Insights into Imprinting: How Is the Phenomenon of Tribocorrosion at Head-Neck Taper Interfaces Related to Corrosion, Fretting, and Implant Design Parameters?

BACKGROUND: Wear and corrosion at modular neck tapers in THA can lead to major clinical implications such as periprosthetic osteolysis, adverse local tissue reactions, or implant failure. The material degradation processes at the taper interface are complex and involve fretting corrosion, third-body abrasion, as well as electrochemical and crevice corrosion. One phenomenon in this context is imprinting of the head taper, where the initially smooth surface develops a topography that reflects the rougher neck taper profile. The formation mechanism of this specific phenomenon, and its relation to other observed damage features, is unclear. An analysis of retrieved implants may offer some insights into this process. QUESTIONS/PURPOSES: (1) Is imprinting related to time in situ of the implants and to the taper damage modes of corrosion and fretting? (2) Are implant design parameters like neck taper profile, stem material, or head seating associated with the formation of imprinting? (3) Is imprinting created by an impression of the neck taper profile or can a different mechanistic explanation for imprinting be derived? METHODS: Thirty-one THAs with cobalt-chromium-molybdenum-alloy (CoCrMo) heads retrieved between 2013 and 2019 at revision surgery from an institutional registry were investigated. Inclusion criteria were: 12/14 tapers, a head size of 36 mm or smaller, time in situ more than 1 year, and intact nonmodular stems without sleeve adaptors. After grouping the residual THAs according to stem type, stem material, and manufacturer, all groups of three or more were included. Of the resulting subset of 31 retrievals, nine THAs exhibited a still assembled head-neck taper connection. The median (range) time in situ was 5 years (1 to 23). Two stem materials (21 titanium-alloy and 10 stainless steel), three kinds of bearing couples (11 metal-on-metal, 13 metal-on-polyethylene, and seven dual-mobility heads), and two different neck taper profiles (six wavy profile and 25 fluted profile) were present in the collection. Four THAs exhibited signs of eccentric head seating. The 31 investigated THAs represented 21% of the retrieved THAs with a CoCrMo alloy head during the specified period.At the head tapers, the damage modes of corrosion, fretting, and imprinting were semiquantitatively rated on a scale between 0 (no corrosion/fretting/imprinting) and 3 (severe corrosion/fretting/imprinting). Corrosion and fretting were assessed applying the Goldberg score, with the modification that the scale started at 0 and not at 1. Imprinting was assessed with a custom scoring system. Rating was done individually at the proximal and distal head taper half and summed to one total damage score for each retrieval and damage mode. Correlations between the damage modes and time in situ and between the damage modes among each other, were assessed using the Spearman rank order correlation coefficient (ρ). Associations between imprinting and implant design parameters were investigated by comparing the total imprinting score distributions with the Mann-Whitney U-test. Metallographically prepared cross-sections of assembled head-neck taper connections were examined by optical microscopy and disassembled head and neck taper surfaces were assessed by scanning electron microscopy (SEM). RESULTS: The imprinting damage score increased with time in-situ (ρ = 0.72; p < 0.001) and the corrosion damage score (ρ = 0.63; p < 0.001) but not with the fretting damage score (ρ = 0.35; p = 0.05). There was no difference in total imprinting score comparing neck taper profiles or stem materials, with the numbers available. Eccentric head seating had elevated total imprinting score (median 6 [interquartile range 0]) compared with centric seating (median 1 [2]; p = 0.001). Light optical investigations showed that imprinting can be present on the head taper surfaces even if the depth of abraded material exceeds the neck taper profile height. SEM investigations showed bands of pitting corrosion in the imprinted grooves. CONCLUSION: The microscopic investigations suggest that imprinting is not an independent phenomenon but a process that accompanies the continuous material degradation of the head taper surface because of circular damage on the passive layer induced by grooved neck tapers. CLINICAL RELEVANCE: Material loss from head-neck taper connections involving CoCrMo alloy heads is a source of metal ions and could potentially be reduced if hip stems with smooth neck tapers were used. Surgeons should pay attention to the exact centric seating of the femoral head onto the stem taper during joining of the parts.

Residual Stress Engineering for Wire Drawing of Austenitic Stainless Steel X5CrNi18-10 by Variation in Die Geometries-Effect of Drawing Speed and Process Temperature.

