Despite high total knee arthroplasty (TKA) survivorship after 10 years (92%-99%), a gap persists where patient satisfaction lags clinical success. Additionally, while cobalt chrome molybdenum (CoCrMo) use decreases in primary total hip arthroplasty, the alloy continues to be widely used in TKA femoral components. In vivo, CoCrMo degradation may be associated with adverse local tissue reactions (ALTR) and compared with the hip, the damage mechanisms that may release metal in the knee and the potential biological effects remain poorly understood. In this study, we characterized the damage on 50 retrieved CoCrMo femoral knee implants paired with 19 titanium alloy and 31 CoCrMo tibial baseplates. We asked (1) what damage modes can release CoCrMo debris in vivo from femoral components and (2) how frequently does the damage occur? First, we developed a semiquantitative scoring system for abrasive wear. Then, we characterized damage modes on CoCrMo femoral implants using digital optical microscopy (DOM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). We found that wear, electrocautery damage, and Ti-6Al-4V material transfer were ubiquitous. Of the 50 CoCrMo femoral implants we investigated, we documented wear on 100% (n = 50/50), electrocautery damage on 98% (n = 49/50), and Ti-6Al-4V material transfer to the posterior condyles on 95% (n = 18/19). Our results suggest that these damage modes may be more prevalent than previously thought and may act as metal release mechanisms in vivo.
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http://dx.doi.org/10.1002/jbm.b.35504 | DOI Listing |
J Biomed Mater Res B Appl Biomater
December 2024
Department of Bioengineering, Clemson University, Clemson, South Carolina, USA.
Despite high total knee arthroplasty (TKA) survivorship after 10 years (92%-99%), a gap persists where patient satisfaction lags clinical success. Additionally, while cobalt chrome molybdenum (CoCrMo) use decreases in primary total hip arthroplasty, the alloy continues to be widely used in TKA femoral components. In vivo, CoCrMo degradation may be associated with adverse local tissue reactions (ALTR) and compared with the hip, the damage mechanisms that may release metal in the knee and the potential biological effects remain poorly understood.
View Article and Find Full Text PDFPolymers (Basel)
April 2024
Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, H-7623 Pécs, Hungary.
The goal of the study was to compare the surface characteristics of typical implant materials used in orthopedic surgery and traumatology, as these determine their successful biointegration. The morphological and chemical structure of Vortex plate anodized titanium from commercially pure (CP) Grade 2 Titanium (Ti2) is generally used in the following; non-cemented total hip replacement (THR) stem and cup Ti alloy (Ti6Al4V) with titanium plasma spray (TPS) coating; cemented THR stem Stainless steel (SS); total knee replacement (TKR) femoral component CoCrMo alloy (CoCr); cemented acetabular component from highly cross-linked ultrahigh molecular weight polyethylene (HXL); and cementless acetabular liner from ultrahigh molecular weight polyethylene (UHMWPE) (Sanatmetal, Ltd., Eger, Hungary) discs, all of which were examined.
View Article and Find Full Text PDFSci Rep
January 2024
Laboratory for Engineering Design and Tribology, Department of Mechanical Engineering, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia.
Front Bioeng Biotechnol
September 2023
Department of Musculoskeletal Tumor, People's Hospital, Peking University, Beijing, China.
Surgery for bone tumors around the knee often involves extensive resection, making the subsequent prosthetic reconstruction challenging. While carbon fiber-reinforced polyetheretherketone (CF-PEEK) has been widely used in orthopedic implants, its application in tumor-type prosthesis is limited. This study aims to evaluate the feasibility of using 30wt% and 60wt% carbon fiber-reinforced polyetheretherketone (CF30-PEEK and CF60-PEEK) as materials for a redesigned tumor-type knee prosthesis through numerical analysis.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
August 2023
Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Background: In total knee arthroplasty, femoral components with coated or oxidized surfaces are commonly used as alternative to CoCrMo in metal sensitive patients. Data on the in vivo behaviour of different coating types is, however, rare. Aim of the study was the investigation of coating stability with respect to implant and patient specific parameters.
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