Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Thayer School of Engineering, Dartmouth College, Hanover NH.
J Arthroplasty. 2021 Mar;36(3):1133-1137. doi: 10.1016/j.arth.2020.10.005. Epub 2020 Oct 9.
The purpose of this study was to evaluate a series of retrieved sleeved ceramic femoral heads used in total hip arthroplasty (THA) and determine qualitative and quantitative damage and corrosion patterns.
An IRB-approved implant retrieval database was utilized to identify all sleeved ceramic femoral heads collected from 1995 to 2004. There were 16 implants with an average duration of in situ of 70 months (range, 13-241 months). The femoral stem was known in 14 cases and was titanium alloy in each of those cases. None were revised for metal-related complications. Ten implants (63%) were from primary THAs, and 6 (38%) were from revision THAs. Damage and corrosion were qualitatively graded using a modified Goldberg method. A quantitative assessment was performed with a coordinate measurement machine (CMM).
Among the 16 retrieved implants, 1 (6%) demonstrated severe Grade 4 corrosion, 5 (31%) had moderate Grade 3 corrosion, 5 (31%) had mild Grade 2 corrosion, and 5 (31%) had no visible corrosion at the inner sleeve that interfaces with the stem trunnion. The only case of grade 4 corrosion occurred in the only head-sleeve in the study that was not factory assembled and was mated with a titanium molybdenum zirconium ferrous (TMZF) alloy stem. The mean maximum linear corrosion depth at the taper interface, as measured by the CMM, was 7.7 microns (range, 0.9-32.9 microns).
This study is the first to quantify corrosion at the titanium interface of sleeved ceramic femoral heads. Potentially clinically significant damage and corrosion patterns were observed in a few failed retrievals; however, the majority of cases demonstrated minimal or no damage.
本研究旨在评估一系列用于全髋关节置换术（THA）的回收套筒陶瓷股骨头，并确定其定性和定量的损伤及腐蚀模式。
利用经 IRB 批准的植入物检索数据库，确定从 1995 年至 2004 年收集的所有套筒陶瓷股骨头。有 16 个植入物，平均体内留存时间为 70 个月（范围 13-241 个月）。14 个病例中已知股骨柄，且均为钛合金。没有因金属相关并发症而进行翻修。10 个植入物（63%）来自初次 THA，6 个（38%）来自翻修 THA。使用改良的 Goldberg 方法对损伤和腐蚀进行定性分级。使用坐标测量机（CMM）进行定量评估。
在 16 个回收的植入物中，有 1 个（6%）表现出严重的 4 级腐蚀，5 个（31%）为中度 3 级腐蚀，5 个（31%）为轻度 2 级腐蚀，5 个（31%）在与股骨柄头接触的套筒内无可见腐蚀。唯一的 4 级腐蚀发生在研究中唯一一个未进行工厂组装且与钛钼锆铁（TMZF）合金柄匹配的头套中。用 CMM 测量的锥面接口处最大线性腐蚀深度的平均值为 7.7 微米（范围 0.9-32.9 微米）。
本研究首次定量评估了套筒陶瓷股骨头钛界面的腐蚀情况。在一些失效的回收中观察到潜在的临床显著损伤和腐蚀模式，但大多数病例显示出最小或无损伤。
