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

Hothi, HS; Panagiotopoulos, AC; Whittaker, RK; Bills, PJ; McMillan, RA; Skinner, JA; Hart, AJ; (2017) Damage Patterns at the Head-Stem Taper Junction Helps Understand the Mechanisms of Material Loss. The Journal of Arthroplasty , 32 (1) pp. 291-295. 10.1016/j.arth.2016.06.045. Green open access

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Abstract

BACKGROUND: 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. METHODS: We 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. RESULTS: We found that 63 implants had "minimal damage" at the taper (material loss <1 mm(3)), 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. CONCLUSION: These 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.

Type: Article
Title: Damage Patterns at the Head-Stem Taper Junction Helps Understand the Mechanisms of Material Loss
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.arth.2016.06.045
Publisher version: http://doi.org/10.1016/j.arth.2016.06.045
Language: English
Additional information: © 2016 Elsevier Inc. All rights reserved. This manuscript version is made available under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at https://creativecommons.org/licenses/. Access may be initially restricted by the publisher.
Keywords: Corrosion, material loss, metal-on-metal, retrieval, taper, wear
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/1508544
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