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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_6 | Pages 20 - 20
1 Apr 2014
Miller A Islam K Grannum S Morris S Hutchinson J Nelson I Hutchinson J
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Aim:. To compare the degree of deformity correction achieved using cobalt chromium versus titanium alloy rods in patients with Adolescent Idiopathic Scoliosis. Method:. A retrospective comparison of two cohorts of patients with Adolescent Idiopathic Scoliosis treated with posterior segmental pedicle screw fixation using either Titanium or Cobalt Chromium rods. The radiographs of 50 patients treated before 2009 (Ti group) and 50 patients after 2009 (CoCr group) were reviewed for changes in: Main Coronal Curvature Sagittal Balance (C7 Plumb Line) Kyphosis (T5-12). Results:. Thirteen were excluded because of incomplete radiographs. 38 patients received CoCr, 45 Ti and 4 patients received hybrid constructs. Correction rate of curves measuring >50 was significantly improved with CoCr (81% vs 69%, p=0.02). Sagittal balance was improved in both groups (CoCr 27.8, Ti 28.0 mm) but no significant difference was seen (p=0.84). Within the Ti group 12 patients moved for normal kyphosis (20–40) to abnormal (<20, >40) while 9 patients moved from abnormal to normal (p=0.66). Within the CoCr Group 10 patients were normalised while only 2 patients moved from normal to abnormal (p=0.04). Mean change in kyphosis showed a trend towards improved correction with CoCr (4.2 vs 2.9) but failed to reach significance (p=0.62). Discussion:. We have demonstrated that CoCr rods significantly improve coronal correction in patient with >50 curves. No difference in overall sagittal balance was seen between metal alloys. There is a trend towards better restoration of T5-12 kyphosis with CoCr however it is unclear if this small difference is clinically relevant. Conflict Of Interest Statement: No conflict of interest


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_6 | Pages 19 - 19
1 Apr 2014
Yoon W Panagiotidou A Noordeen H Blunn G
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Aim:. The aim of this study was test the amount of corrosion occurring at the (Ti) /cobalt chrome (CoCr) interface comparing this with Ti and Ti interfaces. This was compared with retrieved metal work visualised under a scanning electron microscope (SEM). Methods:. The interface of interest is the interface between rod and the screw. We investigated corrosion seen at that interface with a CoCr rod coupled to a Ti screw versus a Ti rod coupled to a Ti screw (6 screws were used) Implants were loaded according to the ASTM F2193 – 02 Standard Specifications and Test Methods for Components Used in the Surgical Fixation of the Spinal Skeletal System. Pitting potentials were monitored using cyclic potentiodynamic polarization tests (ASTM F2129 – 08 Standard Test Method for Conducting Cyclic Potentiodynamic Polarisation Measurements) to determine corrosion susceptibility. Retrieved implants were visualised under (SEM) to confirm corrosion. Results:. Mean fretting current for titanium and cobalt chrome was 7.94 (μA) and for titanium on titanium 5.89 (μA). The results of SEM showed evidence of fretting and galvanic corrosion. Discussion:. Cobalt chrome ions in hip implants have raised concern amongst the orthopaedic community. This study showed that metal ion production occurs due to fretting and galvanic corrosion. This corrosion is increased in cobalt chrome and titanium constructs but statistically more tests are required to confirm this. Further research is required to understand this interface as cobalt chrome ions pose a potential hazard to patients with their reproductive years ahead. Conflict Of Interest Statement: No conflict of interest