Damage Patterns at the Head-Stem Taper Junction Helps Understand the Mechanisms of Material Loss

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• 作者：Harry S. Hothi ; BEng ; MSc ; PhD^a ; ; Andreas C. Panagiotopoulos ; MSc^a ; Robert K. Whittaker ; BSc ; MSc^a ; Paul J. Bills ; BEng ; MSc ; PhD^b ; Rebecca A. McMillan ; BSc ; MBBS^a ; John A. Skinner ; MBBS ; FRCS (Eng) ; FRCS (Orth)^a ; Alister J. Hart ; MA ; MD ; FRCS (Orth)^a
• 关键词：metal-on-metal ; taper ; material loss ; wear ; corrosion ; retrieval
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：32
• 期：1
• 页码：291-295
• 全文大小：585 K
• 卷排序：32

文摘

Material loss at the taper junction of metal-on-metal total hip arthroplasties has been implicated in their early failure. The mechanisms of material loss are not fully understood; analysis of the patterns of damage at the taper can help us better understand why material loss occurs at this junction.MethodsWe mapped the patterns of material loss in a series of 155 metal-on-metal total hip arthroplasties received at our center by scanning the taper surface using a roundness-measuring machine. We examined these material loss maps to develop a 5-tier classification system based on visual differences between different patterns. We correlated these patterns to surgical, implant, and patient factors known to be important for head-stem taper damage.ResultsWe found that 63 implants had “minimal damage” at the taper (material loss <1 mm3), and the remaining 92 implants could be categorized by 4 distinct patterns of taper material loss. We found that (1) head diameter and (2) time to revision were key significant variables separating the groups.ConclusionThese material loss maps allow us to suggest different mechanisms that dominate the cause of the material loss in each pattern: (1) corrosion, (2) mechanically assisted corrosion, or (3) intraoperative damage or poor size tolerances leading to toggling of trunnion in taper.