Corrosion at the Head-Neck Taper as a Cause for Adverse Local Tissue Reactions After Total Hip Arthroplasty

Cooper, H. John; Valle, Craig J. Della; Berger, Richard A.; Tetreault, Matthew W.; Paprosky, Wayne G.; Sporer, Scott M.; Jacobs, Joshua J.

doi:10.2106/jbjs.k.01352

Cited by 536 publications

(451 citation statements)

References 39 publications

(61 reference statements)

Supporting

Mentioning

434

Contrasting

Unclassified

Order By: Relevance

“…There have also been reports of adverse reactions to metal debris due to metallic wear debris produced from the taper junction for MoP THR (Cooper et al, 2012;Lindgren et al, 2011;Mao et al, 2012). The taper junction of the THR, which is the focus of this study, is the interface between the internal taper of the modular femoral head and the trunnion of the femoral stem (see Figure 1) where the surgeon impacts the head onto the femoral stem during surgery.…”

Section: Introductionmentioning

confidence: 99%

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

Ashkanfar

Langton

Joyce

2017

Journal of the Mechanical Behavior of Biomedical Materials

View full text Add to dashboard Cite

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis.http://researchonline.ljmu.ac.uk/5442/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Chromium femoral heads, which had been in service for 5.1 years in average, to validate the FE analyses. It was found that a large taper mismatch (e.g. 9.12´ ) results in a high wear rate (2.960mm 3 per million load cycles). Such wear rates can have a major negative effect on the clinical outcomes of these implants. It was also found that even a slight reduction in mismatch significantly reduced the magnitude of the wear rates (0.069mm 3 per million load cycles on average for 6´ taper mismatch). It is recommended that the cone angles of femoral head and femoral trunnion should be manufactured to produce a taper mismatch of less than 6´ at the taper junction.

show abstract

Section: Introductionmentioning

confidence: 99%

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

Ashkanfar

Langton

Joyce

2017

Journal of the Mechanical Behavior of Biomedical Materials

View full text Add to dashboard Cite

show abstract

“…Currently, there are efforts focusing on management of patients with MoM implants that include guidelines for the use and importance of metal levels that will help surgeons counsel patients and use the levels as one of many tools to help determine when to intervene [22,26]. Lastly, the one case series on corrosion is interesting because it highlights the relative increase in cobalt levels compared to chromium levels in situations where corrosion is the process driving particle generation and failure [10]. This article will be helpful as surgeons evaluate patients with pain and have an implant with a modular junction.…”

Section: Discussionmentioning

confidence: 99%

“…Two of the final articles were removed because they addressed corrosion secondary to stem loosening and a knee modular revision component. This left nine articles focused on corrosion in femoral hip components [9,10,23,29,32,37,42,46,47].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…There were nine studies identified addressing the surgical treatment of implant failures secondary to taper corrosion (Table 5) [9,10,23,29,32,37,42,46,47]. Eight articles were case report studies and one was Level IV.…”

Section: Treatment Of Corrosionmentioning

confidence: 99%

“…While corrosion of modular junctions is not a new finding, its contribution to failed arthroplasties seems to be on the rise. Multiple theories have been proposed for the apparent increase, including increased use of larger-diameter heads, modular adaptors with the larger heads, smaller and shorter tapers, poor assembly, and component metallurgy issues [9,10,23,29,42,47]. In each instance, the underlying process leading to corrosion appears to be mechanically assisted crevice corrosion generating particulate debris.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background Wear and corrosion occurring in patients with hip and knee arthroplasty are common causes of failure leading to revision surgery. A variety of surgical approaches to these problems have been described, with varying efficacy. Polyethylene wear, metal-on-metal (MoM) hip bearing wear, and problems associated with modular taper corrosion are the areas of greatest clinical impact; results of revisions for these problems are likely to dictate a large portion of revision resources for the foreseeable future, and so they call for specific study. Questions/purposes We identified the most frequently reported procedures to treat hip polyethylene wear, knee polyethylene wear, MoM wear after THA, and modular taper corrosion and determined the timing and reasons these failed. Methods We performed systematic reviews of the published literature on the four topics using MEDLINE 1 and Embase in October 2013; searches were supplemented by hand searches of bibliographies. Prespecified criteria resulted in the identification of 38 relevant articles, of which 33 were either case reports or Level IV evidence. Followup was generally at short term and ranged from 0.2 to 8 years. Results The most frequently reported procedures for treating clinically important wear were a partial or complete revision. When treating polyethylene wear, the more frequently reported reasons for hip and knee rerevisions were loosening, continued wear, and instability. Soft tissue reactions were more common and occasionally extensive in patients with MoM or modular taper corrosion. Patients with soft tissue reactions had more complications and higher rerevision rates. Conclusions Studies with longer followup and higher levels of evidence are needed to direct the treatment of wear and corrosion. When soft tissue damage secondary to MoM wear or taper corrosion is present, the results of treatment can be poor. There is an urgent need to better understand these two mechanisms of failure.

show abstract

Trunnionosis

Balso

Schemitsch

Lanting

2021

Evidence‐Based Orthopedics

View full text Add to dashboard Cite

Corrosion at the Head-Neck Taper as a Cause for Adverse Local Tissue Reactions After Total Hip Arthroplasty

Cited by 536 publications

References 39 publications

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: A finite element wear analysis

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Trunnionosis

Contact Info

Product

Resources

About