BACKGROUND: Adverse local tissue reactions (ALTRs) due to tribocorrosion of head-neck taper junctions in contemporary metal-on-polyethylene (MoP) total hip arthroplasty (THA) are emerging as an important reason for failure requiring revision surgery. This study aimed at: (1) reporting early complication rates and outcome, and (2) identifying risk factors associated with complications of revision surgery for head-neck taper corrosion in patients with MoP THA. METHODS: Forty consecutive revision surgeries in 39 patients (male, 16; female, 23) with MoP THA were evaluated. The follow-up period after revision was a minimum of 14 months (range, 14-45). The indication for revision surgery was the presence of symptomatic ALTR on magnetic resonance imaging (MRI) with elevated metal ion levels. RESULTS: The overall complication rate was 25% and the reoperation rate was 10%. The median serum level of cobalt ions decreased significantly 8.2 μg/L (1.2-56.1 μg/L) pre-revision to 3.1 μg/L (0.2-14.0 μg/L) post-revision (P < .01). High fretting and corrosion grades (Goldberg score ≥ 3) were observed in 82% of retrieved implants. MRI findings of solid lesion(s) with abductor deficiency (P < .01) and intraoperative tissue damage at revision (P = .02) were significantly associated with post-revision complications. CONCLUSION: A high rate of early complications (25%) and re-revisions (10%) was observed after revision of ALTR associated with head-neck taper corrosion. Pre-revision MRI findings of solid lesion(s) with abductor deficiency and intraoperative tissue damage were risk factors associated with the occurrence of a complication after revision surgery. This information provides clinically useful information for clinical decision-making and preoperative counseling of MoP THA patients undergoing revision surgery for head-neck taper corrosion.
BACKGROUND: Adverse local tissue reactions (ALTRs) due to tribocorrosion of head-neck taper junctions in contemporary metal-on-polyethylene (MoP) total hip arthroplasty (THA) are emerging as an important reason for failure requiring revision surgery. This study aimed at: (1) reporting early complication rates and outcome, and (2) identifying risk factors associated with complications of revision surgery for head-neck taper corrosion in patients with MoP THA. METHODS: Forty consecutive revision surgeries in 39 patients (male, 16; female, 23) with MoP THA were evaluated. The follow-up period after revision was a minimum of 14 months (range, 14-45). The indication for revision surgery was the presence of symptomatic ALTR on magnetic resonance imaging (MRI) with elevated metal ion levels. RESULTS: The overall complication rate was 25% and the reoperation rate was 10%. The median serum level of cobalt ions decreased significantly 8.2 μg/L (1.2-56.1 μg/L) pre-revision to 3.1 μg/L (0.2-14.0 μg/L) post-revision (P < .01). High fretting and corrosion grades (Goldberg score ≥ 3) were observed in 82% of retrieved implants. MRI findings of solid lesion(s) with abductor deficiency (P < .01) and intraoperative tissue damage at revision (P = .02) were significantly associated with post-revision complications. CONCLUSION: A high rate of early complications (25%) and re-revisions (10%) was observed after revision of ALTR associated with head-neck taper corrosion. Pre-revision MRI findings of solid lesion(s) with abductor deficiency and intraoperative tissue damage were risk factors associated with the occurrence of a complication after revision surgery. This information provides clinically useful information for clinical decision-making and preoperative counseling of MoP THA patients undergoing revision surgery for head-neck taper corrosion.
Authors: Christian Klemt; Sakkadech Limmahakhun; Georges Bounajem; Christopher M Melnic; Michael J Harvey; Young-Min Kwon Journal: Arch Orthop Trauma Surg Date: 2021-04-09 Impact factor: 2.928
Authors: Peter K Sculco; Timothy Wright; Michael-Alexander Malahias; Alexander Gu; Mathias Bostrom; Fares Haddad; Seth Jerabek; Michael Bolognesi; Thomas Fehring; Alejandro Gonzalez DellaValle; William Jiranek; William Walter; Wayne Paprosky; Donald Garbuz; Thomas Sculco Journal: HSS J Date: 2021-09-28
Authors: Christian M Wight; Cari M Whyne; Earl R Bogoch; Radovan Zdero; Ryan M Chapman; Douglas W van Citters; William R Walsh; Emil Schemitsch Journal: Bone Jt Open Date: 2021-11
Authors: Matthew T Houdek; Michael J Taunton; Cody C Wyles; Paul J Jannetto; David G Lewallen; Daniel J Berry Journal: J Arthroplasty Date: 2021-05-01 Impact factor: 4.435