Whittaker, RK;
Zaghloul, AM;
Hothi, HS;
Siddiqui, IA;
Blunn, GW;
Skinner, JA;
Hart, AJ;
(2017)
Clinical Cold Welding of the Modular Total Hip Arthroplasty Prosthesis.
The Journal of Arthroplasty
, 32
(2)
pp. 610-615.
10.1016/j.arth.2016.07.020.
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Abstract
BACKGROUND: A head that is "clinically cold welded" to a stem is one of the commonest reasons for unplanned removal of the stem. It is not clear which hip designs are at greatest risk of clinical cold welding. METHODS: This was a case-control study of consecutively received hip implant retrievals; we chose the design of hip that had the greatest number of truly cold-welded heads (n = 11). For our controls, we chose retrieved hips of the same design but without cold welding of the head (n = 35). We compared the clinical variables between these 2 groups using nonparametric Mann-Whitney tests to investigate the significance of differences between the cold-welded and non-cold-welded groups. RESULTS: The design that most commonly caused cold welding was a combination of a Ti stem and Ti taper: 11 out of 48 (23%) were truly cold welded. Comparison of the clinical data showed that no individual factor could be used to predict this preoperatively with none of the 4 predictors tested showing any significance: (1) time to revision (P = .687), (2) head size (P = .067), (3) patient age at primary (P = .380), and (4) gender (P = .054). CONCLUSION: We have shown that clinical cold welding is most prevalent in Ti-Ti combinations of the stem and taper; approximately 25% of cases received at our center were cold welded. Analysis of clinical variables showed that it is not possible to predict which will be cold welded preoperatively. Surgeons should be aware of this potential complication when revising a Ti-Ti stem/head junction.
| Type: | Article |
|---|---|
| Title: | Clinical Cold Welding of the Modular Total Hip Arthroplasty Prosthesis. |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.arth.2016.07.020 |
| Publisher version: | http://doi.org/10.1016/j.arth.2016.07.020 |
| 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 http://creativecommons.org/ licenses/by/4.0. Access may be initially restricted by the publisher. |
| Keywords: | Cold welding, corrosion, hip, metal-on-metal, retrieval |
| 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/1519992 |
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