Ten-Year Cross-Sectional Study of Mechanically Assisted Crevice Corrosion in 1352 Consecutive Patients With Metal-on-Polyethylene Total Hip Arthroplasty

McGrory, Brian J.; Hussey, Daniel K.

doi:10.1016/j.arth.2017.03.020

Cited by 73 publications

(64 citation statements)

References 31 publications

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“…In a recent cross-sectional study by Hussey and McGrory, 10 years of consecutive MoP THAs performed by a single surgeon were reviewed and analyzed for prevalence of MACC with various factors, including implant type [12]. In it, the authors note that the overall prevalence of MACC in this cohort was 3.2%, but in certain years, specifically 2009-2012, the M/L Taper stem had greater prevalence.…”

Section: Discussionmentioning

confidence: 97%

“…Assembly conditions may also predispose toward corrosion [27], [28]; however, given that these THA constructs were assembled in 2 different operative settings with 2 different primary surgeons, it is unlikely she was subjected to the same factors during each procedure, which suggests against this as a cause of MACC. In short, the exact cause of MACC, in terms of implant design, has not been fully elucidated, although certain implant types have been noted to have a higher prevalence of MACC [12].…”

Section: Discussionmentioning

confidence: 99%

“…If left untreated, more obvious osteolysis may occur. The prevalence of this condition, according to one recent study, is 3.2% but varies by implant and date of surgery [12]. Patients may present as early as a few months from their index procedure and as late as 10 years, but they typically present between 1 and 3 years [4].…”

Section: Introductionmentioning

confidence: 99%

“…Patients may present as early as a few months from their index procedure and as late as 10 years, but they typically present between 1 and 3 years [4]. Symptomatic MACC at the head-neck junction in MoP THA appears to be reported in the literature more commonly with certain implants as well [12], [13], [14].…”

Section: Introductionmentioning

confidence: 99%

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A case of bilateral hip mechanically assisted crevice corrosion after staged total hip arthroplasty

et al. 2018

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Mechanically assisted crevice corrosion (MACC), also known as trunnionosis, and adverse local tissue reaction (ALTR) are entities that can lead to pain and necessitate revision in total hip arthroplasty (THA). We present a case of a 75-year-old female who received a bilateral staged primary THA with metal on cross-linked polyethylene implants and had subsequent bilateral revisions for MACC and ALTR. In both instances, she presented with anterior thigh pain, weakness, and difficulty ambulating, and she was revised to ceramic on cross-linked polyethylene implants. This case may suggest a biologic predisposition or systemic immunogenic reaction to metal debris in some patients with ALTR or represent an implant-specific complication. To our knowledge, this is the first case reported of a patient having bilateral MACC from staged THA performed by 2 different surgeons using the same brand implant.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A case of bilateral hip mechanically assisted crevice corrosion after staged total hip arthroplasty

et al. 2018

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“…In the meantime, the new problem of trunnionosis or taperosis and associated destructive ALTR described above has become a cause for increasing concern regarding CoCrMo and TiAlV taper-trunnion connections, and also with MoP and ceramic bearings and <40 mm head sizes [79].…”

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confidence: 99%

Current Insights Regarding Metal-on-Metal Bearings for Hip Arthroplasty

Straeten

2017

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Modern small diameter metal-on-metal (MoM) bearings for total hip arthroplasty (THA) have been developed in the nineteen-eighties to address the problem of polyethylene wear related osteolysis. Subsequently large diameter MoM hip resurfacings (HRA) were designed for young and active patients to preserve bone and avoid dislocation. Large diameter MoM THA were originally meant as an easy femoral component-only revision solution for femoral neck fractures in HRA, but were then advocated for primary THA as well. In the last decade however, increasing numbers of revisions for adverse local tissues reactions (ALTR) to metal debris have been reported. These ALTR are due to excessive wear of the MoM bearings, usually related to malpositioning of the components leading to edge loading, or in rare cases to metal sensitivity. Besides the immunological reactions, metal particles and ions have a potential local and systemic toxicity. Wear and tribocorrosion at the taper-trunnion connections of MoM THA but also THA with polyethylene and ceramic bearings have also been recognized as a cause of ALTR with extensive tissue destruction. Despite the fact that the long-term survivorship and functional results of certain MoM HRA are excellent and better than THA in the young and active patients group, MoM bearings have become very unpopular and are likely to be replaced by bearing couples of other materials. . When an increasing number of these MoP total hip arthroplasties (THA) had to be revised because of progressive loosening and extensive osteolysis caused by a macrophage response to polyethylene (PE) wear particles [6] whilst hip simulator studies were demonstrating substantially less volumetric wear from MoM bearing surfaces [7,8], MoM hip articulations were reintroduced to solve the problem of polyethylene (PE) particle-induced osteolysis. The imperfections regarding geometry, tolerance and metallurgy (low-carbon content associated with higher wear) of the first generation MoM articulations were resolved in the second generation high carbon content Metasul ® MoM bearings (Sulzer/Centerpulse, Winterthur, Switzerland, 1988), which exhibited very promising short-and medium term results [9]. Furthermore, in the nineties, modern MoM hip resurfacing arthroplasty (HRA) (Figure 1) was proposed to address the inferior clinical results of THA in young and active Keywords

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