What Factors Drive Taper Corrosion?

Pourzal, Robin; Lundberg, Hannah J.; Hall, Deborah A.; Jacobs, Joshua J.

doi:10.1016/j.arth.2018.03.055

Cited by 51 publications

(36 citation statements)

References 39 publications

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“…Fretting and corrosion processes within THR modular junctions are complex and multifactorial . It was the goal of this study to generate in vitro experimental evidence for cell‐accelerated corrosion.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Evidence for Cell‐Accelerated Corrosion Within Modular Junctions of Total Hip Replacements

Bijukumar

Salunkhe

Morris

et al. 2019

Journal Orthopaedic Research

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Corrosion at modular junctions of total hip replacement (THR) remains a major concern today. Multiple types of damage modes have been identified at modular junctions, correlated with different corrosion characteristics that may eventually lead to implant failure. Recently, within the head-taper region of the CoCrMo retrieval implants, cell-like features and trails of etching patterns were observed that could potentially be linked to the involvement of cells of the periprosthetic region. However, there is no experimental evidence to corroborate this phenomenon. Therefore, we aimed to study the potential role of periprosthetic cell types on corrosion of CoCrMo alloy under different culture conditions, including the presence of CoCrMo wear debris. Cells were incubated with and without CoCrMo wear debris (obtained from a hip simulator) with an average particle size of 119 ± 138 nm. Electrochemical impedance spectroscopy (EIS) was used to evaluate the corrosion tendency, corrosion rate, and corrosion kinetics using the media after 24 h of cell culture as the electrolyte. Results of the study showed that there was lower corrosion resistance (p < 0.02) and higher capacitance (p < 0.05) within cell media from macrophages challenged with particles when compared with the other media conditions studied. The potentiodynamic results were also in agreement with the EIS values, showing significantly higher corrosion tendency (low E corr ) (p < 0.0001) and high I corr (p < 0.05) in media from challenged macrophages compared with media with H 2 O 2 solution. Overall, the study provides in vitro experimental evidence for the possible role of macrophages in altering the chemical environment within the crevice and thereby accelerating corrosion of CoCrMo alloy.

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Section: Discussionmentioning

confidence: 99%

In Vitro Evidence for Cell‐Accelerated Corrosion Within Modular Junctions of Total Hip Replacements

Bijukumar

Salunkhe

Morris

et al. 2019

Journal Orthopaedic Research

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“…In vivo , a passive oxide film is spontaneously formed on the metallic surface which protects the implant material from corrosion and inhibits the release of metal ions. However, repetitive mechanical stress leads to the disruption of this protective oxide film hereby facilitating corrosion damage and metal ion release. In addition, galvanic corrosion can occur at taper connections of modular implants, when mixed metal components with different electrochemical potentials are combined.…”

Section: Introductionmentioning

confidence: 99%

Blood Metal Ion Release After Primary Total Knee Arthroplasty: A Prospective Study

