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Clinical Orthopaedics and Related Research®

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01-11-2012 | Symposium: Papers Presented at the 2011 Meeting of the International Hip Society

Corrosion at the Cone/Taper Interface Leads to Failure of Large-diameter Metal-on-metal Total Hip Arthroplasties

Authors: Heiko Meyer, MD, Tina Mueller, BS, Gesine Goldau, BS, Kathrin Chamaon, PhD, Marcel Ruetschi, MD, Christoph H. Lohmann, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2012

Abstract

Background

Metal-on-metal (MoM) THAs have reduced wear rates compared with metal-on-polyethylene. However, elevated serum metal ion levels and pseudotumors have been reported in large MoM articulations.

Questions/purposes

We therefore determined (1) if corrosion occurred at the cone/taper interface leading to instability in patients with large-diameter THAs; (2) how patients presented clinically and radiographically; (3) if adverse periprosthetic tissue reactions occurred; (4) whether metal was released from the implants into the periprosthetic tissues; and (5) if head size correlated with metal release.

Methods

We reviewed 114 patients who had revisions of large-diameter head MoM articulations. Mean time of implantation was 46 months. To identify adverse reactions and particle load, tissues were stained by hematoxylin and eosin and CD3/CD20/CD68 antibodies. Periprosthetic tissues were analyzed for metal content and distribution in different regions. Electrochemical reactions between the stem and adapter were investigated by a minicell electrode.

Results

Electrochemical studies on the stem and the head adapter showed a risk for galvanic corrosion. Ninety-four percent of patients had instability at the cone/taper interface. All patients presented with early clinical symptoms; 59 patients had radiographic signs of loosening. One hundred four patients had foreign body reactions and necrosis. The largest amounts of metal released were titanium or iron. We found no correlation between head size and metal ion release.

Conclusions

These findings suggest that in modular cone/taper connections, friction of the MoM articulations may cause failure of the cone/taper interface leading to galvanic corrosion and loosening. It is unclear whether the design of this MoM system provides sufficient stability at the taper.

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Title: Corrosion at the Cone/Taper Interface Leads to Failure of Large-diameter Metal-on-metal Total Hip Arthroplasties
Authors: Heiko Meyer, MD
Tina Mueller, BS
Gesine Goldau, BS
Kathrin Chamaon, PhD
Marcel Ruetschi, MD
Christoph H. Lohmann, MD
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2502-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Corrosion at the Cone/Taper Interface Leads to Failure of Large-diameter Metal-on-metal Total Hip Arthroplasties

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

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