In Vivo surface wear mechanisms of femoral components of cemented total hip arthroplasties

Howell, Jonathan; Blunt, Liam; Doyle, Christina; Hooper, Robert; Lee, A.J.C; Ling, R. S. M.

doi:10.1016/s0883-5403(03)00278-x

Cited by 77 publications

(77 citation statements)

References 33 publications

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“…As micromotion occurs at the implant cement interface and the stems subsides, metallic and cement particles are generated due to fretting between cement and the rough surface of the implant. This process releases biologically active cement and metallic particles that we detected in our microscopic analysis and also diminishes the conformity between the implant and the cement, which leads to further loosening and loss of bone stock [17].…”

Section: Discussionmentioning

confidence: 86%

“…4). The damage in the surface of the stems was predominantly located in the posteromedial and anterolateral corners as the stems were forced into retroversion after loosening, thus fretting with the cement mantle [7,14,17]. The microscopic examination of the femoral pseudomembrane consistently revealed an inflammatory reaction characterised by the presence of multinucleated giant cells and metallic, cement, and polyethylene deposits.…”

Section: Resultsmentioning

confidence: 99%

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High failure rate of a modern, proximally roughened, cemented stem for total hip arthroplasty

Grose

Valle

Bullough

et al. 2006

International Orthopaedics (SICO

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The role of surface finish on the survivorship of cemented femoral stems continues to be debated. A total of 34 proximally roughened cemented stems were implanted in 33 consecutive patients undergoing total hip arthroplasty by a single surgeon. An alarmingly high failure rate was observed, prompting a retrospective chart review, analysis of radiographs, and evaluation of retrieved stems and pathological specimens. Nineteen patients were available with more than two years follow-up. Of these 19 patients, nine stems had failed (47%) due to severe osteolysis and stem loosening. Failures were significantly more common in the male gender (p<0.005), and young (p=0.05), tall (p<0.002), and heavy patients (p<0.004). All failed revised hips showed severe metallosis, with both gross and microscopic evidence of metallic shedding from the stems. Our findings suggest that this proximally roughened stem is susceptible to early failure. Failure is characterized by stem debonding, subsidence within the cement mantle, shedding of metallic and cement particles due to fretting, and rapidly progressive osteolysis. These findings have been observed with other rough surface finish cemented stems. Résumé Le rôle de l'état de surface des tiges fémorales cimentées sur leur survie est toujours discuté.34 tiges à la partie proximale rugueuse ont été implantées chez 33 patients au cours d'arthroplastie totale de la hanche faites par le même chirurgien. Un taux important d'échec était observé, conduisant à une étude rétrospective avec analyse radiographique, étude des pièces explantées et de l'aspect histologique. 19 patients ont été revus à plus de 2 ans de recul avec parmi eux 9 échecs dus à une ostéolyse avec descellement de la tige fémorale. Ces échecs étaient plus fréquents chez l'homme (p<0,005), le jeune (p=0,05) , le grand (p<0,002), et le lourd (p<0,004). Toutes les reprises ont montré une métallose sévère avec macroscopiquement et microscopiquement des débris de métal arrachés à la tige. L'échec est caractérisé par une mobilisation de la tige, un enfoncement dans le ciment, arrachage de particules métalliques et ostéolyse. Ces faits ont été observés avec d'autres tiges à revêtement rugueux.

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Section: Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

High failure rate of a modern, proximally roughened, cemented stem for total hip arthroplasty

Grose

Valle

Bullough

et al. 2006

International Orthopaedics (SICO

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“…Fretting-corrosion has been observed in a number of clinical cases on both polished and matte femoral stems (Burston et al, 2012;Fowler et al, 2011;Gie and Ling, 1994;Jasty et al, 1991). Howell et al (Howell et al, 2004) presented a comprehensive study, conducting SEM and 3-D interferometry analysis on both retrieved polished and matte femoral stems, identifying that polished and matte femoral stems present two very different wear mechanisms. Polished stems were seen to exhibit signs of ductile wear accompanied by pitting of the surface, a similar morphology observed in this cohort, whilst matte stems presented evidence of abrasive or truncation wear.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of the surface topography, tomography and chemistry of fretting corrosion product found on retrieved polished femoral stems

Bryant

Ward

Farrar³

et al. 2014

Journal of the Mechanical Behavior of Biomedical Materials

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eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. CHARACTERISATION OF THE SURFACE TOPOGRAPHY, TOMOGRAPHY HIGHLIGHTS: The tomography of retrieved femoral stems was characterised. Directionality and plastic deformation of the metallic surfaces was seen. Thick deposited layers were seen to occur within the stem-cement interfaces. Films of Cr2O3 bound with organic material play an important role in the degradation.

