A comparison study of stem taper material loss at similar and mixed metal head-neck taper junctions

Langton, David; Sidaginamale, R; Joyce, Thomas J.; Meek, R.M.D.; Bowsher, John G.; Deehan, David J.; Nargol, Avf; Holland, J

doi:10.1302/0301-620x.99b10.bjj-2016-1005.r1

Cited by 17 publications

(20 citation statements)

References 25 publications

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“…Since there was no particular hypothesis about the relative level of corrosion at the eight zones, 28 pairwise comparisons were carried out to exhaust the entire pairwise comparison of the zones. The distal region of the medial quadrant was found to have the highest odds of receiving a higher corrosion score which is aligned with the previous findings in the literature that identified the distal region [19,20,27] and the medial quadrant [7,10,16,28] having the highest corrosion scores. Also, this study shows that the distal region of all the four quadrants had more corrosion damage in comparison with the proximal region of those quadrants.…”

Section: Discussionsupporting

confidence: 89%

The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

Milimonfared

Oskouei

Taylor

et al. 2018

Metals

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Metallic taper junctions of modular total hip replacement implants are analysed for corrosion damage using visual scoring based on different granularity levels that span from analysing the taper holistically to dividing the taper into several distinct zones. This study aims to objectively explore the spatial distribution and the severity of corrosion damage onto the surface of metallic stem tapers. An ordinal logistic regression model was developed to find the odds of receiving a higher score at eight distinct zones of 137 retrieved stem tapers. A method to find the order of damage severity across the eight zones is introduced based on an overall test of statistical significance. The findings show that corrosion at the stem tapers occurred more commonly in the distal region in comparison with the proximal region. Also, the medial distal zone was found to possess the most severe corrosion damage among all the studied eight zones.

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Section: Discussionsupporting

confidence: 89%

The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

Milimonfared

Oskouei

Taylor

et al. 2018

Metals

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“…Retrieval studies reported material loss from the femoral tapers of CoCrMo femoral heads mounted on titanium alloy trunnions . Similarly, in this hip simulator test, the CoCrMo femoral tapers showed material loss.…”

Section: Discussionmentioning

confidence: 51%

“…43,46,55,56 Retrieval studies reported material loss from the femoral tapers of CoCrMo femoral heads mounted on titanium alloy trunnions. 43,46,47,[57][58][59] Similarly, in this hip simulator test, the CoCrMo femoral tapers showed material loss. A question that may arise is: why did wear arise from the harder CoCrMo alloy femoral taper when the Ti6Al4V alloy trunnion is much softer?…”

Section: Discussionmentioning

confidence: 53%

Hip simulator testing of the taper‐trunnion junction and bearing surfaces of contemporary metal‐on‐cross‐linked‐polyethylene hip prostheses

2019

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Adverse reaction to metal debris released from the taper‐trunnion junction of modular metal‐on‐polyethylene (MoP) total hip replacements (THRs) is an issue of contemporary concern. Therefore, a hip simulator was used to investigate material loss, if any, at both the articulating and taper‐trunnion surfaces of five 32‐mm metal‐on‐cross‐linked‐polyethylene THRs for 5 million cycles (Mc) with a sixth joint serving as a dynamically loaded soak control. Commercially available cobalt–chromium–molybdenum femoral heads articulating against cross‐linked polyethylene (XLPE) acetabular liners were mounted on 12/14 titanium (Ti6Al4V) trunnions. Weight loss (mg) was measured gravimetrically and converted into volume loss (mm3) for heads, liners, and trunnions at regular intervals. Additionally, posttest volumetric wear measurements of the femoral tapers were obtained using a coordinate measuring machine (CMM). The surface roughness (Sa) of femoral tapers was measured posttest. After 5 Mc, the mean volumetric wear rate for XLPE liners was 2.74 ± 0.74 mm3/Mc. The CMM measurements confirmed material loss from the femoral taper with the mean volumetric wear rate of 0.045 ± 0.024 mm3/Mc. The Sa on the worn area of the femoral taper showed a significant increase (p < 0.001) compared with the unworn area. No other long‐term hip simulator tests have investigated wear from the taper‐trunnion junction of contemporary MoP THRs. © Crown Copyright. Journal of Biomedical Materials Research Part B: Applied Biomaterials 108B:156–166, 2020.

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“…CoCr. [54] Histopathological tissue assessment. This was carried out as has previously been described in greater detail.…”

Section: Blood/serum Metal Ion Testingmentioning

confidence: 99%

The influence of hla genotype on the development of metal hypersensitivity following joint replacement

Langton¹,

Bhalekar²,

Joyce

et al. 2021

Preprint

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Joint replacement surgery provides pain relief and restoration of mobility for millions of patients around the world each year.[1] However, the release of wear debris from implant surfaces can limit the lifespan of a prosthesis through the promotion of inflammatory responses.[2] Implants must therefore be constructed from materials with sufficient durability and biocompatibility. One such material is cobalt chrome alloy, which is used in the majority of joint replacements.[3] Unfortunately, it is recognised that some patients develop lymphocyte mediated delayed type hypersensitivity (DTH) responses to this material,[4] a response which may result in extensive bone and soft tissue destruction.[5] A genetic predisposition to DTH has been proposed[6], though specific genes have yet to be identified, or the effects quantified. Here we show that variation in HLA class II genotype influences an individual’s susceptibility to DTH. HLA-DQ haplotypes encoding peptide binding grooves with greater affinity for the N terminal peptide sequence of albumin (containing two recognised metal binding sites) confer a greater risk of DTH. We describe the development and validation of a machine learning algorithm to investigate the possibility that a patient’s genotype and basic clinical parameters may be used to predict DTH. Incorporating this novel finding, gradient boosted survival analysis machine learning models were trained and validated using results from 606 patients from three international units. These models were assessed using Uno’s c-index, time-dependent AUROCs, and integrated calibration index performance statistics. At present, there are no tests in widespread clinical use which use a patient’s genetic profile to guide implant selection or inform post-operative management. The algorithm described herein may address this issue.

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A comparison study of stem taper material loss at similar and mixed metal head-neck taper junctions

Cited by 17 publications

References 25 publications

The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

The Distribution and Severity of Corrosion Damage at Eight Distinct Zones of Metallic Femoral Stem Implants

Hip simulator testing of the taper‐trunnion junction and bearing surfaces of contemporary metal‐on‐cross‐linked‐polyethylene hip prostheses

The influence of hla genotype on the development of metal hypersensitivity following joint replacement

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