In vivo evaluation of a high-strength, high-ductility stainless steel for use in surgical implants.

A high-strength, high-ductility, austenitic stainless steel has been evaluated for use in surgical implants by performing in vivo tests in rats, rabbits, dogs, and rhesus monkeys. This stainless steel, a TRIP (Transformation Induced Plasticity) steel containing about 4% Mo, was compared with two alloys in current clinical use: Type 316L stainless steel and cast Vitallium. Compared with the other two alloys, cast Vitallium generally had higher resistance to corrosion and superior biocompatibility in all animals. The tests in rats and dogs indicated that the corrosion resistances of the TRIP steel and the Type 316L stainless steel were similar and that the tissue reactions caused by these alloys were also similar. However, in rhesus monkeys, the TRIP steel was shown to be susceptible to stress-corrosion cracking and much more susceptible to crevice corrosion than Type 316L stainless steel. Limited tests in rabbits supported the observation that the TRIP steel is susceptible to stress-corrosion cracking. These inconsistencies in the in vivo tests underline the need for a reevaluation of the popular test techniques and of the animals commonly chosen for assessing the suitability of candidate implant materials. The "worst case" results from the rhesus monkey tests were entirely consistent with previous results obtained from in vitro studies. However, further work must be performed before the behavior of metals in humans, rhesus monkeys, or any other animal, can be predicted with confidence from an in vitro test program.