As a result of conventional wire-forming processes, the residual stress distribution in wires is frequently unfavorable for subsequent forming processes such as bending operations. High tensile residual stresses typically occur in the near-surface region of the wires and can limit further application and processability of the semi-finished products. This paper presents an approach for tailoring the residual stress distribution by modifying the forming process, especially with regard to the die geometry and the influence of the drawing velocity as well as the wire temperature. The aim is to mitigate the near-surface tensile residual stresses induced by the drawing process. Preliminary studies have shown that modifications in the forming zone of the dies have a significant impact on the plastic strain and deformation direction, and the approach can be applied to effectively reduce the process-induced near-surface residual stress distributions without affecting the diameter of the product geometry. In this first approach, the process variant using three different drawing die geometries was established for the metastable austenitic stainless steel X5CrNi18-10 (1.4301) using slow (20 mm/s) and fast (2000 mm/s) drawing velocities. The residual stress depth distributions were determined by means of incremental hole drilling. Complementary X-ray stress analysis was carried out to analyze the phase-specific residual stresses since strain-induced martensitic transformations occurred close to the surface as a consequence of the shear deformation and the frictional loading. This paper describes the setup of the drawing tools as well as the results of the experimental tests.

Effect of surface topography and residual stress on the taper connection stability in total hip arthroplasty.

In the present work, the influence of the trunnion surface topography and the near-surface residual stresses on the joining process of a taper connection is examined using a replicate of the realistic taper connection as it occurs in conventional hip joint implants. The focus of the work is on the surface of the taper trunnion made of Ti6Al4V ELI and its effect on the connection stability with a CoCrMo counterpart. In this regard, the interrelation between surface topography, residual stresses, the joining behavior and the corrosion behavior under dynamic loading have been systematically investigated. For this purpose, taper trunnions produced by means of three different machining processes were considered, i.e. fine machining, rough machining and a novel furrowing process. These mechanical surface treatments result in different surface topographies and near-surface work hardening and residual stress states. The results show that the primary taper stability is hardly altered by the different types of trunnion surfaces. For all three surface states, the joining/dismantling procedure did not change the residual stress state at the surface. After corrosion testing under dynamic loading, the fine machined taper surface exhibits the highest stability. Moreover, fine machined tapers consolidated during the dynamic corrosion experiment as the ratio between joining and dismantling force increased from 0.49 ± 0.04 to 0.83 ± 0.08. For the furrowed and rough machined taper surfaces, the connection stability showed a tendency towards increase and decrease, respectively, in the course of dynamic corrosion testing. The results indicate that for choosing an optimal taper trunnion surface, the effects of corrosion must be taken into account.

Influence of FeCl3 and H2O2 in corrosion testing of modular taper connections in total hip arthroplasty: An in vitro study.

Corrosion at the modular taper junctions in total hip arthroplasty is clinically relevant because wear particles and ions generated at this interface can lead to adverse local tissue reactions or even implant failure. In vitro tribo-corrosion tests are usually accomplished in saline solutions or calf serum (CS), but the addition of H2O2 and FeCl3 have been suggested to mimic inflammatory conditions in the joint. Inflammatory conditions may aggravate corrosive processes and, therefore, should lead in vitro to a more severe and realistic tribo-corrosive material attack. Corrosion testing at 12/14 tapers comprising a CoCrMo head taper and a Ti6Al4V trunnion was accomplished in five electrolytes (Ringer's solution (RS), RS with 30 mM H2O2 and/or 0.7 mM FeCl3 and CS) under dynamical loading for five million cycles. Resulting material loss was determined gravimetrically and by ion analysis. The tribo-corrosive material degradation was investigated by light and electron microscopy. FeCl3 enhanced the material loss from taper connections while H2O2 did not lead to a significant alteration of total material loss. In comparison to pure RS, corrosion testing in CS decreased material loss at the head taper while it increased material loss at the trunnion. The combination of FeCl3 and H2O2 led to an enhanced occurrence of micro cracks at the trunnion surface. Adding FeCl3 and optionally also H2O2 aggravates material loss in in vitro corrosion testing of taper junctions and leads to harsher and probably more realistic testing conditions. STATEMENT OF SIGNIFICANCE: Tribo-corrosive processes at taper connections in hip implants are complex and can lead to major clinical implications. Joint inflammation is assumed to aggravate taper corrosion in vivo, why FeCl3 and H2O2 have been proposed as additives to electrolytes to simulate inflammatory conditions in vitro. Often used fretting test setups, however, do not involve real taper geometries. Besides, testing is often accomplished in saline solutions or calf serum, which do not induce a clinically significant amount of corrosive material degradation. This study presents an approach to increase tribo-corrosive processes at realistic taper connections by adding FeCl3 and/or H2O2. Unlike H2O2, FeCl3 increased material loss from taper connections. The combination of both additives enhanced micro crack formation at the trunnion surfaces.

