title: Diagnosis and Management of Adverse Local Tissue Reactions Secondary to Corrosion at the Head-Neck Junction in Patients With Metal on Polyethylene Bearings.
abstract: We reviewed 27 patients who underwent revision for an adverse local tissue reaction (ALTR) secondary to corrosion at the head-neck junction with MoP bearings. Serum cobalt and chromium levels were elevated in all cases, with a mean cobalt of 11.2 ppb and chromium of 2.2 ppb. Patients underwent modular bearing exchange, including a ceramic head with a titanium sleeve in 23 of 27 cases with only one recurrence of ALTR in one of the four patients not treated with a ceramic head. The diagnosis of ALTR secondary to corrosion is associated with cobalt levels of >1 ppb with cobalt levels elevated above chromium. Retention of a well-fixed stem and modular exchange to a ceramic head leads to resolution of symptoms and decreases in metal levels.
authors: Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors: Darren R
authors: DR
authors: Plummer
authors: Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, Illinois.
authors: Richard A
authors: RA
authors: Berger
authors: Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, Illinois.
authors: Wayne G
authors: WG
authors: Paprosky
authors: Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, Illinois.
authors: Scott M
authors: SM
authors: Sporer
authors: Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, Illinois.
authors: Joshua J
authors: JJ
authors: Jacobs
authors: Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, Illinois.
authors: Craig J
authors: CJ
authors: Della Valle
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation; D001799:Blood Sedimentation; D015992:Body Mass Index; D002516:Ceramics / Q000737:chemistry*; D002857:Chromium / Q000097:blood; D003035:Cobalt / Q000097:blood; D003343:Corrosion; D019468:Disease Management; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis* / Q000628:therapy*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D020959:Polyethylene / Q000737:chemistry*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000295:instrumentation; D014025:Titanium / Q000097:blood / Q000737:chemistry
chemical_list: D008670:Metals; D002857:Chromium; D003035:Cobalt; D020959:Polyethylene; D014025:Titanium
keywords: adverse local tissue reaction; bearing surfaces; modular taper corrosion; revision total hip arthroplasty; total hip arthroplasty