Corrosion at the Head-Neck Taper as a Cause for Adverse Local Tissue Reactions After Total Hip Arthroplasty

• DOI: 10.2106/jbjs.k.01352
• Publication Date: 2012-11-15T20:57:05Z
• Authors: H John Cooper; Craig J Della Valle; Richard A Berger; Matthew Tetreault; Wayne G Paprosky; Scott M Sporer; Joshua J Jacobs
• Keywords: Adult; Chromium; Male; Prosthesis-Related Infections; Anthropometry; Arthroplasty, Replacement, Hip; Cobalt; Recovery of Function; Middle Aged; Prosthesis Design; Magnetic Resonance Imaging; Body Mass Index; Prosthesis Failure; 3. Good health; Cohort Studies; Corrosion; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Hip Prosthesis; Aged; Follow-Up Studies

Background: Corrosion at the modular head-neck junction of femoral component in total hip arthroplasty has been identified as a potential concern, although symptomatic adverse local tissue reactions secondary to corrosion have rarely described. Methods: We retrospectively reviewed records ten patients with metal-on-polyethylene prosthesis, from three different manufacturers, who underwent revision surgery for junction. Results: All presented pain or swelling around hip, and two recurrent instability. Serum cobalt levels were elevated prior typically more than serum chromium levels. Surgical findings included large soft-tissue masses surrounding damage visible junction; instability had severe abductor musculature. Pathology specimens consistently demonstrated areas necrosis. The treated debridement head liner exchange, use ceramic titanium sleeve eight cases. mean Harris score improved 58.1 points preoperatively 89.7 13.0 months after (p = 0.01). Repeat levels, measured six 8.0 following revision, decreased 1.61 ng/mL, similar prerevision One patient moderate muscle necrosis developed required second arthroplasty. Conclusions: Adverse can occur bearing taper, their presentation is seen metal-on-metal bearing. Elevated metal particularly differential elevation respect be helpful establishing this diagnosis. Level Evidence: Diagnostic III. See Instructions Authors complete description evidence.