title: Revision of Recalled Modular Neck Rejuvenate and ABG Femoral Implants.
abstract: Modular neck femoral stems have been associated with adverse local tissue reactions (ALTR), leading to a voluntary recall, but these effects have not been well-characterized. A retrospective review of intraoperative findings and cobalt/chromium levels was performed in 103 hips undergoing revision for ALTR. The average preoperative serum cobalt level was 7.6 μg/L (range 1.1-23 μg/L) and chromium level was 1.8 μg/L (range 0.1-6.8 μg/L). Metallic sludge was noted in 100%, synovitis in 98%, pericapsular rind in 82%, and calcar erosion in 85%. An osteotomy was required for removal in 44%. We concluded that revision of modular neck femoral stems is associated with increased preoperative metal ion levels and stem-neck corrosion. Despite advanced stem explantation techniques, osteotomy was frequently required, leading to increased morbidity.
authors.affiliation: Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Walsh
authors.affiliation: Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: James C
authors.initials: JC
authors.lastname: Hubbard
authors.affiliation: St. Cloud Orthopaedics, St. Cloud, Minnesota.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Nessler
authors.affiliation: Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan; Providence Hospital and Medical Centers, Southfield, Michigan.
authors.forename: David C
authors.initials: DC
authors.lastname: Markel
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002857:Chromium / Q000097:blood; D003035:Cobalt / Q000097:blood; D003343:Corrosion; D005260:Female; D005272:Femur Neck / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D057052:Medical Device Recalls; D010027:Osteotomy; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies
chemical_list: D002857:Chromium; D003035:Cobalt
keywords: ABG; adverse local tissue reaction; metal ion level; recalled modular neck hip implants; rejuvenate