The use of multiple-component systems in orthopedic surgery gives the surgeon increased flexibility in choosing the optimal implant, but introduces the possibility of interfacial corrosion. Such corrosion could limit the longevity of prostheses due either to tissue reactions to corrosion products, or to device failure. The incidence and nature of corrosion of modular total hips was evaluated in a consecutive series of 79 retrieved implants from University Hospitals of Cleveland. Surfaces were examined with stereo- and scanning electron microscopy. Several laboratory studies were undertaken to examine mechanisms that might contribute to the initiation of corrosion. The first set of experiments investigated the effect of head neck extension; the second study looked at the effect of material combinations on fretting corrosion and crevice corrosion. Analysis of retrieved implants demonstrated that fretting corrosion played a major role in the initiation of interface corrosion, and that a correlation existed between corrosion and length of neck extensions. Laboratory studies showed that longer head neck extensions may be more susceptible to fretting corrosion because of an instability at the interface. Short-term mixed-metal corrosion studies demonstrated that the coupling of cobalt and titanium alloys did not render the interface more susceptible to corrosion. It is hypothesized that fretting corrosion contributes to the initiation of modular interface corrosion, and that the problem can be reduced by design changes that increase the stability of the interface.

Corrosion has been reported at the modular interfaces of total joint replacement implants, but with conflicting theories as to the cause of such damage. The modular design itself leaves the interface susceptible to galvanic, crevice, or fretting corrosion, or a combination of the three. The purpose of this study was to quantify the effect of material combination on fretting corrosion of orthopedic alloys. Each test specimen consisted of a two-hole plate with spherical countersinks and two cortical bone screws. The plates and screws were made of either Ti6Al4V or wrought cobalt-chromium-molybdenum (CCM), and were tested in all mixed-metal and similar-alloy combinations. Fretting corrosion experiments were conducted for 14 days in 10% calf serum, according to ASTM F897. Corrosion damage was evaluated by weight-loss measurements, atomic absorption spectrophotometry and scanning electron microscopy analyses. The results indicated that Ti6Al4V suffered relatively severe damage when fretted against itself, as a result of adhesive galling. The extent of titanium damage was reduced considerably, however, when Ti6Al4V was fretted against wrought CCM. In contrast, there was essentially no difference in wrought CCM damage when the alloys was fretted against itself compared to fretting against Ti6Al4V. Finally, in similar-alloy combinations, Ti6Al4V suffered more severe damage than wrought CCM.

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Titanium and titanium-6% aluminum-4% vanadium (Ti-6Al-4V) are known to be biocompatible and corrosion resistant. However, there have been numerous reports of elevated tissue levels of titanium due to passive dissolution, wear, or fretting corrosion of implants. Studies were undertaken to determine whether the fretting corrosion of Ti-6Al-4V could be reduced by surface treatment of one or both surfaces in a fretting situation. Three different surface treatments were studied: ion implantation, physical vapor deposition nitriding, and plasma ion nitriding. The specimens used were screws fretting against the countersinks of a two-hole plate. Fretting corrosion was assessed by weight loss, by chemical analysis of test solutions, and by scanning electron microscopy. Surface treatment of one component, the screws, resulted in reduction in the release of titanium to only 18-32% of that seen with the untreated controls. Weight loss of the untreated plates fretted against physical vapor deposition nitrided screws and plasma ion nitrided screws was reduced to 31 and 38% of the control, respectively. The weight loss of plasma nitrided screws was only 30% that of the control. Nitriding of both plates and screws resulted in a further decrease in plate weight loss and metal release. Plasma ion nitriding of both components had the most significant effect, with the weight loss and titanium release being only 11 and 2% of the control values, respectively.