Tribocorrosion in shoulder arthroplasty humeral component retrievals

Teeter, Matthew G.; Carroll, Michael J.; Walch, Gilles; Athwal, George S.

doi:10.1016/j.jse.2015.07.004

Cited by 19 publications

(14 citation statements)

References 14 publications

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“…We found that 89% of all investigated shoulder explants exhibited signs of macroscopic damage patterns. This is in line with publications showing similar damage scores on shoulder taper connections (Day et al, ; Eckert et al, ; Teeter et al, ).…”

Section: Discussionsupporting

confidence: 91%

“…A multitude of retrieval studies regarding the taper connection of hip implants have been published, describing the various damaging modes (Bishop et al, ; Gilbert et al, ; Gilbert, Buckley, & Jacobs, ; Goldberg et al, ; Hall et al, ). Taper junctions of anatomical shoulder implants resemble those of hip implants in many ways, but they are far less studied (Day et al, ; Eckert, Mueller, Jaeger, Panzram, & Kretzer, ; Teeter, Carroll, Walch, & Athwal, ). While all metal implants are prone to corrosion processes in the human body, there is no qualitative evidence of corrosion occurring at the modular taper junction of TSA until today.…”

Section: Introductionmentioning

confidence: 99%

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In vivo corrosion and damages in modular shoulder prostheses

et al. 2019

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Wear and corrosion at taper junctions of orthopaedic endoprostheses remain of great concern and are associated with adverse clinical reactions. Whereas tribocorrosion of hip tapers was extensively investigated, there is only little knowledge regarding the clinical performance of modular total shoulder prostheses. This retrieval study evaluated 35 modular taper junctions of anatomical shoulder explants using stereomicroscopy, confocal microscopy, as well as optical and scanning electron microscopy to determine the damage modes as well as the effects of taper topography and alloy microstructure. Among all humeral head tapers, 89% exhibited material degradation. Different overlapping wear mechanisms were identified such as plastic deformation, adhesive material transfer, microploughing, and fretting damage.Only CoCrMo cast alloy heads showed a susceptibility to electrochemically dominated fretting in comparison to CoCrMo wrought alloy. Moreover, corundum blasted stem tapers show a significantly increased incidence rate for microploughing. To date, this is the most comprehensive study on the damage types of modular taper junctions of anatomical shoulder arthroplasty proving the existence of fretting even on less weight-bearing implants. This study revealed critical fretting factors, such as the surface finish and the alloy type that are essential for the development of countermeasures that avoid any taper corrosion.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

In vivo corrosion and damages in modular shoulder prostheses

et al. 2019

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“…Only two other retrieval studies on tribocorrosion in shoulder arthroplasty have been published [ 11 , 12 ] and only one of those examined anatomic implants. Teeter and colleagues [ 12 ] also reported tribocorrosion in their cohort, albeit at a much lower level (38% of the stems and 32% of the heads, compared to 81% and 75%, resp., as found in this study). They found tribocorrosion to be only prevalent in stemmed designs, whereas no tribocorrosion was seen in the stemless implants.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study a similar tendency was observed; however, some tribocorrosion was also found in the stemless implants. The effect of material combinations was not compared in the study by Teeter et al [ 12 ]. The differences regarding the severity of corrosion might be explained by variations in the retrieval cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard several different factors are associated with tribocorrosion, including material combination, head size, offset, implantation time, and flexural rigidity [ 7 ]. Whereas multiple retrieval studies regarding hip implants are available, only a small number of retrieval studies for modular shoulder arthroplasty exist [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis

Eckert

Mueller

Jaeger

et al. 2016

BioMed Research International

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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.

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Intraoperative assembly of anatomical shoulder prosthesis frequently results in malalignment of the modular taper junction

Herbster

Berth

Märtens

et al. 2021

Journal Orthopaedic Research

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Anatomical shoulder arthroplasties (ASA) may fail because of micromotion at the modular taper junction causing wear due to fretting. Sufficient taper strength can reduce micromotion and potential reasons for failure. However, there are no normative standards for a safe assembly process performed intraoperatively by the surgeon. The purpose of this study is to determine the effect of common intraoperative assembly strategies and to identify critical influencing factors on taper stability. ASA with standard and stemless humeral component in combination with concentric Al 2 O 3 heads and eccentric CoCr28Mo6 alloyed humeral heads were tested. Taper angles and surface roughness were determined. Force magnitudes and impact directions were recorded using a sensorized head impactor and a threedimensional force measuring platform. Subsequently, the axial pull-off forces were measured and taper engagement areas were macroscopically evaluated. In comparison to standard stem tapers that were impacted with an assembly device, stemless tapers were impacted into the artificial bone with significantly lower forces. Taper strength correlates to maximum impact force and was higher for CoCr28Mo6 heads with a mean pull-off ratio of 0.56 than for Al 2 O 3 heads with 0.37. Interestingly, all tapers showed an asymmetric clamping behavior, due to tilting during impaction. This is caused by the variation of the resulting force vector and further promoted by humeral head eccentricity. Assembly technique markedly influences the force magnitude, impact direction, impulse, and consequently taper strength. The resulting force vector and head eccentricity were identified as potential risk factors for taper malalignment.

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Tribocorrosion in shoulder arthroplasty humeral component retrievals

Cited by 19 publications

References 14 publications

In vivo corrosion and damages in modular shoulder prostheses

In vivo corrosion and damages in modular shoulder prostheses

Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis

Intraoperative assembly of anatomical shoulder prosthesis frequently results in malalignment of the modular taper junction

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