An evaluation of the potential consequences of drilling titanium and tantalum implants during surgery - a pilot study

Abstract

Background: The aim of the study was to evaluate the potential consequences of drilling titanium alloy (Ti) and tantalum (Ta) implants.

Methods: During an in vitro study, four holes were made in each of two spatially porous trabecular implants: one Ta and the other Ti alloy (Ti-6Al-7Nb). The weight and the volume of particles produced during the drilling were then measured using a Radwag XA 110/2X (USA) laboratory balance.

Results: The loss of mass of the Ti and Ta implants was respectively 1.26 g and 2.48 g, and the volume of free particles was respectively 280 mm³ and 149 mm³. The particles were recovered after each stage. Despite the use of 5 μm filters, around 0.6% of the total implant mass from both implants was not recovered after drilling (roughly 2% of the mass of the particles created).

Conclusion: It is technically difficult to make holes in Ti and Ta implants using standard surgical tools, and the process creates a significant amount of metal particles which cannot be removed, despite intensive flushing. This may have a potentially adverse influence on the survival of the implant and result in negative systemic consequences.

Keywords: Augments; Drilling; Hip arthroplasty; Knee arthroplasty; Loosening; Revision.

Fig. 1

Weight loss of implants: Titanium (Ti) and Tantalium (Ta)

Fig. 2

The volume of the recovered tantalum and titanium particles from drilling the titanium (Ti), and tantalum (Ta) implants

Fig. 3

The percentages of recovered titanium (Ty), and tantalum (Ta) after drilling implants and the use of measurements for the different stages of the recovery of the particles with saline (NaCl) and distilled water (DW)