Fretting and Corrosion Between a Metal Shell and Metal Liner May Explain the High Rate of Failure of R3 Modular Metal-on-Metal Hips

Ilo, Kevin; Derby, Emma; Whittaker, Robert; Blunn, Gordon; Skinner, John; Hart, Alister

doi:10.1016/j.arth.2016.12.024

Cited by 18 publications

(11 citation statements)

References 17 publications

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“…[7][8][9] Retrieval analysis studies of acetabular components have reported similar findings. 1,2,[10][11][12] However, a recently published in vitro study has found that MACC may not be a significant driver of taper corrosion in titanium shell-CoCrMo liner acetabular tapers, 13 especially when compared with head-neck tapers with the same material combination.…”

Section: Introductionmentioning

confidence: 99%

Nontribological corrosion modes dominate wrought CoCrMo acetabular taper corrosion: A retrieval study

2021

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Corrosion of modular metal-on-metal acetabular tapers in total hip arthroplasty (THA) systems is often attributed to mechanically driven processes. Recent findings suggest that mechanically assisted crevice corrosion (MACC) might not be the dominant cause of corrosion in shell-liner tapers. This study aims to document and present the corrosion modes observed in metal-metal acetabular liners. Twenty-one retrieved wrought CoCrMo liners were examined using digital optical microscopy (DOM), scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS). Corrosion-related damage was documented in nonengagement taper regions, outside of direct taper contact. Within engagement regions, nonmechanically driven corrosion features (pitting, intergranular corrosion) were observed adjacent to fretting and material transfer, which rely on mechanical contact; corrosion independent of MACC was observed even in contact regions. Corrosion types observed included intergranular corrosion (IGC), pitting attack, phase boundary dissolution, all both outside and inside of taper junctions, and MACC within contact regions of the taper. Typical fretting scars associated with MACC were mostly absent, and were not always associated with corrosion damage where present. Finally, hard phase particles (Mo-Si-O) released from the wrought CoCrMo microstructure had redeposited within regions with material loss. Acetabular taper corrosion modes differ significantly from those in head-neck tapers and are dominated by electrochemically driven processes, not mechanical processes, as indicated by corrosion in noncontact regions. With greater prevalence of dual mobility hip implants, acetabular taper corrosion processes must be understood in order to limit their impact on device performance.

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Section: Introductionmentioning

confidence: 99%

Nontribological corrosion modes dominate wrought CoCrMo acetabular taper corrosion: A retrieval study

2021

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“…Due to the modularity of modern revision systems, the number of interfaces increases, and therefore it is reasonable to assume that the chance for particle debris is amplified. Adverse reactions to metal debris (ARMD) and corrosion increase as the number of interfaces increases and have been described for modular revision implants in numerous previous studies [27][28][29][30]. Interestingly, while the amount of relative movement between the shell and the cup increased for both groups, the S-group started with a significantly higher amount of relative movement and remained higher throughout all load levels when compared to the nS-group.…”

Section: Discussionmentioning

confidence: 82%

Primary Stability in Hip Revision Arthroplasty: Comparison of the Stability of Cementless Fixed Augments on a Modular Acetabular Cage System with and without Cranial Straps

Jaenisch

Kohlhof

Wirtz

et al. 2021

JCM

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The goal of this study is to evaluate the primary stability of a cementless augment-and-modular-cage system with and without the addition of cranial straps in a standardized in vitro setting. As the surrogate parameter for the evaluation of primary stability, the measurement of relative motion between the implant components themselves and the bone will be used. Acetabular revision components with a trabecular titanium augment in combination with a large fourth-generation composite left hemipelvis were assembled. These constructs were divided into two groups with (S) and without cranial straps (nS). A total of 1000 cycles was applied at each of three load levels. Relative movements (RM) between the components were measured. Load levels display a significant effect on the amount of RM at all interfaces except between shell/augment. The group assignment appears to have an effect on RM due to significantly differing means at all interfaces. Between bone/shell RM increased as load increased. NS displayed significantly more RM than S. Between shell/augment RM remained constant as load increased. Between shell/cup S showed more RM than nS while both groups’ RM increased with load. We conclude a significant increase of primary stability between the shell and the bone through the addition of cranial straps. Relative motion between components (shell/cup) increases through the addition of cranial straps. A clinical impact of this finding is uncertain and requires further investigation. Finally, the cementless fixation of the augment against the rim-portion of the shell appears stable and compares favorably to prior investigation of different fixation techniques.

