Journal article
Hinge-Knee Megaprostheses Components Wear and Corrode: A Retrospective Study of 40 Devices
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, v 9(10), e24.00381
14 Oct 2025
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction:Hinge-knee megaprostheses are frequently used in complex revision surgeries and are known to have higher complication and revision rates than primary total knee arthroplasties. However, the in vivo damage to the metal and polymer components of megaprostheses remains poorly understood. We, therefore, investigated the damage modes, their severity, and how they varied by implant manufacturer.Method:Forty megaprostheses and associated clinical data were collected from an institutional review board-exempt retrieval program, including implants from three manufacturers. We semiquantitatively scored the in vivo damage modes on polymer and metal megaprostheses components using the Kahlenberg method. The Goldberg score was used to classify corrosion for metal-on-metal interfaces. We then analyzed the differences between damage types and device manufacturers using nonparametric statistics.Results:We identified and classified scratching, pitting, and burnishing as major damage modes on polyethylene inserts and abrasion, delamination, surface deformation, and embedded debris as minor damage modes. Minor damage modes markedly differed between implant cohorts (P < 0.001), whereas major damage modes did not (P > 0.05). On metal components, scratching was more prevalent than burnishing and discoloration (P < 0.001). Damage to metal tibial components differed by manufacturer (P < 0.01) and corrosion was present in varying degrees across cohorts.Conclusion:In vivo damage occurred on both metal and polyethylene megaprostheses components. Within modular taper junctions, mechanics combined with chemically based processes generated corrosion. We found minimal differences between manufacturers, except for minor polyethylene damage and tibial component damage. The rotating hinge may release metal debris when unprotected by a polyethylene bumper evidenced by burnishing.
Metrics
7 Record Views
Details
- Title
- Hinge-Knee Megaprostheses Components Wear and Corrode: A Retrospective Study of 40 Devices
- Creators
- Abigail E. Tetteh (Corresponding Author) - Drexel UniversityTabitha Derr - Drexel UniversityMichael A. Kurtz - Drexel UniversityGregg R. Klein - Hackensack University Medical CenterNicolas S. Piuzzi - Cleveland ClinicArthur Malkani - University of LouisvilleMichael A. Mont - Sinai HospitalSteven M. Kurtz - Drexel University
- Publication Details
- Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, v 9(10), e24.00381
- Publisher
- Wolters Kluwer
- Number of pages
- 12
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Graduate School of Biomedical Sciences and Professional Studies; School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:001593411000001
- Other Identifier
- 991022122382904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics