2019
DOI: 10.1016/j.artd.2019.04.009
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Titanium neck-titanium stem taper corrosion in a modular neck stem

Abstract: An 81-year-old woman presented with progressive groin pain after metal-on-polyethylene total hip arthroplasty with a modular neck stem and was found to have adverse local tissue reaction. As we report for the first time with this implant, we observed titanium neck-titanium stem taper corrosion intraoperatively. We also found head-neck taper corrosion. The patient underwent revision surgery to a modular fluted tapered stem with ceramic head and was asymptomatic at 3-year follow-up visit. In conclusion, consider… Show more

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Cited by 10 publications
(10 citation statements)
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(17 reference statements)
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“…Although bimodular hip implants historically have had a poor track record, this particular stem has not been recalled, and modular titanium neck implants were available and ready for this case. While there have been a number of case reports of MACC at the head-neck junction of this specific 12/14 taper when used with cobalt-chromium heads, there has only been a single case report of possible MACC at the titanium-titanium stem-neck taper junction with this stem [25]. In this one case report, the presumed crevice corrosion seen was the black corrosion product seen on the modular neck at the neck-stem interface near the exposed shoulder of the neck, while the patient had obvious MACC at the head-neck junction with black corrosion products all around that male taper along with elevated cobalt and chromium ion levels while having undetectable titanium ion levels.…”
Section: Case Historymentioning
confidence: 99%
“…Although bimodular hip implants historically have had a poor track record, this particular stem has not been recalled, and modular titanium neck implants were available and ready for this case. While there have been a number of case reports of MACC at the head-neck junction of this specific 12/14 taper when used with cobalt-chromium heads, there has only been a single case report of possible MACC at the titanium-titanium stem-neck taper junction with this stem [25]. In this one case report, the presumed crevice corrosion seen was the black corrosion product seen on the modular neck at the neck-stem interface near the exposed shoulder of the neck, while the patient had obvious MACC at the head-neck junction with black corrosion products all around that male taper along with elevated cobalt and chromium ion levels while having undetectable titanium ion levels.…”
Section: Case Historymentioning
confidence: 99%
“…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.…”
mentioning
confidence: 99%
“…I read with interest the paper entitled by Shah, et al [1], and I would like to congratulate the authors on a report that deals with the challenging problems of stem, neck, and head modularity.…”
mentioning
confidence: 99%
“…The authors seem to think that the ALTR may have been caused by the Ti-Ti stem and neck junction in this paper, but I believe that this would be misleading to the journal readers. As Jacobs et al have pointed out, ALTR associated with Ti fretting and corrosion products on a submicron scale has not been described [1]. Cobalt submicron particles, on the other hand, have been shown conclusively to cause ALTR [2,3].…”
mentioning
confidence: 99%