Fretting Corrosion, Third-Body Polyethylene Damage, and Cup Positioning in Primary vs Revision Dual Mobility Total Hip Arthroplasty

Spece, Hannah; Ouellette, Eric S.; Jones, Olivia L.; MacDonald, Daniel W.; Piuzzi, Nicolás S.; Lee, Gwo-Chin; Mont, Michael A.; Klein, Gregg R.; Kurtz, Steven M.

doi:10.1016/j.arth.2021.01.035

Cited by 10 publications

(19 citation statements)

References 42 publications

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“…Hall et al [11] found imprinted head tapers in patients with hemiarthroplasties; however, the total number of evaluated hemiarthroplasties was small (n =3), and they did not indicate what kind of femoral head (unipolar or dual mobility [bipolar]) was applied. Spece et al [22] investigated fretting corrosion on retrieved DM constructs and found only minimal fretting and corrosion at the respective taper interfaces. However, whether this observation can be attributed to the implant construction itself or is caused by patient cohort–specific features, such as short mean implantation times or reduced activity, remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Insights into Imprinting: How Is the Phenomenon of Tribocorrosion at Head-Neck Taper Interfaces Related to Corrosion, Fretting, and Implant Design Parameters?

Bormann

Kretzer

Gibmeier

et al. 2022

Clin Orthop Relat Res

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BackgroundWear and corrosion at modular neck tapers in THA can lead to major clinical implications such as periprosthetic osteolysis, adverse local tissue reactions, or implant failure. The material degradation processes at the taper interface are complex and involve fretting corrosion, third-body abrasion, as well as electrochemical and crevice corrosion. One phenomenon in this context is imprinting of the head taper, where the initially smooth surface develops a topography that reflects the rougher neck taper profile. The formation mechanism of this specific phenomenon, and its relation to other observed damage features, is unclear. An analysis of retrieved implants may offer some insights into this process.Questions/purposes(1) Is imprinting related to time in situ of the implants and to the taper damage modes of corrosion and fretting? (2) Are implant design parameters like neck taper profile, stem material, or head seating associated with the formation of imprinting? (3) Is imprinting created by an impression of the neck taper profile or can a different mechanistic explanation for imprinting be derived?MethodsThirty-one THAs with cobalt-chromium-molybdenum-alloy (CoCrMo) heads retrieved between 2013 and 2019 at revision surgery from an institutional registry were investigated. Inclusion criteria were: 12/14 tapers, a head size of 36 mm or smaller, time in situ more than 1 year, and intact nonmodular stems without sleeve adaptors. After grouping the residual THAs according to stem type, stem material, and manufacturer, all groups of three or more were included. Of the resulting subset of 31 retrievals, nine THAs exhibited a still assembled head-neck taper connection. The median (range) time in situ was 5 years (1 to 23). Two stem materials (21 titanium-alloy and 10 stainless steel), three kinds of bearing couples (11 metal-on-metal, 13 metal-on-polyethylene, and seven dual-mobility heads), and two different neck taper profiles (six wavy profile and 25 fluted profile) were present in the collection. Four THAs exhibited signs of eccentric head seating. The 31 investigated THAs represented 21% of the retrieved THAs with a CoCrMo alloy head during the specified period.At the head tapers, the damage modes of corrosion, fretting, and imprinting were semiquantitatively rated on a scale between 0 (no corrosion/fretting/imprinting) and 3 (severe corrosion/fretting/imprinting). Corrosion and fretting were assessed applying the Goldberg score, with the modification that the scale started at 0 and not at 1. Imprinting was assessed with a custom scoring system. Rating was done individually at the proximal and distal head taper half and summed to one total damage score for each retrieval and damage mode. Correlations between the damage modes and time in situ and between the damage modes among each other, were assessed using the Spearman rank order correlation coefficient (ρ). Associations between imprinting and implant design parameters were investigated by comparing the total imprinting score distributions with the...

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Section: Discussionmentioning

confidence: 99%

Insights into Imprinting: How Is the Phenomenon of Tribocorrosion at Head-Neck Taper Interfaces Related to Corrosion, Fretting, and Implant Design Parameters?

Bormann

Kretzer

Gibmeier

et al. 2022

Clin Orthop Relat Res

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show abstract

“…Evidence of third body wear has been seen in retrieved hip [14] , [15] , [16] , [17] , [18] and knee implants [19] , [20] , [21] , [22] , particularly in metal-on-polyethylene bearing couples where particles such as polymethylmethacrylate (PMMA) cement, bone and porous coating beads have been found embedded in polyethylene and deformation or ploughing of the polyethylene [23] has been observed ( Fig. 1 ) [ 17 , 20 , [24] , [25] , [26] ]. Scratching on metallic counterfaces understood to be caused by third body particles trapped between the articulating surfaces has also been identified ( Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Scratching on metallic counterfaces understood to be caused by third body particles trapped between the articulating surfaces has also been identified ( Fig. 2 ) [ 17 , 26 , 27 ]. For counterfaces to be scratched, the scratching material, in this case a third body particle, must be harder than that of the counterface [ 15 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

“…1 Polyethylene liner from a retrieved dual mobility hip with third body particles visible embedded in the polyethylene inner (a) and outer (b) bearing, adapted from Spece et al. [26] ; c) shows an SEM image of a retrieved polyethylene cup, the fine scratches in region a are associated with surface wear, the deeper scratches (B) are thought to be caused by third body particles, adapted from Atkinson et al. [24] .…”

Section: Introductionmentioning

confidence: 99%

“…2 (a) scuffed head and (b) cup from a retrieved dual mobility hip with third body particles visible embedded in the polyethylene bearing, adapted from Spece et al. [26] . …”

Section: Introductionmentioning

confidence: 99%

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