Corrosion and Tribology of Materials Used in a Novel Reverse Hip Replacement.
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ABSTRACT:
SUBMITTER: Braddon L
PROVIDER: S-EPMC5551794 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
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Project description:We report a case of head-neck taper fretting corrosion in a patient who had a total hip replacement with a noncemented Stryker Anato femoral stem and a V40 metal head with a Stryker Tritanium hemispherical socket with a highly cross-linked polyethylene liner (metal on polyethylene) (Stryker, Mahwah, NJ, USA). A 57-year-old man presented with early-onset hip pain after right total hip arthroplasty. Workup was negative for infection. Metal artifact reduction sequence MRI revealed an encapsulated fluid mass. Metal ion cobalt level was elevated at 6 ppb. The patient underwent right revision total hip arthroplasty with excellent results at 1-year follow-up.
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Project description:The most common sources for metal ions after total hip arthroplasty (THA) are the bearing surface in metal-on-metal articulations and trunnion corrosion. Concomitant dual interface failure is an uncommon complication in metal-on-polyethylene THA. We report an unusual case of a 59-year-old woman with ceramic-on-ceramic THA in 2005, who underwent revision to metal-on-polyethylene THA 4 years later after femoral head fracture. Subsequently, she developed substantial adverse local tissue reaction and significant metal ion elevation and the failure was found to be due to both wear at the bearing surface and corrosion at the head neck junction requiring second revision. Findings included massive adverse local tissue reaction, abductor mechanism destruction, osteolysis, and corrosion damage of the trunnion. Abrasive damage of the trunnion was also noted, but prior abrasion from the original ceramic fracture could not be ruled out. Postoperative course at 14 months demonstrates 95% and 64% reduction in cobalt and chromium levels respectively, with symptom resolution.
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Project description:Background: Patients frequently consult the internet for health information. Our aim was to perform an Internet-based readability and quality control study using recognised quality scoring systems to assess the patient information available online relating to anaesthesia for total hip and knee replacement surgery. Methods: Online patient information relating to anaesthesia for total hip and knee replacement was identified using Google, Bing and Yahoo with search terms 'hip replacement anaesthetic', 'knee replacement anaesthetic.' Readability was assessed using Flesch Reading Ease (FRE), Flesch-Kincaid grade level (FKGL) and Gunning Fog Index (GFI). Quality was assessed using DISCERN instrument, Health On the Net Foundation seal, and Information Standard mark. Results: 32 websites were analysed. 25% were HONcode certified, 15.6% had the Information Standard. Mean FRE was 55.2±12.8. Mean FKGL was 8.6±1.9. Six websites (18.8%) had the recommended 6 th-grade readability level. Mean of 10.4±2.6 years of formal education was required to read the websites. Websites with Information Standard were easier to read: FKGL (6.2 vs. 9, P < 0.001), GFI (8.8 vs. 10.7, P = 0.04), FRE score (64.2 vs. 9, P = 0.02). Mean DISCERN score was low: 40.3 ± 13. Conclusions: Overall, most websites were poor quality with reading levels too high for the target audience. Information Standard NHS quality mark was associated with improved readability, however along with HONcode were not found to have a statistically significant correlation with quality. Based on this study, we would encourage healthcare professionals to be judicious in the websites they recommend to patients, and to consider both the readability and quality of the information provided.
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Project description:Evidence that macrophages can play a role in accelerating corrosion in CoCrMo alloy in total hip replacement (THR) interfaces leads to questions regarding the underlying cellular mechanisms and immunological responses. Hence, we evaluated the role of macrophages in corrosion processes using the cell culture supernatant from different conditions and the effect of wear particles on macrophage dynamics. Monocytes were exposed to CoCrMo wear particles and their effect on macrophage differentiation was investigated by comparisons with M1 and M2 macrophage differentiation. Corrosion associated macrophages (MCA macrophages) exhibited upregulation of TNF-α, iNOS, STAT-6, and PPARG and down-regulation of CD86 and ARG, when compared to M1 and M2 macrophages. MCA cells also secreted higher levels of IL-8, IL-1β, IL-6, IL-10, TNF-α, and IL-12p70 than M1 macrophages and/or M2 macrophages. Our findings revealed variation in macrophage phenotype (MCA) induced by CoCrMo wear particles in generating a chemical environment that induces cell-accelerated corrosion of CoCrMo alloy at THR modular interfaces. STATEMENT OF SIGNIFICANCE: Fretting wear and corrosion within the implant's modular taper junction are prominent causes of implant failure, as they promote the release of corrosion products and subsequent development of adverse local tissue reactions. Being a multifactorial process, several in vitro models have been developed to recreate the in vivo corrosion process, often summarized as mechanically-assisted crevice corrosion. Considering the excellent corrosion properties of CoCrMo alloy, the severity of chemically-generated damage observed at the modular interface has been surprising and poorly understood. The aim of the current study is to provide a better understanding of macrophages and their plasticity at the THR taper interface when they encounter wear debris from CoCrMo alloy. This is a preliminary study along the path towards determining the mechanism(s) of CAC.
