Letter to the editor on “Titanium neck-titanium stem corrosion in a modular neck stem”

Letter to the Editor on “Disassociation of a Cold-Welded Bimodular Titanium Femoral Stem by Intraoperative Ice Cooling”

“…Their unique technical solution should be remembered by all revision surgeons, and I agree with their logical approach to the difficult decision-making of when to remove a well-positioned, well-fixed, bimodular titanium femoral stem. I agree that current information about the Zimmer M/L taper prosthesis with Kinectiv Technology (Zimmer Biomet, Warsaw, IN) makes it a candidate for partial revision because (1) the neck is constructed of titanium (Ti) alloy, and although a Ti-Ti interface with the stem may cold-weld [ 1 ] or even corrode [ 2 , 3 ], it will likely not lead to an adverse local tissue reaction as there is no cobalt (Co) alloy involved; (2) the design length of this particular modular titanium neck is relatively short and therefore unlikely to break, distinct from longer Ti modular necks that are apt to fracture [ 4 , 5 ]; and (3) usage of a ceramic femoral head at the obverse taper on the neck should diminish corrosion and metal loss [ 6 ], and again, without a Co-alloy component in the mix, minimize the risk of adverse local tissue reactions. The decision to revise such a stem is complex [ 7 ], but the authors make a very logical argument for revising only the head and neck in their patient’s case.…”