Retrieval study of commercially available knee implant coatings TiN, TiNbN and ZrN on TiAl6V4 and CoCr28Mo6

Herbster, Maria; Döring, J.; Nohava, Jiří; Lohmann, Christoph H.; Halle, Thorsten; Bertrand, Jessica

doi:10.1016/j.jmbbm.2020.104034

Cited by 31 publications

(32 citation statements)

References 39 publications

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“…The potential coating materials currently being investigated include SiN x , CrN, TaO, TaC, DLC, TiN, TiCN, ZrO 2 and ZrN. Looking at total knee replacements the use of coatings is more widespread and the retrieval data reveals the coated implants to be comparable to CoCr but there is not enough evidence to support a lower amount of osteolysis-caused failures [ 80 , 113 , [116] , [117] , [118] , [119] , [120] , [121] , [122] , [123] , [124] , [125] ].…”

Section: Discussionmentioning

confidence: 99%

“…Titanium is not used in articulating surfaces due to its poor wear properties [ [77] , [78] , [79] ], but this becomes possible with a coating or surface treatment that improves such properties [ 75 ]. The use of titanium as a substrate material could even be advantageous in terms of coating adhesion [ 80 ]. It is however important to keep in mind that the coating should be compared with the material it aims to substitute, e.g.…”

Section: Substrate Materials and Deposition Methodsmentioning

confidence: 99%

“… The wound healed without complications and the patients eczema as well as the knee pain had disappeared at the last follow up of 18 months. Thomsen et al., 2011 [ 127 ] ZrN, TiN and TiNbN Knee Implantcast, AlphaNorm (now aquired by Corin), Mathys, Link and Aesculap 28 TiN(CoCrMo): 42 TiNbN(CoCrMo): 40.8 ZrN(CoCrMo): 7.8 TiN(Ti6Al4V): 114 TiNbN(Ti6Al4V): 12 Infection: 12 Aseptic loosening: 10 Instability/Luxation: 3 Arthrofibrosis: 1 Periprosthetic fracture: 1 Movement deficit: 1 Herbster et al., 2020 [ 80 ] DLC Hip Adamante®, Biomecanique 101 110.4 25.8% Aseptic loosening: 41 Ossification: 1 Pain: 2 Infection: 1 Implant failure: 1 54% survival for DLC/PE implants at 8.5 years compared to 88.2% for Al 2 O 3 /PE implants. Delamination of the coating caused aggravated wear of the PE liner.…”

Section: Commercial Coatingsmentioning

confidence: 99%

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Current status and future potential of wear-resistant coatings and articulating surfaces for hip and knee implants

Skjöldebrand

Tipper

Hatto³

et al. 2022

Materials Today Bio

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Section: Discussionmentioning

confidence: 99%

Section: Substrate Materials and Deposition Methodsmentioning

confidence: 99%

Section: Commercial Coatingsmentioning

confidence: 99%

See 1 more Smart Citation

Current status and future potential of wear-resistant coatings and articulating surfaces for hip and knee implants

Skjöldebrand

Tipper

Hatto³

et al. 2022

Materials Today Bio

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“…These results are consistent with the result of an adhesion test, as is mentioned above. Actually, the implant materials in their course of service are general under the lower loads [40]. In conclusion, the composite coatings designed and prepared in this article could perfectly realize the requirements of biomechanical properties in implants without the loss of asepsis.…”