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Project description:The development of materials offering electromagnetic interference (EMI) shielding is of significant consideration, since this can help in expanding the lifetime of devices, electromagnetic compatibility, as well as the protection of biological systems. Conductive paints used widely today in electromagnetic interference (EMI) shielding applications are often based on organic solvents that can create safety issues due to the subsequent environment problems. This paper concerned the development of eco-friendly conductive water-based paints for use in EMI-shielding applications. Graphene nanoplatelets, polyaniline emeraldine (PANI) doped with poly(styrene sulfonic acid) (PSS) or HCl or HBr and poly(3,4-ethylenedioxythiophene) poly(styrene sulfonic acid) (PEDOT:PSS) in various ratios were employed in a water base for developing the paints. The target was to develop homogeneous water-based paint-like fluid mixtures easily applied onto surfaces using a paint brush, leading in homogeneous, uniform, opaque layers, draying fast in air at room temperature, and having quite good electrical conductivity that can offer efficient EMI-shielding performance. The results of this parametric trial indicated the optimum compositions leading in paints with optimized properties that can result in uniform, homogeneous, and conductive layers up to a thickness of over 500 μm without deformation and cracking, offering attenuation of up to 60 dBs of incoming GHz electromagnetic radiation. In addition, the structural and morphological characteristics of these paints were studied in detail.
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Project description:Mechanically assisted crevice corrosion (MACC), also known as trunnionosis, and adverse local tissue reaction (ALTR) are entities that can lead to pain and necessitate revision in total hip arthroplasty (THA). We present a case of a 75-year-old female who received a bilateral staged primary THA with metal on cross-linked polyethylene implants and had subsequent bilateral revisions for MACC and ALTR. In both instances, she presented with anterior thigh pain, weakness, and difficulty ambulating, and she was revised to ceramic on cross-linked polyethylene implants. This case may suggest a biologic predisposition or systemic immunogenic reaction to metal debris in some patients with ALTR or represent an implant-specific complication. To our knowledge, this is the first case reported of a patient having bilateral MACC from staged THA performed by 2 different surgeons using the same brand implant.
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Project description:Modern unipolar hip hemiarthroplasty, commonly used for displaced femoral neck fracture, is now modular, with both a variable length cobalt-chromium adapter-sleeve and large femoral head. Patients with these modular components may develop symptomatic trunnion corrosion, with elevated serum metal levels. We report the case of an 82-year-old woman, 5.5 years after a modular unipolar hip hemiarthroplasty, who presented with a 4-month history of hip pain and limp. Evaluation showed elevated serum cobalt and chromium levels and an acetabular cyst. At revision, fluid, tissue, and gross inspection were consistent with trunnion corrosion. The hip was revised with a ceramic head and dual mobility acetabular component, with a good result at 1 year. The designs of commercially available, modern unipolar hip hemiarthroplasty prostheses are reviewed.
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Project description:Corrosion resistance, biocompatibility, improved osteointegration, as well the prevention of inflammation and pain are the most desired characteristics of hip replacement implants. In this study we introduce a novel multi-layered coating on AISI 316LVM stainless steel that shows promise with regard to all mentioned characteristics. The coating is prepared from alternating layers of the biocompatible polysaccharide chitosan and the non-steroid anti-inflammatory drug (NSAID), diclofenac. Electrochemical methods were employed to characterize the corrosion behavior of coated and uncoated samples in physiological solution. It is shown that these coatings improve corrosion resistance. It was also found that these coatings release the incorporated drug in controlled, multi-mechanism manner. Adding additional layers on top of the as-prepared samples, has potential for further tailoring of the release profile and increasing the drug dose. Biocompatibility was proven on human-derived osteoblasts in several experiments. Only viable cells were found on the sample surface after incubation of the samples with the same cell line. This novel coating could prove important for prolongation of the application potential of steel-based hip replacements, which are these days often replaced by more expensive ceramic or other metal alloys.
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