The Gilbert Biomaterials and Regenerative Medicine Laboratory

RESEARCH: IMPLANT RETRIEVAL ANALYSIS

Implant Retrieval Analysis

Understanding the mechanisms of interaction between medical devices and the local environment, including biological interactions, surface mechanics (tribology), corrosion processes and their interplay under varying inflammatory conditions requires detailed characterization of the surfaces of retrieved medical devices. Such retrieval analyses are critical in providing demonstrations of mechanisms of interaction.

The Gilbert lab has been focused on the description of damage modes on metallic implant surfaces, particularly related to modular taper junctions, but more recently to bearing surfaces as well. These have included the study of severity of corrosion in modular tapers and relationships with design, surgical and materials effects. In addition, recent work has focused on surface damage that is either surgically related, specifically electrosurgical-based damage to metallic implant surfaces (Kubacki and Gilbert, J of Arthro, 2017). These observations show that cauterizing tissues near to implants can induce surface melting of CoCrMo and Ti alloys, damaging the surfaces and enhancing potential wear and corrosion processes.

Other work has investigated the hypothesis that inflammatory and immune cells can provide reactive oxygen species locally to implant surfaces and thereby increase the corrosion of CoCrMo and Ti alloy surfaces by raising the oxidizing potential of the local fluid and damaging the oxide film on these metal surfaces. (Gilbert et al. JBMR-A, 2016, Liu and Gilbert, 2017)


Figure: Examples of laboratory induced electrocautery damage, along with retrieved implants showing nearly identical damage modes. Electrocautery can significantly damage implant surfaces during implantation by localized melting resulting from arcing of the plasma through tissue down to the metal surface.


Figure: Examples of modular taper fretting crevice corrosion of CoCrMo head tapers by way of intergranular corrosion attack.

References:

Higgs GB, Hanzlik JA, MacDonald DW, Kane WM, Day JS, Klein GR, Parvizi J, Mont MA, Kraay MJ, Martell JM, Gilbert JL, Rimnac CM, Kurtz SN, “Method of Characterizing Fretting and Corrosion at the Various Taper Connections of Retrieved Modular Components from Metal-on-Metal Total Hip Arthroplasty”, Amer Soc for Testing and Mat, ASTM, Spec Tech Pub 1560 Metal-on-Metal Total Hip Replacement Devices, Eds., Kurtz, S, Greenwald, A, Mihalko, W, Lemmons, J, 2013, pp 146-156.

Higgs GB, Hanzlik JA, MacDonald DW, Gilbert JL, Rimnac CM, Kurtz SM “Is Increased Modularity Associated with Taper Damage in Metal-on-Metal Total Hip Arthroplasty Devices?”, J. Arthroplasty, (2013) 29(8) Supp, 2-6.

Kurtz SM, Kocagoz SB, Hanzlik JA, Underwood RJ, Gilbert JL, MacDonald DW, Lee GC, Mont MA, Kraay MJ, Klein GR, Parvizi J, Rimnac C, “Do Ceramic Heads Reduce Taper Fretting in Hip Arthroplasty? A retrieval Study”, Clin Orthop and Rel Res (2013) 471:3270-3282.

Kocagoz S, Underwood RJ, Sivan S, Gilbert JL, MacDonald DW, Day JS, Kurtz SM, “Does Taper Angle Clearance Influence Fretting and Corrosion Damage at the Head-Stem Interface?”, Seminars in Arthroplasty, 2014 24(4): 246-254.

Arnholt CM, MacDonald DW, Tohfafarosh M, Gilbert JL, Rimnac CM, Kurtz SM, “Mechanically Assisted Taper Corrosion in Modular TKA”, J. Arthroplasty, 2014, 29(9):205-208.

Porter DA, Urban RM, Jacobs JJ, Gilbert JL, Rodriguez JA, Cooper HJ, “Modern Tapers are More Flexible: A Mechanical Analysis of THA Trunnion Designs”, Clin Orthop and Rel Res, (2014) 472: 3963-3970.

Kurtz SM, MacDonald DW, Gilbert JL, Mont MA, Klein G, Chen A, Kraay M, Hamlin Rimnac CM, “Is Taper Fretting Corrosion a Threat to the Clinical Performance of Large-Diameter Hips with HXLPE Bearings?”, ASTM STP 1591, Ed. Greenwald, Lemons, Kurtz, Mihalko, ASTM International, W. Conshohocken, PA, 2015, pp. 45-58.

Clarken-Wright G, Parvizi J, Lee GC, Klein GR, Rimnac CM, Gilbert JL, Kurtz, SM, “Titanium Alloy Sleeves do not Prevent Fretting Corrosion in Modular THA”, Orthop Proc, Jan, 2016.

Kocagoz SB, Underwood RJ, MacDonald DW, Gilbert JL, Kurtz SM, “Ceramic Heads Decrease Metal Release Caused by Head-Taper Fretting and Corrosion”, Clin Orthop and Rel Res, (2016) 474: 985-994.

Morlock MM, Bunte D, Ettema H, Verheyen C, Hamberg A, Gilbert JL, “Primary Hip Replacement Stem Taper Fracture due to Corrosion – A case series of three patients”, Acta Orthopaedica, 2016; 87(2): 189-192.

Higgs GB, MacDonald DW, Chen AF, Klein GR, Hamlin BR, Lee GC, Cates HE, Malkani AL, Kraay MJ, Gilbert JL, Rimnac CM, Kurtz SM, “Does Taper Size Have an Effect on Taper Damage in Retrieved Metal-on-Polyethylene Total Hip Devices?”, J Arthroplasty, Volume 31, Issue 9, Supplement, September 2016, Pages 277–281.

Arnholt C, M, MacDonald DW, Malkani AL, Kliein GR, Rimnac CM, Kurtz SM, Kocagoz SB, Gilbert JL, “Corrosion Damage and Wear Mechanisms in Long-term Retrieved CoCr Femoral Components for Total Knee Arthroplasty”, J of Arthoplasty, 31; 2016: 2900-2906.

Kubacki GM, Gilbert JL, “Electrocautery Induced Damage to Metal Implant Surfaces”, J Arthroplasty, June 2017, doi.org/10.1016/j.arth.2017.06.015.

Gilbert JL, “Corrosion in the Human Body: Metallic Implants in the Complex Body Environment” Corrosion, August 2017, doi.org/10.5006/2563.