title: Risk stratification algorithm for management of patients with dual modular taper total hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons and the Hip Society.
abstract: Although 'dual taper' modular stems with interchangeable modular necks have the potential to optimize hip biomechanical parameters, there is increasing concern regarding the occurrence of adverse local tissue reactions from mechanically assisted crevice corrosion at the neck-stem taper junction. A systematic treatment approach (risk stratification algorithm) based on the currently available data is recommended to optimize patient management. While specialized tests such as metal ion analysis and MARS MRI are useful modalities in evaluating for adverse tissue reactions, over-reliance on any single investigative tool in the clinical decision-making process should be avoided. There should be a low threshold to perform a systematic evaluation of patients with dual taper stem total hip arthroplasty as early recognition and diagnosis will facilitate the initiation of appropriate treatment.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kwon
authors.affiliation: Ortho Carolina Hip and Knee Center, Charlotte, NC.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Fehring
authors.affiliation: Joint Implant Surgeons, Inc., The Ohio State University, New Albany, OH.
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.affiliation: Arkansas Speciality Orthopaedics, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: C Lowry
authors.initials: CL
authors.lastname: Barnes
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Miguel E
authors.initials: ME
authors.lastname: Cabanela
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Jacobs
mesh_terms: D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D003343:Corrosion; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007477:Ions / Q000097:blood; D008279:Magnetic Resonance Imaging; D008670:Metals / Q000097:blood; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment
chemical_list: D007477:Ions; D008670:Metals
keywords: dual taper; risk stratification; taper corrosion