Fatigue Fracture of Titanium Alloy Knee Prostheses

Total knee prostheses were retrieved from patients after radiographs revealed fracture of the Ti-6A1-4 VELI metal backing of the polyethylene tibial component. The components were analyzed using scanning electron microscopy. Porous coated and uncoated tibial trays were found to have failed by fatigue. Implants with porous coatings showed significant loss of the bead coating and subsequent migration of the beads to the articulating surface between the polyethylene tibial component and the femoral component, resulting in significant third-body wear and degradation of the polyethylene. The sintered porous coating exhibited multiple regions where fatigue fracture of the neck region occurred, as well as indications that the sintering process did not fully incorporate the beads onto the substrate. Better process control during sintering and use of subsequent heat treatments to ensure a bimodal microstructure were recommended.