Histological Characterization of Chromium Orthophosphate Corrosion Products from Modular Total Hip Replacements

Kung, Michael S.; Campbell, Pat; Markantonis, John; Knutsen, Ashleen; Ameri, Bijan; Park, Sang‐Hyun; Ebramzadeh, Edward

doi:10.1520/stp159120140141

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…The chemical compositions of corrosion particles at head–neck interface in traditional (non highly crosslinked) MoP hip system have been extensively studied (Urban et al, ; Urban, Jacobs, Gilbert, & Galante, ). Chromium phosphate particles were observed in tissues surrounding MoP hip implants (Cooper et al, ; Kung et al, ). However, there is a lack of systematic study on the nature of corrosion products and its evolution when migrating from the joint surfaces to the synovial fluid and the adjacent soft tissues, especially in the highly crosslinked MoP hip system.…”

Section: Introductionmentioning

confidence: 99%

CoCrMo metal release in metal‐on‐highly crosslinked polyethylene hip implants

et al. 2019

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Increasing cases of adverse local tissue reactions (ALTRs) associated with metal release have been observed in patients with metal‐on‐highly crosslinked polyethylene (MoP) hip implants, the most common design in total hip replacements. Studies have demonstrated the metal release from fretting corrosion at the head–neck junction, but rarely investigated tribocorrosion associated metal release at articulating surfaces in MoP hip implants. The objective of this study is to investigate both tribocorrosion at the articulating surfaces and fretting corrosion at the head–neck junction in CoCrMo femoral heads, as well as their association with metal species released in periprosthetic tissues and body fluids in MoP hip systems. Twenty‐three patients with ALTRs associated with MoP implants were included. Systematic analyses were performed on the wear damage in articulation, corrosion at the head–neck junction and their correlation with degradation products observed in synovial fluid, periprosthetic tissues, and serum. Results showed that tribocorrosion at the articulating surfaces contributed to the elevated concentration of both Co and Cr ions in serum, while fretting corrosion at the head–neck junction mainly released Co ions to serum. Both tribocorrosion at the articulating surfaces and fretting corrosion at the head–neck junction released particles rich in chromium and phosphate, the dominant particles found in synovial fluids and tissues. This study provides strong evidence that tribocorrosion at the articulating surfaces in MoP hip implants could result in significant metal release. This information should be taken into account when studying the mechanisms of ALTRs and developing strategies of preventing metal release in total hip replacements.

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Section: Introductionmentioning

confidence: 99%

CoCrMo metal release in metal‐on‐highly crosslinked polyethylene hip implants

et al. 2019

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“…It is important to note that FTIR-I enables the precise distinction of CrPO 4 from other phosphates or phosphorous materials such as bone and HAp as demonstrated by the detection of a bone fragment in Case 3. Previous studies have shown that CrPO 4 particles can be yellow-golden in color 62 , but based on the results of this study it seems possible that such particles are bone fragments which can easily be misidentified as CrPO 4 , thus demonstrating another benefit of FTIR-I with its ability to spatially and chemically characterize and identify particles Case 4 exhibited considerable corrosion damage on the head taper surface, as well as a strong lymphocyte presence. However, the strong macrophage response appeared to be mainly driven by the excessive material loss generated from the TMZF ® taper that has also been described by others for this implant type 30 .…”

Section: Discussionmentioning

confidence: 77%

Fourier transform infrared spectroscopic imaging of wear and corrosion products within joint capsule tissue from total hip replacements patients

et al. 2019

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Implant debris generated by wear and corrosion is a prominent cause of joint replacement failure. This study utilized Fourier Transform InfraRed spectroscopic Imaging (FTIR-I) to gain a better understanding of the chemical structure of implant debris and its impact on the surrounding biological environment. Therefore, retrieved joint capsule tissue from five total hip replacement patients was analyzed. All five cases presented different implant designs and histopathological patterns. All tissue samples were formalin-fixed and paraffin-embedded. Unstained, 5μm thick sections were prepared. The unstained sections were placed on BaF 2 windows and deparaffinized with xylene prior to analysis. FTIR-I data were collected at a spectral resolution of 4 cm −1 using an Agilent Cary 670 spectrometer coupled with Cary 620 FTIR microscope. The results of study demonstrated that FTIR-I is a powerful tool that can be used complimentary to the existing histopathological evaluation of tissue. FTIR-I was able to distinguish areas with different cell types (macrophages, lymphocytes). Small, but distinct differences could be detected depending on the state of cells (viable, necrotic) and depending on what type of debris was present (polyethylene (PE), suture material and metal oxides). Although, metal oxides were mainly below the measurable range of FTIR-I, the infrared spectra of tissues exhibited noticeable difference in their presence. Tens of micrometer sized polyethylene particles could be easily imaged, but also accumulations of submicron particles could be detected within macrophages. FTIR-I was also able to distinguish between PE debris, and other birefringent materials such as suture. Chromiumphosphate particles originating from corrosion processes within modular taper junctions of hip implants could be identified and easily distinguished from other phosphorous materials such as bone. In conclusion, this study successfully demonstrated that FTIR-I is a useful tool that can image and determine the biochemical information of retrieved tissue samples over tens of square millimeters in a completely label free, non-destructive, and objective manner. The resulting chemical images provide a deeper understanding of the chemical nature of implant debris and their impact on chemical changes of the tissue within which they are embedded.

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