Assessment of Corrosion, Fretting, and Material Loss of Retrieved Modular Total Knee Arthroplasties.
Modular junctions in total hip arthroplasties have been associated with fretting, corrosion, and debris release. The purpose of this study is to analyze damage severity in total knee arthroplasties of a single design by qualitative visual assessment and quantitative material loss measurements to evaluate implant performance and patient impact via material loss.



Twenty-two modular knee retrievals of the same manufacturer were identified from an institutional review board-approved database. Junction designs included tapers with an axial screw and tapers with a radial screw. Constructs consisted of 2 metal alloys: CoCr and Ti6Al4V. Components were qualitatively scored and quantitatively measured for corrosion and fretting. Negative values represent adhered material. Statistical differences were analyzed using sign tests. Correlations were tested with a Spearman rank order test (P < .05).



The median volumetric material loss and the maximum linear depth for the total population were -0.23 mm3and 5.84 μm, respectively. CoCr components in mixed metal junctions had higher maximum linear depth (P = .007) than corresponding Ti components. Fretting scores of Ti6Al4V alloy components in mixed metal junctions were statistically higher than the remaining groups. Taper angle did not correlate with material loss.



Results suggest that CoCr components in mixed metal junctions are more vulnerable to corrosion than other components, suggesting preferential corrosion when interfacing with Ti6Al4V. Overall, although corrosion was noted in this series, material loss was low, and none were revised for clinical metal-related reaction. This suggests the clinical impact from corrosion in total knee arthroplasty is low.
Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Audrey J
AJ
Martin
Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Kirsten A
KA
Seagers
Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Douglas W
DW
Van Citters
D000497:Alloys; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D003343:Corrosion; D019544:Equipment Failure Analysis; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008670:Metals; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D013499:Surface Properties; D014025:Titanium
D000497:Alloys; D008670:Metals; C031462:titanium alloy (TiAl6V4); D014025:Titanium
corrosion; fretting; material loss; modularity; retrieval analysis; total knee arthroplasty