The Relation Between Titanium Taper Corrosion and Cobalt-Chromium Bearing Wear in Large-Head Metal-on-Metal Total Hip Prostheses

Witt, F.; Bosker, B. H.; Bishop, Nick; Ettema, Harmen B.; Verheyen, Cees C. P. M.; Morlock, Michael M.

doi:10.2106/jbjs.m.01199

Cited by 58 publications

(48 citation statements)

References 45 publications

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“…When the rates of the whole data, incorporating the edge worn values are compared to the rates of loss those of the previous studies [15,[19][20][21][22][23]30], the current values sit within the range presented in Table 1.…”

Section: Discussionmentioning

confidence: 73%

The Performance of Mixed Manufacturer Metal On Metal Total Hip Replacements

2017

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Using a femoral head from one manufacturer on the stem of another manufacturer poses the risk that the taper interface between the components may not contact correctly and the performance of the joint will be impaired. The cohorts in this study are a combination of modular Birmingham Hip Resurfacing (BHR) and Adept femoral heads on CPT stems. The study reviews the geometry of the taper interfaces to establish if the taper clearance angles was outside of the normal range for other taper interfaces. In addition the rates of material loss from the bearings and taper and a ranking of the stem damage were reviewed to determine if the levels of loss were above that seen for other similar joints.The material loss analysis demonstrated that the rates or levels of loss from the bearings, taper and stem were no different to levels published for manufacturer matched joints and in many cases were lower. The results demonstrate that the taper clearance angles for the mixed manufacturer joints (BHR-CPT: 0.067 to -0.116, Adept-CPT: 0.101 to -0.056) were within the range of other studies and manufacturer matched clearances (0.134 to -0.149).Using components from different manufacturers has not in this instance increased the level of material loss from the joints, when compared to other similar manufacturer matched joints.

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Section: Discussionmentioning

confidence: 73%

The Performance of Mixed Manufacturer Metal On Metal Total Hip Replacements

2017

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“…However, such has been the fallout from the revelation that MoM implants are negatively impacting on the patients who receive them, a large body of work has been undertaken to understand the reason for patients’ adverse reactions to different material types at the molecular level [3, 16, 19, 22]. This work includes examination of components of the implant such as the taper junction and acetabular cup interface [1, 26]. …”

Section: Discussionmentioning

confidence: 99%

Bearings in Hip Arthroplasty: Joint Registries vs Precision Medicine

Pearson

Grover

Lord

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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BackgroundPrecision medicine has been adopted in a range of clinical settings where omics data have led to greater characterisation of disease and stratification of patients into subcategories of phenotypes and pathologies. However, in orthopaedics, precision medicine lags behind other disciplines such as cancer. Joint registries have now amassed a huge body of data pertaining to implant performance which can be broken down into performance statistics for different material types in different cohorts of patients. The National Joint Registry of England, Wales and Northern Ireland (NJR) is now one of the largest datasets available. Other registries such as those from Sweden and Australia however contain longer follow-up. Together, these registries can provide a wealth of informative for the orthopaedics community when considering which implant to give to any particular patient.Questions/PurposesWe aim to explore the benefits of combining multiple large data streams including joint registries, published data on osteoarthritis (OA) pathogenesis and pathology and data concerning performance of each implant material combination in terms of biocompatibility. We believe that this analysis will provide a comprehensive overview of implant performance hopefully aiding surgeons in making more informed choices about which implant should be used in which patient.MethodsData from three joint registries were combined with established literature to highlight the heterogeneity of OA disease and the different clinical outcomes following arthroplasty with a range of material types.ResultsThis review confirms that joint registries are unable to consider differences in arthritis presentation or underlying drivers of pathology. OA is now recognised to present with varying pathology with differing morbidity in different patient populations. Equally, just as OA is a heterogeneous disease, there are disparate responses to wear debris from different material combinations used in joint replacement surgery. This has been highlighted by recent high-profile scrutiny of early failure of metal-on-metal total hip replacement (THR) implants.ConclusionsBringing together data from joint registries, biomarker analysis, phenotyping of OA patients and knowledge of how different patients respond to implant debris will lead to a truly personalised approach to treating OA patients, ensuring that the correct implant is given to the correct patient at the correct time.Electronic supplementary materialThe online version of this article (doi:10.1007/s11420-016-9531-7) contains supplementary material, which is available to authorized users.

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“…How the mechanical and biologic factors interact with taper design needs further review and discussion. There has been some literature implicating the effect of edge loading [27][28][29] and low clearance [27] on failure of metal-onmetal hip arthroplasty. The effect on metal-on-polyethylene THAs is less clear.…”

Section: Discussionmentioning

confidence: 99%

Effect of Taper Design on Trunnionosis in Metal on Polyethylene Total Hip Arthroplasty

Tan

Teeter

Balso

et al. 2015

The Journal of Arthroplasty

104

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Keywords:taper corrosion taper design trunnionosis metal-on-polyethylene total hip arthroplasty This study examines how taper design affects corrosion and fretting at the head trunnion surface. All hip prostheses retrieved between 1999 and 2013 with 28 mm/+0 heads were selected, resulting in 44 cobalt-chrome-onpolyethylene implants, representing six taper designs. Mean implantation time: 8.9 ± 3.7 years. The femoral head tapers were scored for fretting and corrosion using the Goldberg scale as both a combined score and by three zones (apex, central and base). There was no difference in age (P = 0.34), BMI (P = 0.29), or implantation time (P = 0.19) between taper groups. The 11/13 taper had the highest combined corrosion and fretting score, but no difference (P = 0.22) between groups for combined scores (P = 0.22 for corrosion, P = 0.19 for fretting). In a zone-specific analysis, the 11/13 taper had highest corrosion score at base zone (P = 0.02). Taper design had a significant effect on corrosion at base of trunnion.Crown

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The Relation Between Titanium Taper Corrosion and Cobalt-Chromium Bearing Wear in Large-Head Metal-on-Metal Total Hip Prostheses

Cited by 58 publications

References 45 publications

The Performance of Mixed Manufacturer Metal On Metal Total Hip Replacements

The Performance of Mixed Manufacturer Metal On Metal Total Hip Replacements

Bearings in Hip Arthroplasty: Joint Registries vs Precision Medicine

Effect of Taper Design on Trunnionosis in Metal on Polyethylene Total Hip Arthroplasty

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