Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Cooper, H. John; Urban, Robert M.; Wixson, Richard L.; Meneghini, R. Michael; Jacobs, Joshua J.

doi:10.2106/jbjs.l.01042

Cited by 345 publications

(267 citation statements)

References 49 publications

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“…Finally, MoPxl may be the most important group to monitor over the coming decade. Adverse reactions to metal debris were once thought to be a phenomenon limited to MoM implants; however, recent reports have raised concern in MoPxl bearings for taper junction trunnionosis [10,11,43]. Increased awareness of trunnionosis may necessitate monitoring of serum metal levels in addition to ultrasound or metal artifact reduction sequencing MRI in the painful MoPxl THA according to a contemporary consensus statement algorithm from multiple orthopaedic specialty societies [30].…”

Section: Discussionmentioning

confidence: 99%

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

Wyles

Jiménez-Almonte

Murad

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Total hip arthroplasty (THA) is increasingly being performed in patients with long life expectancies and active lifestyles. Newer implant bearing surfaces, with superior wear characteristics, often are used in this cohort with the goal of improving longevity of the prosthesis, but comparisons across the numerous available bearing surfaces are limited, so the surgeon and patient may have difficulty deciding which implants to use. Questions/purposes The purpose of this study was to answer the following question: Is there a short-to mid-term survivorship difference between common THA bearings used in patients younger than age 65 years? Methods We conducted a systematic review to identify randomized clinical trials (RCTs) published after 2000 that reported survivorship of ceramic-on-ceramic (CoC), ceramic-on-highly crosslinked polyethylene (CoPxl), or metalon-highly crosslinked polyethylene (MoPxl) bearings. To qualify for our review, RCTs had to have a minimum 2-year followup and study patients were required to have an average age younger than 65 years. Direct-comparison meta-analysis and network meta-analysis were performed to combine direct and indirect evidence. IN, USA). One of the authors certifies that he (RTT), or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from MAKO Surgical Corp, USD 10,000 to USD 100,000 from DePuy Orthopaedics, Inc, and less than USD 10,000 from Wright Medical Technology, Inc. One of the authors certifies that he (RJS), or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 from Biomet Inc. 123Clin Orthop Relat Res (2015) 473:2031-2041 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® the three implant types, demonstrating the following probabilities of most effective implant with 95% credible intervals (CrI): CoC = 64.6% (0%-100%); CoPxl = 24.9% (0%-100%); and MoPxl = 9.9% (0%-100%). The CrIs ranged from 0% to 100% for all three bearing surfaces. Direct-comparison meta-analysis allowed for pooling of five RCTs, including 779 THAs, whereas network metaanalysis (before post hoc analysis) enabled pooling of 18 RCTs, including 2599 THAs. Conclusions Current published evidence does not support survivorship differences among commonly used bearing surfaces in patients younger than age 65 years undergoing THA at short-to mid-term followup. Long-term RCT data will be needed to determine if a survivorship benefit is realized in younger, more active patients over time. Level of Evidence Level I, therapeutic study.

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Section: Discussionmentioning

confidence: 99%

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

Wyles

Jiménez-Almonte

Murad

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…In general, the use of both modularity and alternative bearings increases implant costs. With questions being raised concerning corrosion of modular taper junctions and use of some hard-on-hard bearings increasing the risk of complications, we sought to answer the question of whether either of these implant design features has produced improvements in the survivorship or risk of revision at 5 years or longer after the index procedure [9,10,15,16,22,25,27,32,33,36,42,46,50,52,60,69,77]. In general, both alternative bearings and modularity showed no evidence of improvements in survivorship in either the literature or registry reports.…”

Section: Discussionmentioning

confidence: 99%

“…These marketed advantages have, however, come with increased risks and complications [4,15,27,44,70]. Unfortunately, adding another metal taper junction may increase the burden of corrosion debris and the risk of local tissue reactions as well as serve as a possible weak link that can increase the risk of a catastrophic failure [4,15,27,44,70]. As with any additional technological advancement in implant designs, both alternative bearings and increased modularity add cost to the implants in most cases.…”

Section: Introductionmentioning

confidence: 99%

How Have Alternative Bearings and Modularity Affected Revision Rates in Total Hip Arthroplasty?

