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Due to bone resorption and aseptic loosening, the implant was removed after 6\u2009years in the patient, and metallosis was observed during removal. Visually, some areas of the articulating surfaces appeared polished, others were dulled. A chemical composition analysis of the metacarpal head showed that the polished surfaces were chromium rich, implying this surface was the original chromium nitride coating, whereas the dulled surfaces were cobalt rich, indicating the underlying cobalt chromium substrate. In addition, the underlying cobalt chromium substrate was an order of magnitude rougher than the polished surface, indicating the scale of damage to it. It is speculated that the loss of the coating, and the subsequent damage to the underlying substrate due to a third-body wear process, led to osteolysis and the metallosis seen at revision surgery.<\/jats:p>","DOI":"10.1177\/09544119241277697","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T02:04:37Z","timestamp":1726020277000},"page":"985-991","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Explant analysis of a chromium nitride coated metal-on-metal total wrist replacement: A case study"],"prefix":"10.1177","volume":"238","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8497-5790","authenticated-orcid":false,"given":"Thomas J","family":"Joyce","sequence":"first","affiliation":[{"name":"School of Engineering, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6ksu","family":"Kandemir","sequence":"additional","affiliation":[{"name":"School of Engineering, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan","family":"McGuire","sequence":"additional","affiliation":[{"name":"Martin Singer Hand Unit, Groote Schuur Hospital, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Solomons","sequence":"additional","affiliation":[{"name":"Martin Singer Hand Unit, Groote Schuur Hospital, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0398-7053","authenticated-orcid":false,"given":"Daniel J","family":"Brown","sequence":"additional","affiliation":[{"name":"Royal Liverpool University Hospital, Liverpool, UK"},{"name":"Faculty of Health and Life Science, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"bibr1-09544119241277697","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.900597"},{"key":"bibr2-09544119241277697","volume-title":"Joint replacement in the human body","author":"Joyce TJ.","year":"2024"},{"key":"bibr3-09544119241277697","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2011.579720"},{"key":"bibr4-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1779731"},{"key":"bibr5-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1177\/17531934241249919"},{"key":"bibr6-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B11.30130"},{"key":"bibr7-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416674161"},{"key":"bibr8-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1016\/j.wear.2006.11.045"},{"key":"bibr9-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1016\/j.diamond.2012.02.001"},{"key":"bibr10-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1177\/1753193412460627"},{"key":"bibr11-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1177\/1753193408094920"},{"key":"bibr12-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1023\/B:JMSM.0000015482.24542.76"},{"key":"bibr13-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1016\/j.triboint.2010.04.007"},{"key":"bibr14-09544119241277697","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B2.25150"},{"key":"bibr15-09544119241277697","unstructured":"BS ISO 7206-2:2011. 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