In this work, we investigated the band alignment at bismuth (Bi)/germanium (Ge) and Bi/silicon (Si) interfaces to understand the mechanism of strong Fermi level pinning (FLP) at element metal/Ge and/Si interfaces. Bi/Ge and/Si interfaces exhibit almost ideal alignment deviating from the trend of strong FLP at element metal/Ge and/Si interfaces. This result suggests that the strong FLP at element metal/Ge and/Si interfaces is mainly caused by the metal-induced gap states (MIGS) in case of the free electron density of metal, and that the weak FLP at direct metal/Ge and/Si interfaces including germanide/Ge and silicide/Si interfaces is comprehensively understandable from the MIGS in case of low electron density. Furthermore, we also discuss impacts of interface structures on the band alignment at the MIGS-weakened interface.

We report a rare case of tibial baseplate fracture of Miller-Galante II (MG II) prosthesis. We examine the factors that may cause such late fracture and review the literature on radiographic analysis and retrieval studies. A 76-year-old woman, who had undergone bilateral MG II total knee arthroplasty due to rheumatoid arthritis 16 years earlier, presented to our department with a 3-month history of left knee pain. Plain radiographs revealed severe distortion of the medial tibial component. During revision knee arthroplasty, we observed severe metallosis in the knee joint, polyethylene insert deformation, and posteromedial coronal baseplate fracture. After removal of the fractured tray, a bone deficit due to osteolysis was noted. The revision prosthesis (LCCK, Zimmer-Biomet) was implanted uneventfully. Four months after revision surgery, the patient was ambulating and had no complications. The implants on the right side had survived without complications for 17 years. We speculate that the primary causative factor of the fatigue fracture of the base plate due to loss of bony support most likely secondary to osteolysis was varus malalignment at primary implantation. This case highlights the importance of paying close attention to the correct alignment of each component at primary implantation.