Neutron and X-ray Diffraction Analysis of Macro and Phase-Specific Micro Residual Stresses in Deep Rolled Duplex Stainless Steels.

Experimental analyses of depth distributions of phase-specific residual stresses after deep rolling were carried out by means of laboratory X-ray diffraction and neutron diffraction for the two duplex steels X2CrNiMoN22-5-3 and X3CrNiMoN27-5-2, which differ significantly in their ferrite to austenite ratios. The aim of the investigation was to elucidate to which extent comparable results can be achieved with the destructive and the non-destructive approach and how the process induced phase-specific micro residual stresses influence the determination of the phase- and {hkl}-specific reference value d0, required for evaluation of neutron strain scanning experiments. A further focus of the work was the applicability of correction approaches that were developed originally for single-phase materials for accounting for spurious strains during through surface neutron scanning experiments on coarse two-phase materials. The depth distributions of macro residual stresses were separated from the phase-specific micro residual stresses. In this regard, complementary residual stress analysis was carried out by means of incremental hole drilling. The results indicate that meaningful macro residual stress depth distributions can be determined non-destructively by means of neutron diffraction for depths starting at about 150-200 µm. Furthermore, it was shown that the correction of the instrumental surface effects, which are intrinsic for surface neutron strain scanning, through neutron ray-tracing simulation is applicable to multiphase materials and yields reliable results. However, phase-specific micro residual stresses determined by means of neutron diffraction show significant deviations to data determined by means of lab X-ray stress analysis according to the well-known sin2ψ-method.

Determination of Temperature-Dependent Elastic Constants of Steel AISI 4140 by Use of In Situ X-ray Dilatometry Experiments.

In situ dilatometry experiments using high energy synchrotron X-ray diffraction in transmission mode were carried out at the high energy material science beamline P07@PETRAIII at DESY (Deutsches Elektronen Synchrotron) for the tempering steel AISI 4140 at defined mechanical loading. The focus of this study was on the initial tempering state ( f e r r i t e ) and the hardened state ( m a r t e n s i t e ). Lattice strains were calculated from the 2D diffraction data for different h k l planes and from those temperature-dependent lattice plane specific diffraction elastic constants ( D E C s ) were determined. The resulting coupling terms allow for precise stress analysis for typical hypoeutectoid steels using diffraction data during heat treatment processes, that is, for in situ diffraction studies during thermal exposure. In addition, by averaging h k l specific Y o u n g ' s m o d u l i and P o i s s o n r a t i o s macroscopic temperature-dependent elastic constants were determined. In conclusion a novel approach for the determination of phase-specific temperature-dependent DECs was suggested using diffraction based dilatometry that provides more reliable data in comparison to conventional experimental procedures. Moreover, the averaging of lattice plane specific results from in situ diffraction analysis supply robust temperature-dependent macroscopic elastic constants for martensite and ferrite as input data for heat treatment process simulations.

Solidification Cracking Assessment of LTT Filler Materials by Means of Varestraint Testing and µCT.

Investigations of the weldability of metals often deal with hot cracking, as one of the most dreaded imperfections during weld fabrication. The hot cracking investigations presented in this paper were carried out as part of a study on the development of low transformation temperature (LTT) weld filler materials. These alloys allow to mitigate tensile residual stresses that usually arise during welding using conventional weld filler materials. By this means, higher fatigue strength and higher lifetimes of the weld can be achieved. However, LTT weld filler materials are for example, high-alloyed Cr/Ni steels that are susceptible to the formation of hot cracks. To assess hot cracking, we applied the standardized modified varestraint transvarestraint hot cracking test (MVT), which is well appropriate to evaluate different base or filler materials with regard to their hot cracking susceptibility. In order to consider the complete material volume for the assessment of hot cracking, we additionally applied microfocus X-ray computer tomography (µCT). It is shown that by a suitable selection of welding and MVT parameter the analysis of the complete 3D hot crack network can provide additional information with regard to the hot cracking model following Prokhorov. It is now possible to determine easy accessible substitute values (e.g., maximum crack depth) for the extent of the Brittleness Temperature Range (BTR) and the minimum critical strain P m i n .

Short-Term Heat Treatment of Ti6Al4V ELI as Implant Material.

