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Journal of Long-Term Effects of Medical Implants
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN Imprimir: 1050-6934
ISSN En Línea: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2020033871
pages 231-238

Comparison of Inflammatory Cell-Induced Corrosion and Electrocautery-Induced Damage of Total Knee Implants

Griffin Heise
Department of Orthopaedic Surgery and Biomedical Engineering, School of Medicine, University of Tennessee Health Science Center, Memphis TN
Christina Arnholt
Department of Biomedical Engineering, Drexel University, Philadelphia, PA
Jameson H. Sorrels
Department of Orthopaedic Surgery and Biomedical Engineering, School of Medicine, University of Tennessee Health Science Center, Memphis TN
Brian Morrow
School of Dentistry, University of Tennessee Health Science Center, Memphis TN
Steven M. Kurtz
Department of Biomedical Engineering, Drexel University, Philadelphia, PA; Exponent Inc., Philadelphia, PA
William M. Mihalko
Department of Orthopaedic Surgery and Biomedical Engineering, School of Medicine, University of Tennessee Health Science Center, Memphis TN; Campbell Clinic Orthopedics, Germantown, TN

SINOPSIS

Recently, inflammatory cell-induced corrosion (ICIC), a unique type of damage, has been reported in cobalt-chromium (CoCr) implants, but the mechanism remains poorly understood and controversial because electrocautery damage has also been shown to produce similar findings. This study aimed to distinguish between these two damage mechanisms. Forty-one CoCr primary total knee arthroplasty specimens were collected at time of necropsy. After removal and cleaning, light microscopy was used to identify areas of ICIC-like damage scars. A CoCr knee implant was intentionally damaged by electrocautery from both Bovie and Aquamantys sources using a 3-second hover method with 3 different energy settings for comparison to necropsy findings. Average roughness (Ra), max peak-to-valley height (Rmax), kurtosis (Rk), and skewness (Rsk) measurements were collected to represent the topography on the damaged areas for the CoCr implants. Necropsy implants showed signs of ICIC in 7 of 41 implants (17%) examined. Fe/C ratios of the Bovie electrocautery-damaged knee implant were shown to be statistically higher than those of necropsy-retrieved implants. Median Ra measurements were statistically less (P = 0.008) for Bovie-damaged areas compared to ICIC-dam-aged areas on CoCr. Median Rmax and Ra measurements were statistically less (P = 0.012, P < 0.001, respectively) for Aquamantys-damaged areas compared to ICIC-damaged areas on CoCr. While the visual patterns seen in necropsy-retrieved implants appeared similar to those with the intentionally damaged CoCrMo implant, the contents of the corroded regions are unique. The difference in roughness found on ICIC-damaged and electrocautery-damaged regions also indicates examination of surface topography as another distinguishing feature between the two mechanisms.

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