title: Do ceramic femoral heads reduce taper fretting corrosion in hip arthroplasty? A retrieval study.
abstract: BACKGROUND
  Previous studies regarding modular head-neck taper corrosion were largely based on cobalt chrome (CoCr) alloy femoral heads. Less is known about head-neck taper corrosion with ceramic femoral heads.
  
  
  OBJECTIVE
  We asked (1) whether ceramic heads resulted in less taper corrosion than CoCr heads; (2) what device and patient factors influence taper fretting corrosion; and (3) whether the mechanism of taper fretting corrosion in ceramic heads differs from that in CoCr heads.
  
  
  METHODS
  One hundred femoral head-stem pairs were analyzed for evidence of fretting and corrosion using a visual scoring technique based on the severity and extent of fretting and corrosion damage observed at the taper. A matched cohort design was used in which 50 ceramic head-stem pairs were matched with 50 CoCr head-stem pairs based on implantation time, lateral offset, stem design, and flexural rigidity.
  
  
  RESULTS
  Fretting and corrosion scores were lower for the stems in the ceramic head cohort (p=0.03). Stem alloy (p=0.004) and lower stem flexural rigidity (Spearman's rho=-0.32, p=0.02) predicted stem fretting and corrosion damage in the ceramic head cohort but not in the metal head cohort. The mechanism of mechanically assisted crevice corrosion was similar in both cohorts although in the case of ceramic femoral heads, only one of the two surfaces (the male metal taper) engaged in the oxide abrasion and repassivation process.
  
  
  CONCLUSIONS
  The results suggest that by using a ceramic femoral head, CoCr fretting and corrosion from the modular head-neck taper may be mitigated but not eliminated.
  
  
  CONCLUSIONS
  The findings of this study support further study of the role of ceramic heads in potentially reducing femoral taper corrosion.
authors.affiliation: Implant Research Center, School of Biomedical Engineering, Science, and Heath Systems, Drexel University, 3401 Market Street, Suite 345, Philadelphia, PA, 19104, USA, skurtz@drexel.edu.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kurtz
authors.forename: Sevi B
authors.initials: SB
authors.lastname: Kocagöz
authors.forename: Josa A
authors.initials: JA
authors.lastname: Hanzlik
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Underwood
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Gilbert
authors.forename: Daniel W
authors.initials: DW
authors.lastname: MacDonald
authors.forename: Gwo-Chin
authors.initials: GC
authors.lastname: Lee
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kraay
authors.forename: Gregg R
authors.initials: GR
authors.lastname: Klein
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Clare M
authors.initials: CM
authors.lastname: Rimnac
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002516:Ceramics; D002858:Chromium Alloys; D019544:Equipment Failure Analysis; D005260:Female; D005270:Femur Head / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013314:Stress, Mechanical
chemical_list: D002858:Chromium Alloys