Understanding the role of corrosion in the degradation of metal-on-metal implants

Yan, Yu; Neville, Anne; Dowson, D.

doi:10.1243/095441105x63246

Cited by 68 publications

(63 citation statements)

References 25 publications

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“…*p < 0.01. corrosion is still the topic of much debate. 22 Some authors demonstrate that proteins can enhance the propagation of charges between implant and surrounding fluids while other publications suggest a reduced charge transfer by proteins. [23][24][25] In addition, it has been debated whether mature OC are able to corrode the metal surface, but evidence has yet been missing.…”

Section: Discussionmentioning

confidence: 99%

Bio‐corrosion of stainless steel by osteoclasts—in vitro evidence

Cadosch

Chan

Gautschi

et al. 2008

Journal Orthopaedic Research

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Most metals in contact with biological systems undergo corrosion by an electrochemical process. This study investigated whether human osteoclasts (OC) are able to grow on stainless steel (SS) and directly corrode the metal alloy leading to the formation of corresponding metal ions, which may cause inflammatory reactions and activate the immune system. Scanning electron microscopy analysis demonstrated long-term viable OC cultures and evident resorption features on the surface of SS discs on which OC were cultured for 21 days. The findings were confirmed by atomic emission spectrometry investigations showing significantly increased levels of chromium, nickel, and manganese in the supernatant of OC cultures. Furthermore, significant levels of pro-inflammatory cytokines IL-1b, IL-6, and TNF-a, which are considered to be major mediators of osteolysis, were revealed in the same cultures by cytometric bead array analysis. Within the present study, it was shown that human osteoclast precursors are able to grow and differentiate towards mature OC on SS. The mature cells are able to directly corrode the metal surface and release corresponding metal ions, which induce the secretion of pro-inflammatory cytokines that are known to enhance osteoclast differentiation, activation, and survival. Enhanced corrosion and the subsequently released metal ions may therefore result in enhanced osteolytic lesions in the peri-prosthetic bone, contributing to the aseptic loosening of the implant. Keywords: osteoclast; bio-corrosion; stainless steel; osteolysis; TNF-a Over the last decades, significant developments have been taking place to provide suitable metal alloys for implants with optimal mechanical characteristics and good biocompatibility with minimal adverse host tissue reactions. 1 However, their permanent tendency to corrode when exposed to a physiological environment remains a serious concern. 2-4 Elevated concentrations of metal ions have been measured in clinically retrieved peri-prosthetic tissues, distal organs, and body fluids in total hip arthroplasty patients. [5][6][7] The biology behind corrosion inside the human body and the distribution of the metal ions throughout the organism is not fully understood. It has been suggested that extracellular body fluids have corrosive proprieties and contain metal binding proteins. 2,3 Furthermore, it has been debated whether osteoclasts (OC) are able to corrode pure metal when entering into contact with metal surfaces. However, direct evidence of metal corrosion by OC has been missing to date.Osteoclasts are highly specialized multinucleated cells, which are capable of bone resorption. They are formed by the fusion of marrow-derived mononuclear precursors, which circulate in the peripheral blood. Osteoclastic differentiation from hematopoietic and circulating monocytes occurs in the presence of macrophage-colony stimulating factor (M-CSF) and the receptor activator of NF-kB ligand (RANK-L) which are expressed on osteoblastic cells. 8 Mature OC display distinct morpholog...

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Section: Discussionmentioning

confidence: 99%

Bio‐corrosion of stainless steel by osteoclasts—in vitro evidence

Cadosch

Chan

Gautschi

et al. 2008

Journal Orthopaedic Research

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“…In this paper, materials were exposed to tribological contact; the passive film of the tested specimens was removed and re-built. E corr measurement can give a clear indication of this process [20].…”

Section: Free Corrosion Potential (E Corr ) Measurementsmentioning

confidence: 99%

“…In tribocorrosion tests, the passive film was removed by the sliding movement [19,20]. By applying a positive potential (in the passive regime from anodic polarization scan), the mechanical depassivation and electrochemical repassivation can be monitored.…”

Section: Potentiostatic Testsmentioning

confidence: 99%

“…The influence of the biological species is also of great important. Studies have been carried out by the current authors and other research groups to understand the effect of proteins in synovial fluids on the tribological and corrosion properties of implant materials [15][16][17][18][19][20][21]. The effect of proteins on tribocorrosion is complicated and depends on the types of protein and tested materials.…”

Section: Introductionmentioning

confidence: 99%

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Tribo-corrosion properties of cobalt-based medical implant alloys in simulated biological environments

Neville

Dowson

2007

Wear

163

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“…The better lubrication regime observed with large-diameter MOM bearings with low clearance allows for a thicker fluid film which completely separates the articular surfaces, generating less wear [22,35]. Despite the increased surface area available for corrosion [19,40], the potentially reduced surface wear may diminish the production of metal ions. Nonetheless, concerns have been raised regarding increased postoperative serum metal ion concentrations [20].…”

Section: Introductionmentioning

confidence: 99%

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

Moroni

Savarino

Hoque

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Metal-on-metal Birmingham hip resurfacing (MOM-BHR) is an alternative to metal-on-metal total hip arthroplasty (MOM-THA), especially for young and/or active patients. However, wear resulting in increased serum ion levels is a concern. Questions/purposes We asked whether (1) serum chromium (Cr), cobalt (Co), and molybdenum (Mo) concentrations would differ between patients with either MOM-BHR or MOM-THA at 5 years, (2) confounding factors such as gender would influence ion levels; and (3) ion levels would differ at 2 and 5 years for each implant type. Patients and Methods Ions were measured in two groups with either MOM-BHR (n = 20) or MOM-THA (n = 35) and a mean 5-year followup, and two groups with either MOM-BHR (n = 15) or MOM-THA (n = 25) and a mean 2-year followup. Forty-eight healthy blood donors were recruited for reference values. Results At 5 years, there were no differences in ion levels between patients with MOM-BHR or MOM-THA. Gender was a confounding factor, and in the MOM-BHR group at 5 years, Cr concentrations were greater in females compared with those of males. Mean ion levels were similar in patients with 2 and 5 years of followup for each implant type. Ion levels in patients were sevenfold to 10-fold higher than in controls. Conclusions As the metal ion concentrations in the serum at 5 years were in the range reported in the literature, we do not believe concerns regarding excessive metal ion levels after MOM-BHR are justified. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.

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Understanding the role of corrosion in the degradation of metal-on-metal implants

Cited by 68 publications

References 25 publications

Bio‐corrosion of stainless steel by osteoclasts—in vitro evidence

Bio‐corrosion of stainless steel by osteoclasts—in vitro evidence

Tribo-corrosion properties of cobalt-based medical implant alloys in simulated biological environments

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

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