{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:19:27Z","timestamp":1788520767523,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Biomed Mater Res"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Previous studies report rare occurrences of tibial baseplate fractures following primary total knee arthroplasty (TKA). However, at a microstructural scale, it remains unclear how fatigue models developed in\u00a0vitro apply to fractures in\u00a0vivo. In this study, we asked: (1) do any clinical factors differentiate fracture patients from a broader revision sample; and (2) in\u00a0vivo, how does microstructure influence fatigue crack propagation? We identified three fractured tibial baseplates from an institutional review board exempt implant retrieval program. Then, for comparison, we collated clinical data from the same database for\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092120 revision TKA patients with tibial trays. To identify mechanisms, we characterized fracture features using scanning electron and digital optical microscopy. Additionally, we performed cross sectional analysis using focused ion beam milling. The fracture cohort consisted of moderately to very active patients with increased implantation time (15.6\u2009years) compared to the larger revision patient sample (5.1\u2009years,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009). We did not find a significant difference in patient weight between the two groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.98). Macroscopic fracture features aligned well with both previous retrieval analysis and in\u00a0vitro baseplate fatigue tests. On a micron scale, we identified striations on each baseplate, demonstrating fatigue as the fracture mechanism. In\u00a0vivo fatigue fracture processes depended on both the alloy (Ti\u20106Al\u20104V vs. CoCrMo) and the microstructure of the alloy formed during manufacturing. For Ti\u20106Al\u20104V, the presence of equiaxed or acicular microstructure influenced the fatigue crack propagation, the latter arising from large prior \u03b2 grains and a Widmanstatten microstructure, degrading fatigue strength. CoCrMo alloy fatigue cracks propagated linearly, crystallographically influenced by planar slip. However, we did not document any features of overload or fast fracture, suggesting a high cycle, low stress fatigue regime. Ultimately, the crack profiles we present here may provide insight into fatigue fractures of modern tibial baseplates.\n                  <\/jats:p>","DOI":"10.1002\/jbm.b.35507","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T09:35:30Z","timestamp":1732181730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Tibial Baseplate Microstructure Governs High Cycle Fatigue Fracture In\u00a0Vivo"],"prefix":"10.1002","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-579X","authenticated-orcid":false,"given":"Michael A.","family":"Kurtz","sequence":"first","affiliation":[{"name":"Implant Research Core School of Biomedical Engineering, Science, and Health Systems, Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7428-2851","authenticated-orcid":false,"given":"Jeremy L.","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Department of Bioengineering Clemson University  Clemson South Carolina USA"},{"name":"The Clemson University\u2010Medical University of South Carolina Bioengineering Program  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Spece","sequence":"additional","affiliation":[{"name":"Implant Research Core School of Biomedical Engineering, Science, and Health Systems, Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg R.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hackensack University Medical Center  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold E.","family":"Cates","sequence":"additional","affiliation":[{"name":"Tennessee Orthopedic Clinics  Knoxville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Kurtz","sequence":"additional","affiliation":[{"name":"Implant Research Core School of Biomedical Engineering, Science, and Health Systems, Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/970703"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11153"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.07.024"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2013.11.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2022.02.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/4080816"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.20.00109"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.06.009"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2004.09.033"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma15072575"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2019.09.002"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2022.08.002"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4160-8"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2008.0151"},{"issue":"2","key":"e_1_2_9_16_1","first-page":"220","article-title":"Fracture of the Metal Tibial Tray After Kinematic Total Knee Replacement. 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