Reiner

Sorbi

Müller

et al. 2020

Orthopaedic Surgery

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Objectives:To investigate the course of in vivo blood metal ion levels in patients undergoing primary total knee arthroplasty (TKA) and to investigate potential risk factors associated with metal ion release in these patients. Methods:Twenty-five patients with indication for TKA were included in this prospective study. Whole blood metal ion analysis was performed pre-operatively and at 1 week, 6 weeks, 3 months, 6 months, and 12 months postoperatively. Clinical scores were obtained using the American Knee Society Score (AKSS) and the Oxford Knee Score (OKS) at each follow-up and patientsʼ activity levels were assessed by measuring the mean annual walking cycles at 12 months follow-up. Anteroposterior and lateral radiographs of the operated knee were evaluated postoperatively and at 12-month follow-up with regard to implant position and radiological signs of implant loosening. Correlation analysis using multivariate linear regression was performed to investigate the influence of different variables (age, gender, functional scores, number of walking cycles, and body mass index [BMI]) on blood cobalt ion concentrations.Results: Mean metal ion levels of cobalt, chromium, molybdenum, and titanium were 0.28 μg/L (SD, 0.14), 0.43 μg/L (SD, 0.49), 0.62 μg/L (SD, 0.45), and 1.96 μg/L (SD, 0.98), respectively at 12-month follow-up. Mean cobalt ion levels significantly increased 1-year after surgery compared to preoperative measurements. There was no statistically significant increase of mean metal ion levels of chromium, titanium, and molybdenum at 1-year follow-up. Overall, metal ion levels were low and no patient demonstrated cobalt ion levels above 1 μg/L. Postoperative radiographs demonstrated wellaligned TKAs in all patients and no signs of osteolysis or implant loosening were detected at 1-year follow-up. Both the AKSS and OKS significantly improved during the course of the study up to the final follow-up. Multivariate regression analysis did not show a statistically significant correlation between the tested variables and blood cobalt ion concentrations. Conclusion:A statistically significant increase of mean cobalt ion concentration at 1-year follow-up was found in this cohort of patients with well-functioning TKA, although overall blood metal ion levels were relatively low. Despite low systemic metal ion concentrations seen in this cohort, the local effects of increased metal ion concentrations in the periprosthetic environment on the long-term outcome of TKA should be further investigated.

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“…However, the available data remain inconclusive as to their relevance, and their actual impact remains unclear even to date. Other factors excluded from the analytical model, but under the direct influence of the surgeon, are the impaction technique [6] and the avoidance of mismatch by combining heads and stems with different taper designs (i.e., from different manufacturers) [25,67,68,84].…”

Section: Discussionmentioning

confidence: 99%

“…Changes in local chemistry within crevices then lead to the complex interactions of crevice corrosion [26,27]. Although repassivation (i.e., reformation of the protective oxide layers) occurs naturally, fretting alters the repassivation of the exposed metals [24,25,37].…”

Section: Technical Aspects Of Taper Connections In Hip Arthroplastymentioning

confidence: 99%

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What the Surgeon Can Do to Reduce the Risk of Trunnionosis in Hip Arthroplasty: Recommendations from the Literature

Rieker

Wahl

2020

Materials

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Trunnionosis, defined as wear and corrosion at the head-neck taper connection, is a cause of failure in hip arthroplasty. Trunnionosis is linked to a synergistic combination of factors related to the prosthesis, the patient, and the surgeon. This review presents analytical models that allow for the quantification of the impact of these factors, with the aim of providing practical recommendations to help surgeons minimize the occurrence of this failure mode. A tighter fit reduces micromotion and, consequently, fretting of the taper connection. The paramount parameters controlling the fixation force are the coefficient of friction and the impaction force. The influence of the head diameter, as well as of the diameter and angle of the taper, is comparatively small, but varus alignment of the taper and heads with longer necks are unfavourable under physiologic loads. The trunnion should be rinsed, cleaned, and dried carefully, while avoiding any contamination of the bore-the female counterpart within the head-prior to assembly. Biological debris, and even residual water, might critically reduce the fixation of the taper connection between the head and the neck. The impaction force applied to the components should correspond to at least two strong blows with a 500 g hammer, striking the head with an ad hoc impactor aligned with the axis of the taper. These strong blows should correspond to a minimum impaction force of 4000 N.

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What Factors Drive Taper Corrosion?

Cited by 51 publications

References 39 publications

In Vitro Evidence for Cell‐Accelerated Corrosion Within Modular Junctions of Total Hip Replacements

In Vitro Evidence for Cell‐Accelerated Corrosion Within Modular Junctions of Total Hip Replacements

Blood Metal Ion Release After Primary Total Knee Arthroplasty: A Prospective Study

What the Surgeon Can Do to Reduce the Risk of Trunnionosis in Hip Arthroplasty: Recommendations from the Literature

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