Section: Mechanical Propertiesmentioning

confidence: 84%

Study on the ZrN/Ag2O Micro–Nano Gradient Composite Structure Constructed on Pure Ti for Biomaterials

et al. 2021

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Titanium and titanium alloys have been extensively utilized in biomedical implants due to their excellent comprehensive mechanical properties and biocompatibility. In this study, a ZrN/Ag2O micro–nano gradient composite structure was prepared on the surface of pure Ti by multi-arc ion plating (MAIP) technique and metal vapor vacuum arc (MEVVA) ion implantation technology. This study indicated that a dramatic improvement in performance in the surface hardness (~1800 HV0.1) was attributed to the presence of the ceramic phase (ZrN) with high hardness included in composite structure. The relatively low wear rate of gradient composite structure confirmed its excellent performance in abrasion resistance and the abrasion mechanism of gradient composite structure was mainly abrasive wear. After the potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) tests, because of the synergy effect of ZrN micron coating and Ag2O nanoparticles, the ZrN/Ag2O gradient coatings indicated the highest free corrosion potential (Ecorr) and lowest corrosion current density (icorr) in Ringer’s solution, and the polarization resistances of multilayer coatings were greater than that of the substrate, exhibiting positive effects on retarding localized corrosion tendency. Additionally, the suitable dose of ZrN/Ag2O gradient composite coating can obtain antibacterial ability, which exerts no significant cytotoxicity and even excellent cytocompatibility over a longer service process. Furthermore, this study is conducive to design and develop for multifunctional coatings of implant materials.

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“…Of the revised failures, 12 (37%) were tibial, eight (23%) were femoral, and 14 (40%) were combined tibial. In their retrieval analysis of 28 coated knee prostheses (TiN, TiNbN, and ZrN on TiAl6V4 and CoCr28Mo6) from nine different manufacturers, Herbster et al 66 analyzed coating designs on preserved regions (substrate, layer thickness and roughness, mechanical properties, adhesive strength, and friction performance against polyethylene) and found an incidence of 79% discoloration, 21% coating delamination, pitting damage leading to corrosion underneath the coating layers.…”

Section: Discussionmentioning

confidence: 99%

Metal allergy in primary and revision total knee arthroplasty

Matar

Porter

2021

Bone & Joint Open

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Aims Metal allergy in knee arthroplasty patients is a controversial topic. We aimed to conduct a scoping review to clarify the management of metal allergy in primary and revision total knee arthroplasty (TKA). Methods Studies were identified by searching electronic databases: Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Embase, from their inception to November 2020, for studies evaluating TKA patients with metal hypersensitivity/allergy. All studies reporting on diagnosing or managing metal hypersensitivity in TKA were included. Data were extracted and summarized based on study design, study population, interventions and outcomes. A practical guide is then formulated based on the available evidence. Results We included 38 heterogeneous studies (two randomized controlled trials, six comparative studies, 19 case series, and 11 case reports). The evidence indicates that metal hypersensitivity is a rare complication with some histopathological features leading to pain and dissatisfaction with no reliable screening tests preoperatively. Hypoallergenic implants are viable alternatives for patients with self-reported/confirmed metal hypersensitivity if declared preoperatively; however, concerns remain over their long-term outcomes with ceramic implants outperforming titanium nitride-coated implants and informed consent is paramount. For patients presenting with painful TKA, metal hypersensitivity is a diagnosis of exclusion where patch skin testing, lymphocyte transformation test, and synovial biopsies are useful adjuncts before revision surgery is undertaken to hypoallergenic implants with shared decision-making and informed consent. Conclusion Using the limited available evidence in the literature, we provide a practical approach to metal hypersensitivity in TKA patients. Future national/registry-based studies are needed to identify the scale of metal hypersensitivity, agreed diagnostic criteria, and management strategies. Cite this article: Bone Jt Open 2021;2(10):785–795.

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Retrieval study of commercially available knee implant coatings TiN, TiNbN and ZrN on TiAl6V4 and CoCr28Mo6

Cited by 31 publications

References 39 publications

Current status and future potential of wear-resistant coatings and articulating surfaces for hip and knee implants

Current status and future potential of wear-resistant coatings and articulating surfaces for hip and knee implants

Study on the ZrN/Ag2O Micro–Nano Gradient Composite Structure Constructed on Pure Ti for Biomaterials

Metal allergy in primary and revision total knee arthroplasty

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