title: Clinical relevance of corrosion patterns attributed to inflammatory cell-induced corrosion: A retrieval study.
abstract: In vitro studies have shown that human osteoclasts can corrode stainless steel and titanium leading to the production of metal ions responsible for inflammatory reactions. Moreover, traces of cellular activities on metal orthopaedic explants have recently been reported as inflammatory cell-induced (ICI) corrosion being the result of the cells sealing on the metal surfaces and releasing reactive oxygen species (ROS) through Fenton-like reactions. The extent and clinical relevance of this phenomenon has yet to be understood. We analysed a cohort of 100 CoCr alloy hips collected at our retrieval centre; we performed macroscopic and microscopic screening and used statistical analysis to correlate our findings with implant and clinical variables. We found that 59% of our implants had evidence of surface damage consistent with what has previously been described as cell-induced corrosion. There was a significant association between the patterns and aseptic loosening for the ASR modular (r = -0.488, p = 0.016) and the Durom modular (r = 0.454, p = 0.026). This is the largest implant retrieval study to examine the phenomena of so-called ICI corrosion and is the first to investigate its clinical relevance. We recommend further work to determine the role of cells in the damage patterns observed. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 155-164, 2017.
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: Di Laura
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Harry S
authors.initials: HS
authors.lastname: Hothi
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Jay M
authors.initials: JM
authors.lastname: Meswania
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Whittaker
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Danielle
authors.initials: D
authors.lastname: de Villiers
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Jozef
authors.initials: J
authors.lastname: Zustin
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Gordon W
authors.initials: GW
authors.lastname: Blunn
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: John A
authors.initials: JA
authors.lastname: Skinner
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Alister J
authors.initials: AJ
authors.lastname: Hart
mesh_terms: D000328:Adult; D000368:Aged; D002858:Chromium Alloys / Q000737:chemistry*; D003343:Corrosion; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D010010:Osteoclasts / Q000378:metabolism* / Q000473:pathology; D011475:Prosthesis Failure; D017382:Reactive Oxygen Species / Q000378:metabolism*
chemical_list: D002858:Chromium Alloys; D017382:Reactive Oxygen Species
keywords: CoCr; cell; corrosion; inflammation; orthopaedic implants