Catastrophic Femoral Neck Failure after THA with the Accolade® I Stem in Three Patients

Spanyer, Jonathon; Hines, Jennifer; Beaumont, Christopher M.; Yerasimides, Jonathan

doi:10.1007/s11999-015-4438-z

Cited by 27 publications

(24 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A further contributing factor is the accelerated corrosion of TMZF in simulated body fluid in comparison to Ti6Al4V, which might further precipitate the process [30]. It is surprising that the catastrophic GTF cases did apparently not exhibit clinical symptoms due to raised Co and Cr metal ions, which must have been caused by the amount of CoCr lost from the female head taper (above 15mm³, Figure 6, Figure 7), and/or the large amounts of taper, even so the extend is much larger [9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies on elevated metal ion levels or even catastrophic gross taper failures (GTF) after hip joint replacement highlight one particular stem design with a small V-40 taper made from a less stiff Ti-12Mo-6Zr-2Fe titanium-alloy (TMZF; Accolade I, Stryker, Mahwah, NJ) in combination with head sizes of mostly 36mm and above ( Figure 1) [9][10][11][12][13][14][15][16][17][18]. This proprietary beta titanium alloy was introduced in 2002 based on the potential benefits of more closely mimicking the modulus of elasticity of cortical bone than standard Ti-6Al-4V alloys [19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Head Taper Corrosion Causing Head Bottoming Out and Consecutive Gross Stem Taper Failure in Total Hip Arthroplasty

Morlock

Dickinson

Günther

et al. 2018

The Journal of Arthroplasty

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Head Taper Corrosion Causing Head Bottoming Out and Consecutive Gross Stem Taper Failure in Total Hip Arthroplasty

Morlock

Dickinson

Günther

et al. 2018

The Journal of Arthroplasty

View full text Add to dashboard Cite

show abstract

“…Head-neck taper corrosion was not listed as a potential mode of failure as part of the recall. These two types of failure have been observed across a range of other manufacturers as a rare event[6–10, 19–22]. …”

Section: Discussionmentioning

confidence: 99%

“…Clinical studies have reported ALTR association with head-neck taper corrosion[6, 7] and with gross trunnion failure (GTF)[8]. A small series of cases involving GTF with the Low Friction Ion Treatment (LFIT) CoCr femoral head and the Accolade titanium-molybdenum-zirconium-iron alloy (TMZF) stem, as well as other designs, has also been reported[9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head

Urish

Hamlin

Plakseychuk

et al. 2017

The Journal of Arthroplasty

View full text Add to dashboard Cite

Background Gross trunnion failure (GTF) is a rare complication in total hip arthroplasty reported across a range of manufacturers. Specific lots of the Stryker LFIT Anatomic cobalt chromium alloy (CoCr) V40 femoral head were recalled in August of 2016. In part, the recall was based out of concerns for disassociation of the femoral head from the stem and GTF. Methods We report on 28 patients (30 implants) with either GTF (n=18) or head-neck taper corrosion (n=12) of the LFIT CoCr femoral head and the Accolade TMZF femoral stems. All of these cases were associated with adverse local tissue reaction (ALTR) requiring revision of the THA. Results In our series, a conservative estimate of the incidence of failure was 4.7% (n = 636 total implanted) at 8.0±1.4 years from the index procedure. Failures were associated with a high offset 127° femoral stem nec k angle and increased neck lengths. 43.3% (13/30) of the observed failures included implant sizes outside of the voluntary recall (27.8% (5/18) of the GTF and 75.0% (8/12) of the taper corrosion cases). Serum cobalt and chromium levels were elevated (Cobalt: 8.4±7.0μg/mL; Chromium: 3.4±3.3μ/L; Cobalt/Chromium ratio: 3.7). MARS MRI demonstrated large cystic fluid collections typical with ALTR. During revision, a pseudotumor was observed in all cases. Pathology suggested a chronic inflammatory response. Impending GTF could be diagnosed based on aspiration of black synovial fluid and an oblique femoral head as compared to the neck taper on radiographs. Conclusion In our series of the recalled LFIT CoCr femoral head, the risk of impending GTF or head-neck taper corrosion should be considered as a potential diagnosis in a painful Accolade TMZF THA with unknown etiology. Almost half of the failures we observed included sizes outside of the voluntary recall.

show abstract

“…Fracture of the femoral component of a total hip arthroplasty is a rare cause for revision compared with infection, aseptic loosening, and instability [1] , [2] . Fracture of both cemented and cementless femoral component stems has been reported [1] , [2] , [3] , [4] . In the 1970s, the reported rate of stem fracture ranged from 0.23% to 10.7% [3] , [4] , [5] .…”

Section: Introductionmentioning

confidence: 99%

Fracture of the neck of an uncemented femoral component unrelated to trunnion corrosion

et al. 2019

View full text Add to dashboard Cite

This is the first report, to our knowledge, of a fracture, unrelated to trunnion corrosion, through the midneck of a well-fixed uncemented cobalt-chromium alloy femoral component that had been implanted via a total hip revision arthroplasty 25 years ago. Three years after a second revision for polyethylene wear, the patient noted an acute onset of pain in the left hip. There was no antecedent pain in the hip or thigh. Radiographs and intraoperative findings showed a well-fixed femoral component. Electron microscopic retrieval analysis showed intergranular material cracks. Revision of the femoral component was performed with an extended trochanteric osteotomy. This fracture of the femoral component neck was likely related to metal fabrication techniques, and surveillance of this component may be warranted.

show abstract

Catastrophic Femoral Neck Failure after THA with the Accolade® I Stem in Three Patients

Cited by 27 publications

References 17 publications

Head Taper Corrosion Causing Head Bottoming Out and Consecutive Gross Stem Taper Failure in Total Hip Arthroplasty

Head Taper Corrosion Causing Head Bottoming Out and Consecutive Gross Stem Taper Failure in Total Hip Arthroplasty

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head

Fracture of the neck of an uncemented femoral component unrelated to trunnion corrosion

Contact Info

Product

Resources

About