How to diagnose taper corrosion

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  • When to suspect corrosion
  • Pain as a possible initial symptom
  • Is it an infection?
  • Serum metal levels may be elevated
  • Evidence of adverse local tissue reaction?
  • Use of imaging technology
  • Rare cases
  • Conclusion
  • References

Part 1 | Risk factors for taper corrosion in total hip arthroplasty

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Part 3 | Surgical options for addressing taper corrosion

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Contributing experts

This series of articles was created with the support of the following specialists (in alphabetical order):

Moussa Hamadouche

Cochin University Hospital
Paris, France

Michael Morlock

Hamburg University of Technology
Hamburg, Germany

Carsten Perka

Charité—University Medicine Berlin
Berlin, Germany

 

This issue was created by Word+Vision Media Productions, Switzerland

References

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  2. Morlock M, Bünte D, Gührs J, et al. Corrosion of the head-stem taper junction—Are we on the verge of an epidemic? HSS J. 2016 Oct;12(3).
  3. Lash NJ, Whitehouse MR, Greidanus NV, et al. Delayed dislocation following metal-on-polyethylene arthroplasty of the hip due to 'silent' trunnion corrosion. Bone Joint J. 2016 Feb;98-B(2):187-193.
  4. Cooper HJ, Della Valle CJ, Berger RA, et al. Corrosion at the head-neck taper as a cause for adverse local tissue reactions after total hip arthroplasty. J Bone Joint Surg Am. 2012 Sep 19;94(18):1655-1661.
  5. Kwon YM. Evaluation of the painful dual taper modular neck stem total hip arthroplasty: Do they all require revision? J Arthroplasty. 2016 Jul;31(7):1385-1389.
  6. Jennings J, Dennis D, Yang C. Corrosion of the head-neck junction after total hip arthroplasty. J Am Acad Orthop Surg. 2016 Jun;24(6):349-356.
  7. Whitehouse MR, Endo M, Zachara S, et al. Adverse local tissue reactions in metal-on-polyethylene total hip arthroplasty due to trunnion corrosion: the risk of misdiagnosis. Bone Joint J. 2015 Aug;97-B(8):1024-1030.
  8. Weiser MC, Chen DD. Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls. Curr Rev Musculoskelet Med. 2016 Mar; 9(1): 75–83.
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  11. Nam D, Nunley RM, Sauber TJ, et al. Incidence and Location of Pain in Young, Active Patients Following Hip Arthroplasty. J Arthroplasty. 2015 Nov;30(11):1971-1975.
  12. Matsen Ko L, Coleman JJ, Stas V, et al. Iliopsoas irritation as presentation of head-neck corrosion after total hip arthroplasty: a case series. Orthop Clin North Am. 2015 Oct;46(4):461-468.
  13. Fehring KA, Fehring TK. Modes of failure in metal-on-metal total hip arthroplasty. Orthop Clin North Am. 2015 Apr;46(2):185-192.
  14. Cooper JH, Urban RM, Wixson RL. Adverse local tissue reaction arising from corrosion at the femoral neck-body junction in a dual-taper stem with a cobalt-chromium modular neck. J Bone Joint Surg Am. 2013 May 15; 95(10): 865–872.
  15. Prieto HA, Berbari EF, Sierra RJ. Acute delayed infection: increased risk in failed metal on metal total hip arthroplasty. J Arthroplasty. 2014 Sep;29(9):1808-1812.
  16. Cooper JH, Urban RM, Wixson RL. Adverse local tissue reaction arising from corrosion at the femoral neck-body junction in a dual-taper stem with a cobalt-chromium modular neck. J Bone Joint Surg Am. 2013 May 15; 95(10): 865–872.
  17. Levine BR, Hsu AR, Skipor AK, et al. Ten-year outcome of serum metal ion levels after primary total hip arthroplasty: a concise follow-up of a previous report*. J Bone Joint Surg Am. 2013 Mar 20;95(6):512-8.
  18. Wyles CC, McArthur BA, Wagner ER, et al. Ceramic femoral heads for all patients? An argument for cost containment in hip surgery. Am J Orthop (Belle Mead NJ). 2016 Sep/Oct;45(6):E362-E366.
  19. Kwon YM, Fehring TK, Lombardi AV, et al. Risk stratification algorithm for management of patients with dual modular taper total hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons and the Hip Society. J Arthroplasty. 2014 Nov; 29(11):2060-2064.
  20. Fehring TK, Carter JL, Fehring KA, et al. Cobalt to chromium ratio is not a key marker for adverse local tissue reaction (ALTR) in metal on metal hips. J Arthroplasty. 2015 Sep; 30(9 Suppl):107-109.
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  22. Bisseling P, de Wit BW, Hol AM, et al. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study. Bone Joint J. 2015 Sep;97-B(9):1175-1182.
  23. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979 Jun;(141):17-27.
  24. Toms AP, Marshall TJ, Cahir J, et al. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips. Clinical Radiology. 2008 63(1):49–58.
  25. Tower S. Arthroprosthetic cobaltism: identification of the at-risk patient. Alaska Med. 2010 Sep;52:28-32.
  26. Martin JR, Spencer-Gardner L, Camp CL, et al. Cardiac cobaltism: a rare complication after bilateral metal-on-metal total hip arthroplasty. [Case report] Arthroplasty Today. 2015 Dec;1(4):99-102. Available at: http://www.sciencedirect.com/science/article/pii/S2352344115000710 Accessed October 21, 2016.