@inproceedings{0103cd4e15314944ac3e9c24fcc440ce,
title = "Is taper fretting corrosion a threat to the clinical performance of large-diameter hips with highly crosslinked polyethylene bearings?",
abstract = "Modular head-neck taper corrosion has been studied with historical implant designs from the 1980s and 1990s. Less is known about the prevalence of taper corrosion in contemporary hip bearings incorporating highly crosslinked polyethylene (HXLPE) with large head diameters. We asked (1) what is the prevalence and severity of fretting and corrosion damage at the head-neck modular interfaces in HXLPE total hip arthroplasty (THA) with large head diameters, (2) what device and patient factors influence taper fretting corrosion in contemporary metal-on-polyethylene (MoP) THA, and (3) is taper corrosion associated with increased wear of the HXLPE bearing surface? Between 2000 and 2014, 890 THA systems were collected in a multi-institutional retrieval program. From these, 508 cobalt-chromium (CoCr) alloy heads, ranging in diameter from 22 mm to 44 mm, from six manufacturers were analyzed along with 216 metallic (CoCr, Ti-6AI-4V, or Ti-Mo-Zr-Fe) femoral stems. Head with diameters ≥36mm were considered large diameter. The components were cleaned and scored for fretting and corrosion damage at the head and stem taper interfaces, in accordance with a previously established semiquantitative method. Linear penetration of the femoral head into the retrieved HXLPE liners was assessed directly to determine linear penetration rate (mm/yr). Mild to severe taper fretting corrosion (score ≥2) was found in 78 % of the head taper interfaces and 53 % of femoral stem tapers. The fretting corrosion scores were positively correlated to implantation time (p < 0.001). No correlation, however, was found between head taper interface damage and head diameter (p ≥ 0.09). Fretting corrosion scores were not correlated with head penetration rate into the HXLPE liners (p > 0.38). The results of this study do not support the hypothesis that large (>36mm) CoCr femoral heads articulating on HXLPE liners are associated with increased risk of fretting corrosion damage when compared with smaller diameter heads.",
keywords = "CoCr, Corrosion, Femoral head, Fretting, HXLPE, Highly crosslinked polyethylene, Stem, Taper, Total hip arthroplasty, Wear",
author = "Kurtz, {Steven M.} and MacDonald, {Daniel W.} and Gilbert, {Jeremy L.} and Mont, {Michael A.} and Gregg Klein and Antonia Chen and Matthew Kraay and Brian Hamlin and Rimnac, {Clare M.}",
note = "Publisher Copyright: Copyright {\textcopyright} 2015 by ASTM International.; Symposium on Modularity and Tapers in Total Joint Replacement Devices ; Conference date: 10-11-2014",
year = "2015",
doi = "10.1520/STP159120140153",
language = "English (US)",
series = "ASTM Special Technical Publication",
publisher = "ASTM International",
pages = "45--58",
editor = "Kurtz, {Steven M.} and Greenwald, {A. Seth} and Lemons, {Jack E.} and Mihalko, {William M.}",
booktitle = "Modularity and Tapers in Total Joint Replacement Devices",
}