Inflammatory cell-induced corrosion in total knee arthroplasty: A retrieval study

Metal release in patients with joint replacements is associated with local tissue reactions, pain, and ultimately revision of implants. One of the causes of this metal loss is speculated to be due to a mechanism of inflammatory cell-induced corrosion (ICIC). In this knee retrieval study, we aimed to: (1) identify the extent and location of ICI corrosion patterns on our femoral and tibial components and (2) correlate our findings with implant and clinical information. We investigated 28 femoral and 9 tibial components made of polished CoCr for presence of ICIC, using macroscopic and microscopic screening and statistical analyses to identify any significant correlations between our results and clinical information. We found that 71% of femoral and 100% of tibial components showed evidence of ICIC and significantly more was present on non-contacting regions (p<0.0001). We found a significant correlation between the presence of ICIC and instability (p=0.0113) and a significant difference between poster stabilized and cruciate retaining designs in the amount of ICIC on internal edges (p=0.0375). This corrosion pattern was prevalent in our series of knee retrievals and may help explain some of the mechanisms of material loss that may occur in vivo. (c) 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 460-467, 2018.