Authors: Heiko Meyer Tina Mueller Gesine Goldau Kathrin Chamaon Marcel Ruetschi Christoph H Lohmann
Publish Date: 2012/08/03
Volume: 470, Issue: 11, Pages: 3101-3108
Abstract
We therefore determined 1 if corrosion occurred at the cone/taper interface leading to instability in patients with largediameter THAs 2 how patients presented clinically and radiographically 3 if adverse periprosthetic tissue reactions occurred 4 whether metal was released from the implants into the periprosthetic tissues and 5 if head size correlated with metal releaseWe reviewed 114 patients who had revisions of largediameter head MoM articulations Mean time of implantation was 46 months To identify adverse reactions and particle load tissues were stained by hematoxylin and eosin and CD3/CD20/CD68 antibodies Periprosthetic tissues were analyzed for metal content and distribution in different regions Electrochemical reactions between the stem and adapter were investigated by a minicell electrodeElectrochemical studies on the stem and the head adapter showed a risk for galvanic corrosion Ninetyfour percent of patients had instability at the cone/taper interface All patients presented with early clinical symptoms 59 patients had radiographic signs of loosening One hundred four patients had foreign body reactions and necrosis The largest amounts of metal released were titanium or iron We found no correlation between head size and metal ion releaseThese findings suggest that in modular cone/taper connections friction of the MoM articulations may cause failure of the cone/taper interface leading to galvanic corrosion and loosening It is unclear whether the design of this MoM system provides sufficient stability at the taperWe thank Dr B Feuerstein and Dr G Krause for technical support in the analysis of metal contents Mrs Carolin Hertzsch for help with the histological stainings Dr F Awiszus for statistical analyses and Dr D Brauers for providing demographic data of the patients
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