CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY

Y-M. Kwon; S. An; S. Limmahakhun; P. Arauz; C. Klemt

doi:10.1302/1358-992X.2019.12.010

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CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY

The Hip Society (THS) 2019 Summer Meeting, Kohler, WI, USA, 25–27 September 2019.

Y-M. Kwon
S. An
S. Limmahakhun
P. Arauz
C. Klemt

CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY

Kwon Y, An S, Limmahakhun S, Arauz P, Klemt C. CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY. Orthop Procs. 2019;101-B(SUPP_12):10-10. doi:10.1302/1358-992X.2019.12.010

Kwon, Y-M., et al. “CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, vol. 101-B, no. SUPP_12, 2019, pp. 10-10., https://doi.org/10.1302/1358-992X.2019.12.010

Kwon, Y., An, S., Limmahakhun, S., Arauz, P., & Klemt, C. (2019). CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY. Orthopaedic Proceedings, 101-B(SUPP_12), 10-10. https://doi.org/10.1302/1358-992X.2019.12.010

Kwon, Y., An, S., Limmahakhun, S., Arauz, P. and Klemt, C. (2019) “CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, 101-B(SUPP_12), pp. 10-10. Available at: https://doi.org/10.1302/1358-992X.2019.12.010

Kwon, Y-M., S. An, S. Limmahakhun, P. Arauz, and C. Klemt. “CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings 101-B, no. SUPP_12 (2019): 10-10. https://doi.org/10.1302/1358-992X.2019.12.010

Kwon Y, An S, Limmahakhun S, Arauz P, Klemt C. CLINICAL RISK FACTORS ASSOCIATED WITH ADVERSE LOCAL TISSUE REACTION IN HEAD-NECK TAPER CORROSION OF PRIMARY METAL-ON-POLYETHYLENE TOTAL HIP ARTHROPLASTY. Orthop Procs. 2019 Oct 1;101-B(SUPP_12):10-10. https://doi.org/10.1302/1358-992X.2019.12.010

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Abstract

Background

Adverse local tissue reactions (ALTR) in metal-on-polyethylene (MoP) total hip arthroplasty (THA) with head-neck taper corrosion is likely to be multifactorial involving implant and patient factors. However, there is a paucity of clinical data on implant parameters as predisposing factors in MoP head-neck taper corrosion. The aim of this study was to identify any potential implant factors associated with failed MoP THA due to head-neck taper corrosion.

Methods

A total of 67 MoP THA patients in two groups was investigated: 1) ALTR (n=38) on MARS MRI and 2) non-ALTR (n=29) on MARS MRI. All patients had highly cross-linked polyethylene liners with cobalt-chromium femoral heads with a single head-neck modularity. Parameters compared between groups included: acetabular component orientation, femoral neck shaft angle, radiographic measurement of medial and vertical femoral offsets, limb length discrepancy, component size, femoral head offset, implant type, femoral stem alloy and taper design.

Results

The occurrence of ALTR was associated with increased femoral head offset (non-ALTR vs. ALTR, 0.5 ± 3.7 vs. 4.1 ± 3.6, p = 0.008), increased radiographic femoral stem offset (35.9 ± 7.4 mm vs 40.7 ± 7.1mm, p = 0.018), and the use of TMZF alloy stems (p = 0.051). The presence of ALTR was significantly associated with higher cobalt (9.1 µg/L vs. 0.4µg/L, p=0.001) and chromium (2.6µg/L vs. 0.4µg/L). A significant correlation was identified between the serum cobalt level and the femoral stem offset (R=0.375, p=0.009).

Conclusions

Although the occurrence of head-neck taper corrosion in MoP THA is likely to be an interplay between implant and patient factors, the results of this study identified increased femoral head and stem offset and the use of TMZF alloy stems as risk factors associated with clinically relevant ALTR due to head-neck taper corrosion in MoP THA patients. The study provides evidenced-based information in risk stratification of symptomatic MoP THA patients for head-neck taper corrosion.

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