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Clinical Orthopaedics and Related Research®

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01-12-2014 | Clinical Research

Modern Trunnions Are More Flexible: A Mechanical Analysis of THA Taper Designs

Authors: David A. Porter, MD, Robert M. Urban, PhD, Joshua J. Jacobs, MD, Jeremy L. Gilbert, PhD, José A. Rodriguez, MD, H. John Cooper, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2014

Abstract

Background

There is renewed concern surrounding the potential for corrosion at the modular head-neck junction to cause early failure in contemporary THAs. Although taper corrosion involves a complex interplay of many factors, a previous study suggested that a decrease in flexural rigidity of the femoral trunnion may be associated with an increased likelihood of corrosion at retrieval.

Questions/purposes

By analyzing a large revision retrieval database of femoral stems released during a span of three decades, we asked: (1) how much does flexural rigidity vary among different taper designs; (2) what is the contribution of taper geometry alone to flexural rigidity of the femoral trunnion; and (3) how have flexural rigidity and taper length changed with time in this group of revised retrievals?

Methods

A dual-center retrieval analysis of 85 modular femoral stems released between 1983 and 2012 was performed, and the flexural rigidity and length of the femoral trunnions were determined. These stems were implanted between 1991 and 2012 and retrieved at revision or removal surgery between 2004 and 2012. There were 10 different taper designs made from five different metal alloys from 16 manufacturers. Digital calipers were used to measure taper geometries by two independent observers.

Results

Median flexural rigidity was 228 N-m²; however, there was a wide range of values among the various stems spanning nearly an order of magnitude between the most flexible (80 N-m²) and most rigid (623 N-m²) trunnions, which was partly attributable to the taper geometry and to the material properties of the base alloy. There was a negative correlation between flexural rigidity and length of the trunnion and release date of the stem.

Conclusions

There is wide variability in flexural rigidity of various taper designs, with a trend toward trunnions becoming shorter and less rigid with time.

Clinical Relevance

This temporal trend may partly explain why taper corrosion is being seen with increasing frequency in modern THAs.

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Title: Modern Trunnions Are More Flexible: A Mechanical Analysis of THA Taper Designs
Authors: David A. Porter, MD
Robert M. Urban, PhD
Joshua J. Jacobs, MD
Jeremy L. Gilbert, PhD
José A. Rodriguez, MD
H. John Cooper, MD
Publication date: 01-12-2014
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 12/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-014-3965-3

At a glance: The STEP trials

Springer Medicine

Modern Trunnions Are More Flexible: A Mechanical Analysis of THA Taper Designs

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Clinical Relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Clinical Relevance

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