicate that taper-trunnion damage is more prevalent for M/M explants, but C/M explants are still susceptible to damage. More comprehensive analysis of damage is necessary to better understand the origins of taper-trunnion damage.
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Affiliation(s)
- Eileen S Cadel
- US Food and Drug Administration, Silver Spring, Maryland, USA
| | - L D Timmie Topoleski
- US Food and Drug Administration, Silver Spring, Maryland, USA.,University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - Oleg Vesnovsky
- US Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Robert H Hopper
- Anderson Orthopaedic Research Institute, Alexandria, Virginia, USA
| | - Charles A Engh
- Anderson Orthopaedic Research Institute, Alexandria, Virginia, USA
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Royhman D, Pourzal R, Hall D, Lundberg HJ, Wimmer MA, Jacobs J, Hallab NJ, Mathew MT. Fretting-corrosion in hip taper modular junctions: The influence of topography and pH levels - An in-vitro study. J Mech Behav Biomed Mater 2021; 118:104443. [PMID: 33752094 DOI: 10.1016/j.jmbbm.2021.104443] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/03/2020] [Accepted: 02/27/2021] [Indexed: 10/21/2022]
Abstract
Contemporary hip implants feature a modular design. Increased reported failure rates associated with the utilization of modular junctions have raised many clinical concerns. Typically, these modular interfaces contain circumferential machining marks (threads or microgrooves), but the effect of the machining marks on the fretting-corrosion behavior of total hip implant materials is unknown. This study reports the effects of microgrooves on the fretting-corrosion behavior of hip implant materials. The flat portions of two cylindrical, polished, CrCrMo alloy pins were loaded horizontally against one rectangular Ti alloy rod. Two surface preparation groups were used for the Ti6Al4V rod (polished and machined). The polished group was prepared using the same methods as the CoCrMo pins. The machined samples were prepared by creating parallel lines on the rod surfaces to represent microgrooves present on the stem tapers of head-neck modular junctions. Newborn calf serum (30 g/L protein content; 37 °C) at pH of levels of 7.6 and 3.0 were used to simulate the normal joint fluid and a lowered pH within a crevice, respectively. The samples were tested in a fretting corrosion apparatus under a 200N normal force and a 1Hz sinusoidal fretting motion with a displacement amplitude of 25 μm. All electrochemical measurements were performed with a potentiostat in a three-electrode configuration. The results show significant differences between machined samples and polished samples in both electrochemical and mechanical responses. In all cases, the magnitude of the drop in potential was greater in the machined group compared to the polished group. The machined group showed a lower total dissipated friction energy for the entire test compared to the polished group. Additionally, the potentiostatic test measurements revealed a higher evolved charge in the machined group compared to the polished group at both pH conditions (pH 7.6 and 3.0). The machined surfaces lowered the overall dissipated friction energy at pH 7.6 compared to pH 3.0, but also compromised electrochemical performance in the tested conditions. Therefore, the role of synergistic interaction of wear and corrosion with surface topographical changes is evident from the outcome of the study. Despite the shift towards higher electrochemical destabilization in the machined group, both polished and machined groups still exhibited a mechanically dominated degradation.
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Affiliation(s)
- Dmitry Royhman
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA
| | - Robin Pourzal
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Deborah Hall
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Hannah J Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Joshua Jacobs
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nadim J Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Mathew T Mathew
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Science, UIC School of Medicine, Rockford, IL, USA.
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Eliaz N. Corrosion of Metallic Biomaterials: A Review. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E407. [PMID: 30696087 PMCID: PMC6384782 DOI: 10.3390/ma12030407] [Citation(s) in RCA: 246] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 12/15/2022]
Abstract
Metallic biomaterials are used in medical devices in humans more than any other family of materials. The corrosion resistance of an implant material affects its functionality and durability and is a prime factor governing biocompatibility. The fundamental paradigm of metallic biomaterials, except biodegradable metals, has been "the more corrosion resistant, the more biocompatible." The body environment is harsh and raises several challenges with respect to corrosion control. In this invited review paper, the body environment is analysed in detail and the possible effects of the corrosion of different biomaterials on biocompatibility are discussed. Then, the kinetics of corrosion, passivity, its breakdown and regeneration in vivo are conferred. Next, the mostly used metallic biomaterials and their corrosion performance are reviewed. These biomaterials include stainless steels, cobalt-chromium alloys, titanium and its alloys, Nitinol shape memory alloy, dental amalgams, gold, metallic glasses and biodegradable metals. Then, the principles of implant failure, retrieval and failure analysis are highlighted, followed by description of the most common corrosion processes in vivo. Finally, approaches to control the corrosion of metallic biomaterials are highlighted.
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Affiliation(s)
- Noam Eliaz
- Department of Materials Science and Engineering, Tel-Aviv University, Ramat Aviv 6997801, Israel.
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