Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls
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Molloy DO, Munir S, Jack CM, Cross MB, Walter WL, Walter Sr WK. Fretting and corrosion in modular-neck total hip arthroplasty femoral stems. J Bone Joint Surg Am. 2014;96(6):488–93. Article is of importance as it confirmed the clinical, radiographic, and intra-operative findings of neck-stem mechanically assisted corrosion in the Stryker ABGII femoral stem.CrossRef PubMed
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Meftah M, Haleem AM, Burn MB, Smith KM, Incavo SJ. Early corrosion-related failure of the rejuvenate modular total hip replacement system. J Bone Joint Surg Am. 2014;96(6):481–7. Article is of importance as it confirmed the clinical, radiographic, and intra-operative findings of neck-stem mechanically assisted corrosion in the Stryker Rejuvenate femoral stem.CrossRef PubMed
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Yi PH, Cross MB, Moric M, Levine BR, Sporer SM, Paprosky WG, et al. Do serologic and synovial tests help diagnose infection in revision hip arthroplasty with metal-on-metal bearings or corrosion? Clin Orthop Relat Res. 2015;473(2):498–505. Article is of major importance as it outlines the diagnostic difficulty in differentiating PJI in patients with corroded modular neck femoral stems and makes a cutoff recommendations for cell counts indicative of PJI in these cases.PubMedCentral CrossRef PubMed
文摘
The management of the patient with a recalled, modular neck-body total hip arthroplasty can be complex, as it involves a combination of clinical, technical, and medicolegal challenges. Management begins with a thorough history and physical exam, radiographic evaluation, infection workup, and serum metal ion levels. Three-dimensional imaging is obtained based on patient symptomatology and metal ion levels and is used to evaluate for the presence of an adverse local tissue response as well as the integrity of the existing soft tissue envelope. The decision to perform revision surgery is based on a combination of patient symptomatology, laboratory values, and imaging findings. Revision surgery involves the entire armamentarium of femoral revision techniques, and the acetabulum may need to be revised at the surgeon’s discretion. The femoral implant can often be removed without disrupting the femoral bone envelope; however, the surgeon should have a low threshold to perform an extended trochanteric osteotomy.