Journal article
Is There Material Loss at the Backside Taper in Modular CoCr Acetabular Liners?
Clinical orthopaedics and related research, v 473(1)
01 Jan 2015
PMID: 25318923
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Metal wear and corrosion products generated by hip replacements have been linked to adverse local tissue reactions. Recent investigations of the stem/head taper junction have identified this modular interface as another possible source of metal debris; however, little is known regarding other modular metallic interfaces, their ability to produce metal debris, and possibly to provide insight in the mechanisms that produce metal debris.
We asked three questions: (1) can we develop a reliable method to estimate volumetric material loss from the backside taper of modular metal-on-metal liners, (2) do backside tapers of modular metal-on-metal liners show a quantifiable volumetric material loss, and, if so, (3) how do regions of quantitatively identified material loss correspond to visual and microscopic investigations of surface damage?
Twenty-one cobalt-chromium (CoCr) liners of one design and manufacturer were collected through an institutional review board-approved retrieval program. All liners were collected during revision surgeries, where the primary revision reason was loosening (n = 11). A roundness machine measured 144 axial profiles equally spaced about the circumference of the taper region near the rim to estimate volume and depth of material loss. Sensitivity and repeatability analyses were performed. Additionally, visual and scanning electron microscopy investigations were done for three liners.
Our measurement method was found to be reproducible. The sensitivity (how dependent measurement results are on experimental parameters) and repeatability (how consistent results are between measurements) analyses confirmed that component alignment had no apparent effect (weak correlation, R-2 = 0.04) on estimated volumetric material loss calculations. Liners were shown to have a quantifiable material loss (maximum = 1.7 mm(3)). Visual investigations of the liner surface could identify pristine surfaces as as-manufactured regions, but could misidentify discoloration as a possible region of material loss. Scanning electron microscopy more accurately distinguished between as-manufactured and damaged regions of the taper.
The roundness machine has been used to develop a repeatable method for characterizing material loss; future work comparing a gravimetric standard with estimations of material loss determined from the roundness machine may show the accuracy and effectiveness of this method. Liners show rates of material loss that compare with those reported for other taper junctions. Visual inspection alone may misidentify as-manufactured regions as regions of material loss.
This study identifies the acetabular liner/shell interface in modular metal-on-metal devices as a potential source of metal wear or corrosion products. The relation between metal debris and clinical performance, regardless of the type of bearing couple, is a concern for clinicians. Therefore, it is important to characterize every type of modular junction to understand the quantity, location, and mechanism(s) of material loss.
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Details
- Title
- Is There Material Loss at the Backside Taper in Modular CoCr Acetabular Liners?
- Creators
- Matthias T. Agne - Drexel UniversityRichard J. Underwood - Exponent (United States)Sevi B. Kocagoz - Drexel UniversityDaniel W. MacDonald - Drexel UniversityJudd S. Day - ExponentJavad Parvizi - Rothman InstituteMatthew J. Kraay - University Hospitals Case Medical CenterMichael A. Mont - Rubin Institute for Advanced OrthopaedicsGregg R. Klein - Hartzband Center for Hip and Knee ReplacementHarold E. Cates - Tennessee Orthopaedic ClinicsSteven M. Kurtz - Exponent (United States)
- Publication Details
- Clinical orthopaedics and related research, v 473(1)
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 11
- Grant note
- DePuy Synthes (Warsaw, IN, USA) Joint Active Systems (Effingham, IL, USA) CeramTec (Plochingen, Germany) Stelkast (McMurray, PA, USA) Medtronic (Minneapolis, MN, USA); Medtronic Medical Compression Systems (West Hills, CA, USA) Zimmer, Inc (Warsaw, IN, USA) DJO (Vista, CA, USA) Formae (Paoli, PA, USA) CeramTec (Laurens, SC, USA) Stryker Orthopaedics (Mahwah, NJ, USA) Biomet (Warsaw, IN, USA) Active Implants (Memphis, TN, USA) R01AR047904 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) Kyocera Medical (Yodogawa-ku, Osaka, Japan) Pfizer (New York, NY, USA); Pfizer Invibio (Lancashire, UK) Cadence Pharmaceuticals, Inc (San Diego, CA, USA) Celanese (Florence, KY, USA) Wright Medical Technology (Arlington, TN, USA) Smith & Nephew (Memphis, TN, USA) Aesculap/B. Braun (Center Valley, PA, USA) Sage Products LLC (Cary, IL, USA) Spinal Motion (Mountain View, CA, USA) 3 M (Saint Paul, MN, USA) DJ Orthopaedics (Vista, CA, USA) Salient Surgical (Minneapolis, MN, USA) R01 AR47904 / National Institutes of Health (NIAMS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) TissueGene (Rockville, MD, USA) Zimmer Inc (Warsaw, IN, USA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000346902900052
- Scopus ID
- 2-s2.0-84922079705
- Other Identifier
- 991019167980804721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Surgery