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“…Secondly, surface parameters were used to quantify the degree of wear exhibited on different areas of the stem. The parameters chosen to quantify wear are shown in Table 3, along with a simple explanation of each [25]. Figure 14 demonstrates the location of the 3D interferometry analysis preformed on the polished femoral stems and counterpart PMMA bone cement after 500,000 cycles of cyclic loading.…”

Section: Surface Analysis Of Femoral Stem and Pmma Bone Cement Surfacesmentioning

confidence: 99%

“…These were considered unsuccessful due to high incidences of PMMA induced inflammatory reactions due to abrasion at the interface [6]. Whilst all femoral components display some form of wear and corrosion at revision, the different interfacial conditions produce very different surface morphologies as demonstrated by Howell et al [7]. They noted that blasted femoral stems tend to demonstrate light polishing on the medial and lateral edges, whilst polished femoral stems demonstrate high incidences of fretting related damage.…”

Section: Introductionmentioning

confidence: 99%

The role of surface pre-treatment on the microstructure, corrosion and fretting corrosion of cemented femoral stems

Bryant

Farrar²,

Freeman³

et al. 2016

Biotribology

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The use of cemented femoral stems is common practice worldwide with strong clinical data supporting their use.Over the years, different surface processing techniques have been employed to enhance the performance of the stem-cement interface. As a result different clinical outcomes and visual presentation at revision has been observed. Whilst research has focussed on increasing adhesion and better load bearing capacity, the effects of surface processing on the degradation of cemented femoral stems has not been investigated. The aims of this study was to investigate the effects of surface processing on the subsurface microstructure, surface chemistry and tribocorrosion degradation mechanisms of cemented tapered femoral stems subjected to polishing and blasting (Vaquasheen) processes. Cemented femoral stems were orientated and loaded according to for 500,000 cycles in 0.9% NaCl at 37 ˚C. A three-electrode electrochemical cell was integrated into the mechanical test to facilitate in-situ corrosion measurements. The severity and mechanism of damaged were assessed scanning and transmission electron microscopy, X-ray photoelectron spectrometry, solution mass spectrometry and white light interferometry. Surface processing was seen to drastically influence the level of corrosion within the interface with polished surfaces demonstrating the highest levels of corrosion. Surface analysis consistently demonstrated the presence of a SiO2 layer on the vaquasheened stems thought to originate from the glass bead blast matrix. This resulted in lower levels of corrosion both under static and tribocorrosion assessment. In conclusion, blasted surfaces resulted in lower wear induced corrosion when compared to the polished surfaces. However the total metallic ion levels did not follow the same trend. This is thought to be due to the formation of metallic debris and dissolution of debris due to abrasion of the femoral stems. Over the years, different surface processing techniques have been employed to enhance the performance of the stem-cement interface. As a result different clinical outcomes and visual presentation at revision has been observed. Whilst research has focussed on increasing adhesion and better load bearing capacity, the effects of surface processing on the degradation of cemented femoral stems has not been investigated. The aims of this study was to investigate the effects of surface processing on the subsurface microstructure, surface chemistry and tribocorrosion degradation mechanisms of cemented tapered femoral stems subjected to polishing and blasting (Vaquasheen) processes. Cemented femoral stems were orientated and loaded according to for 500,000 cycles in 0.9% NaCl at 37 ˚C. A three-electrode electrochemical cell was integrated into the mechanical test to facilitate in-situ corrosion measurements. The severity and mechanism of damaged were assessed scanning and transmission electron microscopy, X-ray photoelectron spectrometry, solution mass spectrometry and white light interferometry. Surface processin...

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In Vivo surface wear mechanisms of femoral components of cemented total hip arthroplasties

Cited by 77 publications

References 33 publications

High failure rate of a modern, proximally roughened, cemented stem for total hip arthroplasty

High failure rate of a modern, proximally roughened, cemented stem for total hip arthroplasty

Characterisation of the surface topography, tomography and chemistry of fretting corrosion product found on retrieved polished femoral stems

The role of surface pre-treatment on the microstructure, corrosion and fretting corrosion of cemented femoral stems

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