Head taper corrosion causing head bottoming out and consecutive gross stem taper failure in total hip arthroplasty
| Autor: | Emilie C. Dickinson, Valerie Polster, Dennis Bünte, Michael M. Morlock, Klaus-Peter Günther |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Chromium Male Arthroplasty Replacement Hip Prosthesis Design Corrosion 03 medical and health sciences Tip clearance 0302 clinical medicine TMZF Humans Medicine gross taper failure Orthopedics and Sports Medicine 030212 general & internal medicine ddc:610 Composite material Taper corrosion Aged Titanium 030222 orthopedics business.industry Abrasive Titanium alloy head size Cobalt Middle Aged Prosthesis Failure taper corrosion Medizin [610] Polyethylene disassociation Head (vessel) Female Chromium Alloys Hip Prosthesis Implant Deformation (engineering) business |
| Zdroj: | The Journal of arthroplasty 11 (33): 3581-3590 (2018-11) |
| Popis: | Background Taper corrosion in total hip arthroplasty for bearings with metal heads against polyethylene has developed from an anecdotal observation to a clinical problem. Increased taper wear and even gross taper failure have been reported for one particular design. It is hypothesized that corrosion of the female head taper results in taper widening, allowing the cobalt-chromium head to turn on the stem and wear down the softer titanium alloy by abrasive wear, ultimately causing failure. The purpose of this study is to investigate the time course of this process and the general role of taper dimensions and material in this problem. Methods Retrieved cobalt-chromium alloy heads (n = 30, LFIT; Stryker, Mahwah, NJ) and Ti-12Mo-6Zr-2Fe (TMZF) stems (n = 10, Accolade I; Stryker) were available for analysis. Taper material loss was determined using three-dimensional coordinate measurements and scanning. The pristine tip clearance between head and stem was analytically determined. The influence of taper material and taper size on taper deformation and micromotion was investigated using a finite element model. Results Material loss at the head taper increased with time in situ up to a volume of 20.8 mm3 (P Conclusion A 11/13 TMZF taper design with 36-mm head diameters bears a higher risk for corrosion than larger tapers made from stiffer materials. Failures of this combination are not restricted to the head sizes included in the recall. Patients with this implant combination should be closely monitored. |
| Databáze: | OpenAIRE |
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