Surface Characterization of Retrieved Metal-on-Metal Total Hip Implants from Patients with Adverse Reaction to Metal Debris

Abstract

The use of metal-on-metal (MoM) total hip implants has decreased recently due to reports of high failure rates and adverse local tissue reaction (ALTR). It has been hypothesized that wear metal debris released from CoCr bearing surfaces may provoke delayed hypersensitivity reactions. The goal of this study is to evaluate the microscopic bearing surface characteristics of implants revised due to evidence of ALTR. The bearing surface of each head and cup was analyzed using multiple microscopy techniques for characterization of the surface features. The presence of severe mechanical scratching was a common characteristic found in all of the implants evaluated. Mechanical factors seemed to be the prevalent failure mode related to the appearance of ALTR with this particular set of retrieved implants.

Effects of decontamination solutions on the surface of titanium: investigation of surface morphology, composition, and roughness

“…9) observed after rubbing treatments could be associated with surface layers loss due to wear and corrosion. In these regions, the localized dissociation can result in metal particle or debris generation, which has been discussed to potentially trigger inflammation in vivo (Burbano et al 2014). While differences in roughness from control to treated surfaces with immersion procedures were observed, comparatively roughness change from the rubbing treatments was often higher in magnitude, as demonstrated in Fig.…”

Nanoscale Mechanical Evaluation of Electrochemically Generated Tribolayer on CoCrMo Alloy for Hip Joint Application

“…The electrochemical treatment protocol was performed following the steps: (1) open-circuit potential to determine all wire connections were accurate; (2) potentiostatic measurements were conducted at -0.9 V to ensure the alloy surface was properly cleaned (cleaning phase);…”

“…The clinical significance of the electrochemical interactions of CoCrMo surfaces with proteins and body fluids in vivo has been for several years the focus of numerous investigations [16-18, 22, 33, 38]. The complex in vivo environment with electrochemical and mechanical degradation mechanisms not only impacts the longevity of a device but also the safety of patients, since wear of these alloys can lead to hypersensitivity and pseudotumors from ion and particle release to surrounding tissues [1,5,7,15,45]. Several studies of well-functioning MoM (metal-onmetal) hip prostheses, in which the predominant mechanism of degradation was minor surface fatigue, tribocorrosion, and chemical reactions, have been reported [2,10,49,50].…”

Corrosion and Wear Performance of Titanium and Cobalt Chromium Molybdenum Alloys Coated with Dicationic Imidazolium-Based Ionic Liquids

“…The combination of mechanical damage and corrosion results in accelerated and often permanent damage to the oxide layer [11], resulting in increased levels of metal ion dissolution [12]. Metal ions released from the metallic surface of an implant can accumulate in surrounding tissues [13] which has been associated with an array of problems ranging from prolonged inflammation [14] and allergic reactions [15] to severe tissue necrosis [16], osteolysis [16,17], and even pseudotumor formation [18].…”