Mihalko

Wimmer

Pacione

et al. 2014

Clin Orthop Relat Res

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Background Total hip arthroplasty (THA) continues to be one of the most successful surgical procedures in the medical field. However, over the last two decades, the use of modularity and alternative bearings in THA has become routine. Given the known problems associated with hardon-hard bearing couples, including taper failures with more modular stem designs, local and systemic effects from metal-on-metal bearings, and fractures with ceramic-onceramic bearings, it is not known whether in aggregate the survivorship of these implants is better or worse than the metal-on-polyethylene bearings that they sought to replace. Questions/purposes Have alternative bearings (metal-onmetal and ceramic-on-ceramic) and implant modularity decreased revision rates of primary THAs?Methods In this systematic review of MEDLINE and EMBASE, we used several Boolean search strings for each topic and surveyed national registry data from Englishspeaking countries. Clinical research (Level IV or higher) with C 5 years of followup was included; retrieval studies and case reports were excluded. We included registry data at C 7 years followup. A total of 32 studies (and five registry reports) on metal-on-metal, 19 studies (and five registry reports) on ceramic-on-ceramic, and 20 studies (and one registry report) on modular stem designs met inclusion criteria and were evaluated in detail. Insufficient data were available on metal-on-ceramic and ceramic-onmetal implants, and monoblock acetabular designs were evaluated in another recent systematic review so these were not evaluated here.One of the authors (WMM) receives royalty payments, during the study period, an amount of USD 10,000 to USD 100,000 from B Braun/Aesculap Inc (Center Valley, PA, USA) and less than USD 10,000 from Elsevier Inc (Philadelphia, PA, USA); receives USD 10,000 to USD 100,000 as a consultant for B Braun/Aesculap Inc and less than USD 10,000 from Medtronic Inc (Memphis, TN, USA); receives research funding, during the study period, an amount of less than USD 10,000 from B Braun/Aesculap Inc and less than USD 10,000 Stryker Inc (Mahwah, NJ, USA); and serves on the editorial boards for the Journal of Arthroplasty, The Knee, the International Journal of Orthopaedics, and The Journal of Long Term Effects of Medical Implants. One of the authors (MAW) receives institutional funding in the amount of less than USD 10,000 from Biomet, Inc (Warsaw, IN, USA), USD 10,000 to USD 100,000 from CeramTec GmbH (Lauf, Germany), and material support from Zimmer Inc (Warsaw, Inc, USA) and B Braun/Aesculap AG. He is an unpaid consultant for Endolab GmbH and a paid consultant receiving an amount of less than USD 10,000 from Irwing Fritche Urquhart & Moore LLC (New Orleans, LA, USA). One of the authors (MPL) owns Zimmer Holdings, Inc stock but received no payments during the study period. Results There was no evidence in the literature that alternative bearings (either metal-on-metal or ceramic-onceramic) in THA have decreased revision rates. Registry data, however, showed that large he...

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“…Fretting corrosion, or mechanically assisted crevice corrosion (MACC), of modular tapers is a well-documented process by which damage of the implant may lead to corrosion and wear debris that may cause a negative biological response in some patients including increased serum ion levels, pseudotumor formation, aseptic loosening, and others [7,8,27]. Many efforts have been made to document in vivo evidence of fretting corrosion through retrieval studies aimed at a better understanding of the mechanisms through which it occurs and the conditions that may lead to its initiation [3,6,11,12,15,18,23,27].…”

Section: Introductionmentioning

confidence: 99%

Properties and Corrosion Performance of Self-reinforced Composite PEEK for Proposed Use as a Modular Taper Gasket

Ouellette

Gilbert

2016

Clinical Orthopaedics &Amp; Related Research

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Background Fretting corrosion in medical alloys is a persistent problem, and the need for biomaterials that can effectively suppress mechanically assisted crevice corrosion in modular taper junctions or otherwise insulate metalon-metal interfaces in mechanically demanding environments is as yet unmet. Questions/purposes The purpose of this study is to characterize a novel material, self-reinforced composite polyetheretherketone (SRC-PEEK) and to evaluate its ability to inhibit fretting corrosion in a pin-on-disk metalon-metal interface test.Methods SRC-PEEK was fabricated by hot compaction of in-house-made PEEK fibers by compacting uniaxial layups at 344°C under a load of 18,000 N for 10 minutes. SRC-PEEK, bulk isotropic PEEK, and the in-house-made PEEK fibers were analyzed for thermal transitions (T g , T m ) through differential scanning calorimetry, crystallinity, crystal size, crystalline orientation (Hermanns orientation parameter) through wide-angle x-ray scattering, and modulus, tensile strength, yield stress, and strain to failure through monotonic tensile testing. SRC-insulated pin-ondisk samples were compared with metal-on-metal control samples in pin-on-disk fretting corrosion experiments using fretting current and fretting mechanics measurements. Fifty-micron cyclic motion at 2.5 Hz was applied to the interface, first over a range of loads (0.5-35 N) while held at À0.05 V versus Ag/AgCl and then over a range of voltages (À0.5 to 0.5 V) at a constant contact stress of 73 ± 19 MPa for SRC-PEEK and 209 ± 41 MPa for metal-onmetal, which were different for each group as a result of changes in true contact area due to variations in modulus between sample groups. Pins, disks, and SRC samples were imaged for damage (on alloy and SRC surfaces) and evidence of corrosion (on alloy pin and disk surfaces). SRC specimens were analyzed for traces of alloy transferred to the surface using energy dispersive spectroscopy after pinon-disk testing.

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Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

Cited by 345 publications

References 49 publications

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

How Have Alternative Bearings and Modularity Affected Revision Rates in Total Hip Arthroplasty?

Properties and Corrosion Performance of Self-reinforced Composite PEEK for Proposed Use as a Modular Taper Gasket

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