The effect of using components from different manufacturers on the rate of wear and corrosion of the head–stem taper junction of metal-on-metal hip arthroplasties

Abstract

The use of stems with heads of another manufacturer does not appear to affect the amount of metal lost from the surfaces between these two components at total hip arthroplasty. Other surgical, implant and patient factors should be considered when determining the mechanisms of failure of large diameter metal-on-metal hip arthroplasties. Cite this article: Bone Joint J 2016;98-B:917-24.

Trunnion corrosion

“…No difference in the rate of material loss at the head-neck junction was identified when head-stem combinations from the same manufacturer were compared with those from different manufacturers. 15 No difference was observed in material loss when cobalt-chrome heads were used on cobalt-chrome or stainless steel stems. 16…”

Effect of trunnion roughness and length on the modular taper junction strength under typical intraoperative assembly forces

“…However, the latest clinical data do not reflect the desired positive effects [3][4][5][6] with revision rates of up to 86 % for a doubletapered modular hip prosthesis after a follow-up time of less than five years [4]. In recent years concerns have arisen regarding fretting [7,8], wear [9,10] and corrosion at modular taper junctions [8,9,[11][12][13][14][15] further increasing the number of revision surgeries [5,8,9,12,16]. The resulting postoperative complications include, but are not limited to, pain [7,13,17], soft tissue damage [7,11], the formation of pseudotumours [7,15,18,19] and osteolysis [20,21] and are frequently associated with high metal ion levels in the blood and/ or urine [15,[22][23][24].…”

“…Taper junctions are exposed to high bending and torsional loads during daily activities supporting the occurrence of micromotion. These can provoke mechanical, as well as electrochemical initiated, processes in the fluid environment of the hip joint leading firstly, to fretting [27,37,38] and mechanically assisted crevice corrosion [9,14,16,39] and secondly, to a cascade of adverse local tissue responses [5,13,40] in the form of pseudotumours [18,19,39,15], allergic reactions and middle to high grade tissue damage [11,15]. The material susceptibility to fretting and corrosion seems to be an important factor in the failure mechanism as well.…”

Evidence Based Recommendations for Reducing Head-Neck Taper Connection Fretting Corrosion in Hip Replacement Prostheses

“…If taper connection fretting corrosion alone is considered, the evidence against large head diameter in MoM THA is weaker. Head diameter is well published as a significant factor, but high-powered studies have also found it not significant, thus weakening the evidence and suggesting co-factors’ importance (8, 12, 15, 16, 21, 24, 27, 29, 30, 32, 33, 35, 40, 44-45-46-47, 52, 92, 93, 96). Pereira et al (19) found head diameter as an important co-factor with head abrasive wear in predicting fretting corrosion in a retrieval study of MoP THA components.…”