Gross trunnion failure in metal on polyethylene total hip arthroplasty—a systematic review of literature

Bansal, Tungish; Aggarwal, Sameer; Dhillon, Mandeep Singh; Patel, Sandeep

doi:10.1007/s00264-019-04474-z

Cited by 27 publications

(24 citation statements)

References 34 publications

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“…Recently, a beta phase titanium alloy (TMZF) was introduced to provide better stress shielding properties and thus increased osseointegration [7]. However, implants made from TMZF showed in some cases gross trunnion failure (GTF) [8][9][10][11][12]. This failure mode led to an excessive release of titanium alloy debris and in some cases disengagement of the head from the stem.…”

Section: Introductionmentioning

confidence: 99%

Effect of Potential and Microstructure on the Tribocorrosion Behaviour of Beta and Near Beta Ti Alloys I

Neto

Rainforth

2020

Biotribology

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Current hip prostheses make extensive use of the aerospace alloy Ti-6Al-4V. This material was designed for aerospace applications but has far from ideal mechanical properties for biomedical applications, namely, a high elastic modulus and poor fatigue resistance. Moreover, its poor tribological properties are well known.However, beta, or near beta Ti alloys are known to have superior properties in that its elastic modulus is closer to that of bone coupled with a good fatigue resistance.Therefore, this work aims to analyse the tribocorrosion behaviour of 4 different titanium alloys (Ti-13Nb-13Zr, Ti-12Mo-6Zr-2Fe and Ti-29Nb-13Ta-4.6Zr aged at 300 o C and at 400 o C) at anodic potential, OCP and cathodic potential at 0.5N, 1N and 2N in bovine serum to identify the main cause of material degradation, the presence of a tribofilm and the synergism between corrosion and wear. The results show the alloys become more active when subjected to sliding in all conditions, but the material loss is lower at anodic potential. The alloys studied present a positive effect of corrosion on wear.

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Section: Introductionmentioning

confidence: 99%

Effect of Potential and Microstructure on the Tribocorrosion Behaviour of Beta and Near Beta Ti Alloys I

Neto

Rainforth

2020

Biotribology

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“…Taper incongruences caused by mixing heads and tapers from different manufacturers might affect the strength of the taper connection and must be avoided, given the variability of the effect associated with cobalt-chromium (CoCr) heads, because taper incongruences may critically reduce the fracture load of ceramic heads [67,68], and because of certification issues. Gross trunnion failures are reportedly above average for tapers made of beta titanium alloy (titanium-molybdenum-zirconium-iron (TMZF)) [34]. This specific beta titanium alloy might have fretting corrosion characteristics that are unfavourable for taper connections.…”

Section: Technical Aspects Of Taper Connections In Hip Arthroplastymentioning

confidence: 99%

“…These can lead to synovitis, local osteolysis, the necrosis of periprosthetic tissues and, finally, component loosening [11,13,31]. Long-term MACC leads to material loss at the taper junction, which can, in rare cases, lead to the frank dissociation of the connection, as well as marked taper deformity [13,20,[32][33][34].…”

Section: Introductionmentioning

confidence: 99%

What the Surgeon Can Do to Reduce the Risk of Trunnionosis in Hip Arthroplasty: Recommendations from the Literature

Rieker

Wahl

2020

Materials

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Trunnionosis, defined as wear and corrosion at the head-neck taper connection, is a cause of failure in hip arthroplasty. Trunnionosis is linked to a synergistic combination of factors related to the prosthesis, the patient, and the surgeon. This review presents analytical models that allow for the quantification of the impact of these factors, with the aim of providing practical recommendations to help surgeons minimize the occurrence of this failure mode. A tighter fit reduces micromotion and, consequently, fretting of the taper connection. The paramount parameters controlling the fixation force are the coefficient of friction and the impaction force. The influence of the head diameter, as well as of the diameter and angle of the taper, is comparatively small, but varus alignment of the taper and heads with longer necks are unfavourable under physiologic loads. The trunnion should be rinsed, cleaned, and dried carefully, while avoiding any contamination of the bore-the female counterpart within the head-prior to assembly. Biological debris, and even residual water, might critically reduce the fixation of the taper connection between the head and the neck. The impaction force applied to the components should correspond to at least two strong blows with a 500 g hammer, striking the head with an ad hoc impactor aligned with the axis of the taper. These strong blows should correspond to a minimum impaction force of 4000 N.

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“…The majority of the head-neck disassociation cases have been reported to occur following a forceful attempt of closed reduction after a total hip arthroplasty dislocation. Besides, gross trunnion failure due to crevice corrosion has been identified as an important cause of head and neck dissociation in the late period [2]. Only one non-traumatic early femoral head-neck disassociation is reported in the literature, which had developed following a total hip arthroplasty with a constrained cup [3].…”

Section: Introductionmentioning

confidence: 99%

Early Disassembly of Femoral Head and Neck Components After Total Hip Arthroplasty Revision

Tutuncu¹,

Karaismailoğlu²,

Şahin³

et al. 2021

Cureus

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Modular femoral and acetabular components are frequently used in hip arthroplasty. Although the use of modular components offers many advantages, the increased number of components leads to a high risk of disassembly. Disassociation of the femoral head and neck is a rarely reported complication in the literature. This case report depicts a patient with non-traumatic early disassociation of the femoral head and neck components following total hip revision arthroplasty. Femoral head-neck disassembly in early postoperative period may occur due to manufacturing error or insufficient impaction. If sufficient impaction is thought to be achieved, manufacturing errors should be kept in mind as potential underlying reasons for femoral headneck dissociation.

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Gross trunnion failure in metal on polyethylene total hip arthroplasty—a systematic review of literature

Cited by 27 publications

References 34 publications

Effect of Potential and Microstructure on the Tribocorrosion Behaviour of Beta and Near Beta Ti Alloys I

Effect of Potential and Microstructure on the Tribocorrosion Behaviour of Beta and Near Beta Ti Alloys I

What the Surgeon Can Do to Reduce the Risk of Trunnionosis in Hip Arthroplasty: Recommendations from the Literature

Early Disassembly of Femoral Head and Neck Components After Total Hip Arthroplasty Revision

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