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“…The benefits of using an acetabular liner within a shell include ease of revision by changing the liner without removing a well‐integrated acetabular cup. In addition, shell fixation with screws is required in cases of bone tissue loss, and a modular acetabular component allows for this possibility without interfering with the bearing surface of the femoral component . The early designs comprised of non‐cross‐linked ultra‐high molecular weight polyethylene (UHMWPE).…”

Section: Introductionmentioning

confidence: 99%

“…Recent retrieval studies have shown that modular acetabular components, primarily associated with MoM designs, sustain damage in their taper junctions, usually attributed to mechanically‐assisted crevice corrosion (MACC) and wear . However, the nature of the damage observed in these tapers is distinctly different than that seen in, for example, head‐neck junctions.…”

Section: Introductionmentioning

confidence: 99%

In vitro test methods for seating and fretting corrosion behavior of modular metal‐on‐metal acetabular tapers

Shenoy

Gilbert

2019

Journal Orthopaedic Research

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Retrieval studies show that metal-on-metal acetabular shell-liner tapers are susceptible to corrosion, which is hypothesized to arise from mechanically-assisted crevice corrosion (MACC). The role of materials on MACC of acetabular tapers has not been previously studied. In vitro tests of seating, pushout, and fretting corrosion performance of acetabular tapers are presented to assess the role of material combinations (Ti-6Al-4V shells, HC CoCrMo, LC CoCrMo, and 316L SS liners). The acetabular tapers were wetassembled to a seating load of 1,000 N. The liner load-displacement seating mechanics were measured. Fretting corrosion currents were evaluated using a uniaxial incremental cyclic compression test up to 4,000 N, with the load applied at a 55°angle to the taper interface. Fretting currents, fretting onset loads, taper disengagement strength were measured and load-displacement plots were obtained. Pushout tests were also performed pre-and post-fretting corrosion. The average liner seating displacements varied from 134 to 226 μm across groups. Fretting currents at 3,600 N cyclic load were low and ranged between 0.05 and 0.27 μA and were independent of material combination (p > 0.05), reflecting small amounts of fretting. Fretting corrosion onset loads were between 1,800 and 2,100 N, and did not differ across groups (p > 0.05). Pushout loads were 27-43% of the maximum load applied. Fretting corrosion levels were very low for all material combinations and not different from one another. The seating and pushout responses were also not material dependent. The low fretting currents measured imply that MACC may not be a major cause for acetabular taper corrosion.

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Fretting and Corrosion Between a Metal Shell and Metal Liner May Explain the High Rate of Failure of R3 Modular Metal-on-Metal Hips

Abstract: The high failure rate of the metal liner option of the R3 acetabular system may be attributed to corrosion on the backside of the liner which appear to result from geometry and design characteristics of the acetabular shell.

Cited by 18 publications

References 17 publications

Nontribological corrosion modes dominate wrought CoCrMo acetabular taper corrosion: A retrieval study

Nontribological corrosion modes dominate wrought CoCrMo acetabular taper corrosion: A retrieval study

Primary Stability in Hip Revision Arthroplasty: Comparison of the Stability of Cementless Fixed Augments on a Modular Acetabular Cage System with and without Cranial Straps

In vitro test methods for seating and fretting corrosion behavior of modular metal‐on‐metal acetabular tapers

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