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General Orthopaedics

FEMORAL TAPEROSIS: A CONSEQUENCE OF MODULAR TOTAL HIP DESIGNS

Current Concepts in Joint Replacement (CCJR) – Spring 2015



Abstract

Corrosion at metal/metal modular interfaces in total hip arthroplasty was first described in the early 1990's, and the susceptibility of modular tapers to mechanically assisted crevice corrosion (MACC), a combination of fretting and crevice corrosion, was subsequently introduced. Since that time, there have been numerous reports of corrosion at this taper interface, documented primarily in retrieval studies or in rare cases of catastrophic failure.

We have reported that fretting corrosion at the modular taper may produce soluble and particulate debris that can migrate locally or systemically, and more recently reported that this process can cause an adverse local tissue reaction. Based on the type of tissue reaction and the presence of elevated serum metal ion levels, this process appears quite similar to adverse local tissue reactions secondary to metal-on-metal bearing surfaces. While modularity in THR has demonstrable clinical benefits, modular junctions increase the risk of corrosion and the types of adverse soft tissue reactions seen in patients with accelerated metal release from metal-on-metal bearing THRs.