Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis

Abstract

Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual's clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined.

A review of the bio-tribology of medical devices

“…Figure 7 shows typical fretting corrosion damages of retrieved hip components. Similar phenomena also exist in knee joints [36,37], shoulder joints [38], and spinal fixation using assemblies. It is generally believed that fretting corrosion is widespread in various artificial joints.…”

Trunnionosis in Total Knee Arthroplasty: Is it a clinical problem?

“…There are simply many more examples of THA trunnionosis to observe and collect data on. However, while this may be true there is at least some evidence that the prevalence of trunnionosis in TKA may be larger than currently reported [23][24][25][26][27][28] . The underreporting of trunnionosis in TKA only amplifies the growing disparity in the literature regarding trunnionosis in TKA vs THA.…”

“…Trunnionosis in TKA has been studied less than that of THA due to the prevalence of which trunnionosis occurs in each respective group [4,20] . This is likely due to the larger role of modular designs in THA vs TKA [25,27] . Whereas modularity is instrumental in both primary and revision THA cases, modularity in TKA is often only used for revision cases [4,26,27] .…”

An Experimental Study on the Fretting Corrosion Behaviours of Three Material Pairs at Modular Interfaces for Hip Joint Implants

“…It is well known that there is widespread fretting corrosion in the conical connection of the ball head and the femoral stem in total hip joints [11][12][13][14][15][16][17][18][19][20]. Similar phenomena also exist in the knee joints, shoulder joints, and spinal fixation that use the modular assembly [21][22][23][24][25][26][27]. In the past decades, the fretting corrosion behaviours of materials used for artificial joints have been investigated in many studies on the effects of mechanical conditions such as load, frequency, and displacement amplitude as well as electrochemical conditions such as pH, potential, and corrosive media.…”