Galvanically enhanced fretting-crevice corrosion of cemented femoral stems.

The Ultima TPS MoM THR was designed and developed as a 2nd generation MoM THR specifically aimed at younger more active patients due to the anticipated low wear rates and increased longevity of MoM THRs. In 2010, published clinical data highlighted the early failure of the Ultima TPS MoM due to fretting-crevice corrosion at the stem-cement interface. Since 2010 similar observations have been reported by other clinical centres implicating competitor products as well as the Ultima TPS MoM THR. In an attempt to replicate the electrochemical reaction and interactions established across MoM THR systems, fretting-crevice corrosion tests subjected to galvanic coupling were conducted. Galvanic coupling was seen to significantly increase the rates of corrosion under static and dynamic conditions. This was due to the large potential differences developed across the system between active and passive areas, increasing the rates of corrosion and metallic ion release from the stem-cement interface.

Characterisation of the surface topography, tomography and chemistry of fretting corrosion product found on retrieved polished femoral stems.

This study presents the characterisation of the surface topography, tomography and chemistry of fretting corrosion product found on retrieved polished femoral stems. Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS), Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FI-IR) were utilised in order to assess the surface morphology of retrieved Metal-on-Metal Total Hip Replacements and surface chemistry of the films found on the surface. Gross slip, plastic deformation and directionality of the surface were extensively seen on the proximal surfaces of the retrievals. A more corrosive phenomenon was observed in the distal regions of the stem, demonstrating a seemingly intergranular attack. Tribochemical reactions were seen to occur within the stem-cement interfaces with tribofilms being observed on the femoral stem and counterpart PMMA bone cement. XPS, TEM-EDX and FT-IR analyses demonstrated that the films present in the stem surfaces were a complex mixture of chromium oxide and amorphous organic material. A comparison between current experimental and clinical literature has been conducted and findings from this study demonstrate that the formation and chemistry of films are drastically influenced by the type of wear or degradation mechanism. Films formed in the stem-cement interface are thought to further influence the biological environment outside the stem-cement interface due to the formation of Cr and O rich films within the interface whilst Co is free to migrate away.

Effect of counterface material on the characteristics of retrieved uncemented cobalt-chromium and titanium alloy total hip replacements.

A number of total hip components explanted at revision with bearing surfaces in either cobalt-chromium-molybdenum alloy or titanium-6% aluminium-4% vanadium alloy were examined and compared to contemporaneously manufactured but unused items; particular attention was paid to the bearing surfaces which were examined visually, by low-power microscopy, scanning electron microscopy (SEM), confocal microscopy, white light interferometry, laser profilometry and conventional stylus profilometry. The cobalt alloy heads maintained their surface finish well over periods up to 12 years. The titanium implants became badly damaged over much shorter periods although even badly scratched heads continued to meet the current standards for titanium alloy heads. Analysis showed that the damage to the titanium alloy heads was not a random but a well-defined process of scarring of a consistent size created by abrasion with small particles of bone. These damaged heads had the potential to wear the matching UHMWPE components rapidly creating large amounts of polymer debris. The finding that measurement of these damaged heads is within current standards raises concerns as to whether current standards incorporate fully the requirements for clinical performance.

Estimation of wear in total hip replacement using a ten station hip simulator.

The results of hip simulator tests on a total of 16 total hip joints, all of them 22.25 mm Charnley designs, are presented. Wear at up to 6.75 million cycles was assessed by using a coordinate measuring machine. The results gave good agreement with clinical estimates of wear rate on the same design of joint replacement from a number of sources. Good agreement was also obtained when comparison was made with the published results from more sophisticated simulators. The major source of variation in the results was found to occur in the first million cycles where creep predominates. The results of this study support the use of this type of simplified simulator for estimating wear in a total hip prosthesis. The capability to test a significant number of joints simultaneously may make this mechanism preferable to more complex machines in many cases.

Comparative study of the wear of UHMWPE with zirconia ceramic and stainless steel femoral heads in artificial hip joints.

The wear of ultra high molecular weight polyethylene (UHMWPE) when sliding against zirconia ceramic and stainless steel counterfaces has been compared in a pin-on-plate reciprocator and in a hip joint simulator. A lower wear factor was found for the UHMWPE when sliding on the zirconia ceramic counterfaces in the pin-on-plate tests. In the hip joint simulator test, the acetabular cups articulating on zirconia heads showed consistently lower volume changes than the cups articulating on stainless steel heads. The higher volume changes found with the stainless steel heads were associated with an increased roughness of the femoral heads during the tests. This roughening was caused by the adherence of a rough polymer transfer film.