Crevice Corrosion Degrades Metaphyseal Sleeves Following Total Knee Arthroplasty: A Retrieval Study
Abstract
BACKGROUND
Surgeons use metaphyseal sleeves in revision total knee arthroplasty (TKA) to compensate for bone loss and improve stability. However, a clinical case series documented corrosion on these devices and associated the subsequent metal release with adverse local tissue reactions. In this study, we investigated corrosion at the mixed-alloy, metaphyseal sleeve-implant interface. We asked: (1) How common is corrosion? (2) Does more damage occur at the femoral cobalt chrome alloy (CoCrMo) taper? (3) What damage modes occur?
METHODS
We analyzed 17 femoral and 15 tibial implant-sleeve components following revision surgery. First, corrosion was classified using the Goldberg score and quantified using the axial corrosion (ΔCmax) on CoCrMo implants. Then, moderately and severely corroded devices were imaged using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Differences in corrosion on CoCrMo tibial and femoral implants were assessed using nonparametric statistics.
RESULTS
We observed corrosion on 82% of femoral adapters, 100% of femoral sleeves, 73% of tibial trays, and 86% of tibial sleeves. On CoCrMo femoral adapters, we measured more axial corrosion than on CoCrMo tibial trays (P = 0.04). The predominant damage modes on femoral adapters included pitting, etching, and oxide debris. On titanium alloy femoral sleeves, we documented a burnishing effect, revealing the underlying microstructure.
CONCLUSION
Our findings indicate that…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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