The effect of altering head length on corrosion using a material loss method

Lanting, Brent A.; Wood, Thomas J.; Young, S.; Citters, Douglas W. Van; MacDonald, Steven J.; Howard, James L.; Teeter, Matthew G.

doi:10.1177/1120700018779886

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…Presuming that metal ion levels are a reliable indicator of taper corrosion, our results support the findings of a series of retrieval studies which have not found any association between taper corrosion and head size. 19,24,29,32,33 In contrast, other studies have associated larger metal heads with taper fretting and corrosion. 11,12,23 Since large heads may increase stress on the head-neck junction, 15 one would expect them to associate with taper corrosion-related complications, like the higher risk of revision due to adverse reaction to metal debris observed in ⩾36-mm metal-oncross-linked polyethylene bearings in the Australian registry.…”

Section: Discussionmentioning

confidence: 96%

No difference in whole-blood metal ions between 32-mm and 36- to 44-mm femoral heads in metal-on-polyethylene total hip arthroplasty: a 2-year report from a randomised control trial

et al. 2021

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Aim: To investigate the effect of femoral head size on blood metal-ion levels caused by taper corrosion in metal-on-polyethylene total hip arthroplasty, comparing 36- to 44-mm heads with 32-mm heads. Methods: In a randomised, controlled, single-blinded trial, 96 patients were allocated to receive either a 32-mm metal head or the largest possible metal head (36–44 mm) that could be accommodated in the thinnest available vitamin E, cross-linked polyethylene insert. Blood metal ion levels were collected at 1- and 2-year follow-ups. Results: At 1-year, metal-ion levels did not differ between the groups. The median (interquartile range) blood-ion levels for the 32-mm versus the 36- to 44-mm group were 0.11 µg/L (0.08–0.15) versus 0.12 µg/L (0.08–0.22), p = 0.546, for cobalt, 0.50 µg/L (0.50–0.59) versus 0.50 µg/L (0.50–1.20), p = 0.059, for chromium and 1.58 µg/L (1.38–2.05) versus 1.48 µg/L (1.14–1.87), p = 0.385, for titanium. At 2 years, there was no difference either and the corresponding values were 0.15 µg/L (0.12–0.24) versus 0.18 µg/L (0.12–0.28), p = 0.682 for cobalt, 0.50 µg/L (0.50–0.50) versus 0.50 µg/L (0.50–0.57), p = 0.554, for chromium and 1.54 µg/L (1.16–1.87) versus 1.42 µg/L (1.01–1.72), p = 0.207 for titanium. Conclusions: The use of the largest possible metal head (36–44 mm) compared to a 32-mm head in metal–on-polyethylene bearings does not appear to elevate blood metal-ion levels up to 2 years postoperatively. As taper corrosion is probably time-dependent, longer-term reports are needed to evaluate the association between large metal heads and blood metal ion levels. Trial registration: ClinicalTrials.gov (reg. ID NCT0231 6704)

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Section: Discussionmentioning

confidence: 96%

No difference in whole-blood metal ions between 32-mm and 36- to 44-mm femoral heads in metal-on-polyethylene total hip arthroplasty: a 2-year report from a randomised control trial

et al. 2021

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“…Finally, increased head offset has been implicated as a cause of corrosion due to the increased varus load on the taper 8 . However, there is mixed evidence in the literature, and the relationship between head offset and corrosion remains unclear 42 .…”

Section: Discussionmentioning

confidence: 99%

Intermediate to Long-Term Outcomes and Causes of Aseptic Failure of an At-Risk Femoral Stem

Gazendam

Ekhtiari

Wood

2022

Journal of Bone and Joint Surgery

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Background: The Accolade TMZF is a tapered-wedge cementless metaphyseal-coated femoral stem that was widely utilized from 2002 to 2012. In recent years, there have been reports of early catastrophic failure of this implant. The purposes of the present study were to establish the long-term survival of this stem and to analyze patients who underwent aseptic revision to understand the causes and risk factors for failure.Methods: We retrospectively reviewed the records of all patients who had undergone primary total hip arthroplasty with use of an Accolade TMZF stem at a high-volume arthroplasty center. The causes and timing of revision surgery were documented. Survivorship analysis was performed with use of Kaplan-Meier curves to determine the overall and aseptic survival rates at the time of the latest follow-up. Patient and implant factors commonly associated with aseptic failure were extracted, and a Cox proportional hazards model was used.Results: A consecutive series of 2,609 patients who had undergone unilateral primary total hip arthroplasty with use of an Accolade TMZF femoral stem were included. The mean time from the primary procedure was 11.3 years (range, 0 days to 19.4 years). The cumulative survival rate was 95.5% ± 0.1% at the time of the latest follow-up. One hundred and seven patients underwent revision surgery, with aseptic loosening of the femoral component being the most common cause of aseptic failure in this cohort (33 of 2,609; 1.3%). Smaller femoral size and larger femoral head offset were independent risk factors for aseptic failure.Conclusions: To our knowledge, this is the largest series representing the longest follow-up of this tapered-wedge cementless femoral implant. Despite early concerns, the Accolade TMZF stem had excellent survivorship in this cohort. Trunnionosis as the cause for revision surgery was rare.

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“…Unworn areas can readily be identified using visual inspection [19,57], observing regions with evidence of original machining marks, or which are known to have not been in mechanical contact [101]. This process has been noted to improve when using SEM [49] and optical microscopy [21] over standard visual inspection.…”

Section: Unworn Region and Engagementmentioning

confidence: 99%

Comparison and appraisal of techniques for the determination of material loss from tapered orthopaedic surfaces

Dransfield

Addinall

Bills

2021

Wear

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The effect of altering head length on corrosion using a material loss method

Cited by 4 publications

References 27 publications

No difference in whole-blood metal ions between 32-mm and 36- to 44-mm femoral heads in metal-on-polyethylene total hip arthroplasty: a 2-year report from a randomised control trial

No difference in whole-blood metal ions between 32-mm and 36- to 44-mm femoral heads in metal-on-polyethylene total hip arthroplasty: a 2-year report from a randomised control trial

Intermediate to Long-Term Outcomes and Causes of Aseptic Failure of an At-Risk Femoral Stem

Comparison and appraisal of techniques for the determination of material loss from tapered orthopaedic surfaces

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