Metal-on-Metal Compared With Metal-on-Polyethylene: The Effect on Trunnion Corrosion in Total Hip Arthroplasty

Trunnion tribocorrosion in total hip arthroplasties is concerning, but retrieval studies often are subjective or lack comparison groups. Quantitative comparisons of clinically relevant implants are required. The purpose of this investigation was to evaluate material loss in metal-on-metal (MoM) and...

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Bibliographic Details
Published in:The Journal of arthroplasty Vol. 32; no. 8; pp. 2574 - 2579
Main Authors: Lanting, Brent A., Teeter, Matthew G., Howard, James L., MacDonald, Steven J., Van Citters, Douglas W.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.08.2017
Subjects:
Arthroplasty, Replacement, Hip - instrumentation
Corrosion
Femur Head - surgery
fretting
Hip Joint - surgery
Hip Prosthesis - statistics & numerical data
Humans
Metal-on-Metal Joint Prostheses - statistics & numerical data
Metals
Orthopedics
Polyethylene
Prosthesis Design
Prosthesis Failure
taperosis
Time Factors
total hip
trunnionosis
fretting
corrosion
taperosis
total hip
trunnionosis
ISSN:0883-5403, 1532-8406, 1532-8406
Online Access:Get full text
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Summary:Trunnion tribocorrosion in total hip arthroplasties is concerning, but retrieval studies often are subjective or lack comparison groups. Quantitative comparisons of clinically relevant implants are required. The purpose of this investigation was to evaluate material loss in metal-on-metal (MoM) and metal-on-polyethylene (MoP) total hip articulations while controlling for trunnion design and head size. The 166 retrieved femoral heads from 2 manufacturers were analyzed. Four cohorts based on head size, trunnion design, manufacturer, and articulation type (MoM vs MoP) were created. Corrosion was measured by a coordinate measurement machine, and material loss was assessed (MATLAB). Retrieved femoral heads from MoP articulations had 5 times less trunnion material loss than MoM articulations, on average, for both manufacturers. There was no difference in material loss between large modular head (>40 mm) and 36-mm MoM hip trunnion. Implants with a material loss above the detectable limit demonstrated a correlation with time in vivo only in MoP articulations. Retrieved femoral heads from MoP bearing couples had a lower magnitude of material loss than MoM couples, independent of head diameter. A time in vivo effect was only seen in MoP bearings.
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ISSN:0883-5403
1532-8406
1532-8406
DOI:10.1016/j.arth.2017.03.012