Head Size and Metal-on-Metal Bearings

Migaud, Henri; Berton, C.; Putman, Sophie; Combes, A.; Blairon, Alexandre; Kern, G.; Girard, Julien

doi:10.1007/978-3-642-35653-7_12

Cited by 1 publication

(2 citation statements)

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“…[18] Small diameter heads (28-32 mm) have had favorable results since the late 1980s. [19,20,21] However, the market demand to reduce dislocations in THA pushed the M-o-M bearings into larger head diameters. While it took time to see the problems with large M-o-M heads, it is also possible that the signs were overlooked.…”

Section: Current Concerns With Metallic Materialsmentioning

confidence: 99%

“…These larger heads, however, put larger loads on the taper junction and are suspected to be responsible for the problems suddenly occurring at this side." [21,26] The success of a self-locking taper is influenced by the design of the taper, particularly the taper angle, the roughness, and the mating materials between the "male" and "female" components. (Figure 9a, 9b) This results in cointegration (locking), with material transfer across the zone of contact (cold welds).…”

Section: Current Concerns With Metallic Materialsmentioning

confidence: 99%

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Metallic Modular Taper Junctions in Total Hip Arthroplasty

McTighe¹,

Brazil²,

Keppler³

et al. 2015

ReconRev

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The emergence of modularity in total hip arthroplasty (THA) in the 1980s and 1990s was based on the fact that the benefit of these design features outweighed the risk. The use of metallic modular junctions presents a unique set of advantages and problems for use in THA. The advantages include improvement in fit and fill of the implant to bone, restoration of joint mechanics, reduced complications in revision surgery and reduction of costly inventory. However, the risks or concerns are a little harder to identify and deal with. Certainly corrosion, and fatigue failure are the two most prevalent concerns but now the specifics of fretting wear and corrosive wear increasing particulate debris and the potential biological response is having an impact on the design and potential longevity of the reconstructed hip. Material and designs are facing a shorter life expectancy than what was previously thought, mostly due to an increasing level of physical activity by the patient. Because there are no accurate laboratory test whereby the service life and performance of these implants can be predicted, early controlled clinical evaluations are necessary. Early publication of testing and clinical impressions should be encouraged in an attempt to reduce exposure to potential at risk patients, implants and material. The reduction and possible elimination of risks will require a balancing of all the variables requiring a multidisciplinary endeavor.This paper is designed to review the risk factors, and benefits of modular junctions in total hip arthroplasty (THA). Also some basic engineering principals that can reduce risk factors and improve functionality of modular junctions.

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