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Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis.

Eckert JA, Mueller U, Jaeger S, Panzram B, Kretzer JP - Biomed Res Int (2016)

Bottom Line: Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty.The prevalence of fretting and corrosion was confirmed in this cohort.A weak correlation between time to revision and increased levels of tribocorrosion was seen.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.

ABSTRACT
Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual's clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined.

No MeSH data available.


Related in: MedlinePlus

Analyzed types of shoulder implants: two different stems types were analyzed: retrieved stems had either a male (a) or a female (b) taper.
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fig2: Analyzed types of shoulder implants: two different stems types were analyzed: retrieved stems had either a male (a) or a female (b) taper.

Mentions: A total of 38 consecutively retrieved anatomic implants were available for analysis. All explants were revised at the Clinic for Orthopedics and Trauma Surgery of the Heidelberg University Hospital. Two of the retrieved implants had a Ti head and a ceramic head, respectively, which were excluded. Out of the 36 retrieved implants, 30 had a stem fixation, whereas 6 had a stemless fixation. In all cases, CoCr heads were used. Twenty-three of the analyzed implants (64%) had a Ti stemmed or stemless fixation, and 13 implants (36%) featured a CoCr stemmed or stemless fixation (Figure 1). All implants were used in anatomical total shoulder arthroplasty (TSA; n = 7) or hemiarthroplasty (HA; n = 29). The mean time to revision was 3.7 ± 4.1 years (0.03–13.5 years), 10 patients were male, and 27 patients were female. Manufacturers included Tornier (n = 14), Zimmer (n = 7), Arthrex (n = 7), Depuy (n = 3), Biomet (n = 2), Exactech (n = 1), Plus Orthopedics (n = 1), and Synthes (n = 1). In 4 cases, the stem had a female taper, whereas, in all the other cases, the stem had a male taper (Figure 2). Among the four female tapers, three were made of CoCr and one of Ti. All the stemless implants had a male taper on the humeral component. Patient demographics are given in Table 1. The reasons for revision and distribution are given in Table 2. Inclusion criteria were as follows: explantation of the entire humeral component and availability of all clinical data (dates of primary surgery/revision surgery, age, body weight, body mass index (BMI), and indication for revision).


Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis.

Eckert JA, Mueller U, Jaeger S, Panzram B, Kretzer JP - Biomed Res Int (2016)

Analyzed types of shoulder implants: two different stems types were analyzed: retrieved stems had either a male (a) or a female (b) taper.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940522&req=5

fig2: Analyzed types of shoulder implants: two different stems types were analyzed: retrieved stems had either a male (a) or a female (b) taper.
Mentions: A total of 38 consecutively retrieved anatomic implants were available for analysis. All explants were revised at the Clinic for Orthopedics and Trauma Surgery of the Heidelberg University Hospital. Two of the retrieved implants had a Ti head and a ceramic head, respectively, which were excluded. Out of the 36 retrieved implants, 30 had a stem fixation, whereas 6 had a stemless fixation. In all cases, CoCr heads were used. Twenty-three of the analyzed implants (64%) had a Ti stemmed or stemless fixation, and 13 implants (36%) featured a CoCr stemmed or stemless fixation (Figure 1). All implants were used in anatomical total shoulder arthroplasty (TSA; n = 7) or hemiarthroplasty (HA; n = 29). The mean time to revision was 3.7 ± 4.1 years (0.03–13.5 years), 10 patients were male, and 27 patients were female. Manufacturers included Tornier (n = 14), Zimmer (n = 7), Arthrex (n = 7), Depuy (n = 3), Biomet (n = 2), Exactech (n = 1), Plus Orthopedics (n = 1), and Synthes (n = 1). In 4 cases, the stem had a female taper, whereas, in all the other cases, the stem had a male taper (Figure 2). Among the four female tapers, three were made of CoCr and one of Ti. All the stemless implants had a male taper on the humeral component. Patient demographics are given in Table 1. The reasons for revision and distribution are given in Table 2. Inclusion criteria were as follows: explantation of the entire humeral component and availability of all clinical data (dates of primary surgery/revision surgery, age, body weight, body mass index (BMI), and indication for revision).

Bottom Line: Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty.The prevalence of fretting and corrosion was confirmed in this cohort.A weak correlation between time to revision and increased levels of tribocorrosion was seen.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.

ABSTRACT
Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual's clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined.

No MeSH data available.


Related in: MedlinePlus