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Taper corrosion: a complication of total hip arthroplasty

The focus on taper corrosion in modular hip arthroplasty increased around 2007 as a result of clinical problems with large-head metal-on-metal (MoM) bearings on standard stems. Corrosion problems with bi-modular primary hip stems focused attention on this issue even more. Factors increasing the risk...

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Autores principales: Morlock, Michael M., Hube, Robert, Wassilew, Georgi, Prange, Felix, Huber, Gerd, Perka, Carsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2020
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722945/
https://www.ncbi.nlm.nih.gov/pubmed/33312704
http://dx.doi.org/10.1302/2058-5241.5.200013
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author Morlock, Michael M.
Hube, Robert
Wassilew, Georgi
Prange, Felix
Huber, Gerd
Perka, Carsten
author_facet Morlock, Michael M.
Hube, Robert
Wassilew, Georgi
Prange, Felix
Huber, Gerd
Perka, Carsten
author_sort Morlock, Michael M.
collection PubMed
description The focus on taper corrosion in modular hip arthroplasty increased around 2007 as a result of clinical problems with large-head metal-on-metal (MoM) bearings on standard stems. Corrosion problems with bi-modular primary hip stems focused attention on this issue even more. Factors increasing the risk of taper corrosion were identified in laboratory and retrieval studies: stiffness of the stem neck, taper diameter and design, head diameter, offset, assembly force, head and stem material and loading. The high variability of the occurrence of corrosion in the clinical application highlights its multi-factorial nature, identifying the implantation procedure and patient-related factors as important additional factors for taper corrosion. Discontinuing the use of MoM has reduced the revisions due to metal-related pathologies dramatically from 49.7% (MoM > 32 mm), over 9.2% (MoM ⩽ 32 mm) to 0.8% (excluding all MoM). Further reduction can be achieved by omitting less stiff Ti-alloys and large metal heads (36 mm and above) against polyethylene (PE). Standardized taper assembly of smaller and ceramic heads will reduce the clinical occurrence of taper corrosion even further. If 36 mm heads are clinically indicated, only ceramic heads should be used. Taper-related problems will not comprise a major clinical problem anymore if the mentioned factors are respected. Cite this article: EFORT Open Rev 2020;5:776-784. DOI: 10.1302/2058-5241.5.200013
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spelling pubmed-77229452020-12-10 Taper corrosion: a complication of total hip arthroplasty Morlock, Michael M. Hube, Robert Wassilew, Georgi Prange, Felix Huber, Gerd Perka, Carsten EFORT Open Rev Hip The focus on taper corrosion in modular hip arthroplasty increased around 2007 as a result of clinical problems with large-head metal-on-metal (MoM) bearings on standard stems. Corrosion problems with bi-modular primary hip stems focused attention on this issue even more. Factors increasing the risk of taper corrosion were identified in laboratory and retrieval studies: stiffness of the stem neck, taper diameter and design, head diameter, offset, assembly force, head and stem material and loading. The high variability of the occurrence of corrosion in the clinical application highlights its multi-factorial nature, identifying the implantation procedure and patient-related factors as important additional factors for taper corrosion. Discontinuing the use of MoM has reduced the revisions due to metal-related pathologies dramatically from 49.7% (MoM > 32 mm), over 9.2% (MoM ⩽ 32 mm) to 0.8% (excluding all MoM). Further reduction can be achieved by omitting less stiff Ti-alloys and large metal heads (36 mm and above) against polyethylene (PE). Standardized taper assembly of smaller and ceramic heads will reduce the clinical occurrence of taper corrosion even further. If 36 mm heads are clinically indicated, only ceramic heads should be used. Taper-related problems will not comprise a major clinical problem anymore if the mentioned factors are respected. Cite this article: EFORT Open Rev 2020;5:776-784. DOI: 10.1302/2058-5241.5.200013 British Editorial Society of Bone and Joint Surgery 2020-11-13 /pmc/articles/PMC7722945/ /pubmed/33312704 http://dx.doi.org/10.1302/2058-5241.5.200013 Text en © 2020 The author(s) https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Hip
Morlock, Michael M.
Hube, Robert
Wassilew, Georgi
Prange, Felix
Huber, Gerd
Perka, Carsten
Taper corrosion: a complication of total hip arthroplasty
title Taper corrosion: a complication of total hip arthroplasty
title_full Taper corrosion: a complication of total hip arthroplasty
title_fullStr Taper corrosion: a complication of total hip arthroplasty
title_full_unstemmed Taper corrosion: a complication of total hip arthroplasty
title_short Taper corrosion: a complication of total hip arthroplasty
title_sort taper corrosion: a complication of total hip arthroplasty
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722945/
https://www.ncbi.nlm.nih.gov/pubmed/33312704
http://dx.doi.org/10.1302/2058-5241.5.200013
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