Due to its mechanical properties and good biocompatibility, Ti6Al4V ELI (extra low interstitials) is widely used in medical technology, especially as material for implants. The specific microstructures that are approved for this purpose are listed in the standard ISO 20160:2006. Inductive short-term heat treatment is suitable for the adjustment of near-surface component properties such as residual stress conditions. A systematic evaluation of the Ti6Al4V microstructures resulting from short-term heat treatment is presently missing. In order to assess the parameter field that leads to suitable microstructures for load-bearing implants, dilatometer experiments have been conducted. For this purpose, dilatometer experiments with heating rates up to 1000 °C/s, holding times between 0.5 and 30 s and cooling rates of 100 and 1000 °C/s were systematically examined in the present study. Temperatures up to 950 °C and a holding time of 0.5 s led to microstructures, which are approved for medical applications according to the standard ISO 20160:2006. Below 950 °C, longer holding times can also be selected.

Corrosion Behavior of Surface-Treated Metallic Implant Materials.

Corrosion of taper connections in total hip arthroplasty remains of concern, as particles and ions generated by corrosive processes can cause clinical problems such as periprosthetic osteolysis or adverse reaction to metallic debris. Mechanical surface treatments that introduce compressive residual stresses (RSs) in metallic materials can lead to a better performance in terms of fretting and fatigue and may lower the susceptibility to corrosion. The study investigates the impact of mechanical surface treatments on the corrosion behavior of metallic biomaterials. Compressive RSs were introduced by deep rolling and microblasting in Ti6Al4V and CoCrMo samples. Polished samples served as reference. Corrosion behavior was characterized by repeated anodic polarization. Residual stresses of up to about -900 MPa were introduced by deep rolling with a reach in depth of approximately 500 µm. Microblasting led to compressive RSs up to approximately -800 and -600 MPa for Ti6Al4V and CoCrMo, respectively, in the immediate vicinity of the surface. For Ti6Al4V, microblasting resulted in decreased corrosion resistance with lower breakdown potentials and/or increased passive current densities in comparison to the polished and deep-rolled samples. The corrosion behavior of CoCrMo on the other hand was not affected by the mechanical surface treatments.

Electrocautery Damage Can Reduce Implant Fatigue Strength: Cases and in Vitro Investigation.

BACKGROUND: The risk of femoral stem fracture after total hip replacement is low and can often be associated with a specific implant system or other factors that may reduce the fatigue strength. Additionally, damage to a metal component during revision surgery by an electrocautery device may further affect the fatigue behavior. METHODS: Two clinical cases of stem failure after revision of fractured ceramic components are presented; the retrieved components were analyzed for the cause of failure. In vitro cyclic load-to-failure testing of titanium alloy femoral stems after electrocautery application at 2 different locations (at the base and about midway on the femoral neck) was performed using a stepwise increase in load until implant fracture occurred. In addition, a detailed characterization of the local material structure around the electrocautery marks was performed. RESULTS: Superficial discoloration and melting marks were found on the retrieved components, including at the location of crack initiation in the anterolateral region, which may have reduced the fatigue strength of the material. In addition, elemental analysis indicated material transfer from the electrocautery tip. Damage to the surface by the electrocautery device significantly reduced the in vitro load to failure by up to 47% compared with that of undamaged femoral neck specimens. Material analysis revealed a relevant modification in microstructure, with an extension of approximately 2.7 mm and a depth of 550 µm, which could be divided in 3 structural zones. CONCLUSIONS: Intraoperative electrocautery device contact with the implant during surgical revision of a total hip replacement cannot always be avoided. However, on the basis of our findings, the risk of implant failure is increased due to a change in microstructure and a potential reduction of the implant's fatigue strength. Surgeons and manufacturers of electrocautery devices should be aware of this concern. CLINICAL RELEVANCE: During revision surgery, contact between an electrocautery device and the femoral component should be avoided to reduce the chance of subsequent femoral neck fracture.

Fatigue performance of medical Ti6Al4V alloy after mechanical surface treatments.

Mechanical surface treatments have a long history in traditional engineering disciplines, such as the automotive or aerospace industries. Today, they are widely applied to metal components to increase the mechanical performance of these. However, their application in the medical field is rather rare. The present study aims to compare the potential of relevant mechanical surface treatments on the high cycle fatigue (R = 0.1 for a maximum of 10 million cycles) performance of a Ti6Al4V standard alloy for orthopedic, spinal, dental and trauma surgical implants: shot peening, deep rolling, ultrasonic shot peening and laser shock peening. Hour-glass shaped Ti6Al4V specimens were treated and analyzed with regard to the material's microstructure, microhardness, residual stress depth profiles and the mechanical behavior during fatigue testing. All treatments introduced substantial compressive residual stresses and exhibited considerable potential for increasing fatigue performance from 10% to 17.2% after laser shock peening compared to non-treated samples. It is assumed that final mechanical surface treatments may also increase fretting wear resistance in the modular connection of total hip and knee replacements.