title: Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls.
abstract: The management of the patient with a recalled, modular neck-body total hip arthroplasty can be complex, as it involves a combination of clinical, technical, and medicolegal challenges. Management begins with a thorough history and physical exam, radiographic evaluation, infection workup, and serum metal ion levels. Three-dimensional imaging is obtained based on patient symptomatology and metal ion levels and is used to evaluate for the presence of an adverse local tissue response as well as the integrity of the existing soft tissue envelope. The decision to perform revision surgery is based on a combination of patient symptomatology, laboratory values, and imaging findings. Revision surgery involves the entire armamentarium of femoral revision techniques, and the acetabulum may need to be revised at the surgeon's discretion. The femoral implant can often be removed without disrupting the femoral bone envelope; however, the surgeon should have a low threshold to perform an extended trochanteric osteotomy.
authors.affiliation: Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 9th Floor, Box 1188, New York, NY, 10029, USA. mitchell.weiser@mountsinai.org.
authors.forename: Mitchell C
authors.initials: MC
authors.lastname: Weiser
authors.affiliation: Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 9th Floor, Box 1188, New York, NY, 10029, USA. darwin.chen@mountsinai.org.
authors.forename: Darwin D
authors.initials: DD
authors.lastname: Chen
keywords: Adverse local tissue reaction; Corrosion; Modular neck; Revision hip arthroplasty
references.citation: J Arthroplasty. 1995 Jun;10(3):329-38
references.pmid: 7673912
references.citation: J Arthroplasty. 2015 Aug;30(8):1470-5
references.pmid: 25817187
references.citation: Clin Orthop Relat Res. 2015 Feb;473(2):498-505
references.pmid: 25171935
references.citation: J Bone Joint Surg Am. 2010 Dec 1;92(17):2847-51
references.pmid: 21037026
references.citation: Clin Toxicol (Phila). 2014 Sep-Oct;52(8):837-47
references.pmid: 25132471
references.citation: J Arthroplasty. 2002 Sep;17(6):675-80
references.pmid: 12216018
references.citation: Clin Orthop Relat Res. 2012 Jul;470(7):1907-16
references.pmid: 22179979
references.citation: J Arthroplasty. 2016 Jan;31(1):186-9
references.pmid: 26318084
references.citation: J Am Acad Orthop Surg. 2012 Aug;20(8):481-6
references.pmid: 22855850
references.citation: Contact Dermatitis. 2012 Jan;66(1):4-19
references.pmid: 21957996
references.citation: J Arthroplasty. 2001 Dec;16(8 Suppl 1):188-94
references.pmid: 11742474
references.citation: Clin Orthop Relat Res. 2002 Aug;(401):149-61
references.pmid: 12151892
references.citation: Allergy. 2009 Aug;64(8):1157-65
references.pmid: 19220218
references.citation: J Biomed Mater Res. 2000 Sep;53(5):480-9
references.pmid: 10984695
references.citation: J Bone Joint Surg Am. 2013 Mar 20;95(6):512-8
references.pmid: 23515985
references.citation: J Arthroplasty. 2014 Oct;29(10):2049-52
references.pmid: 24997654
references.citation: Arch Dermatol. 2012 Jun;148(6):687-93
references.pmid: 22351785
references.citation: Clin Orthop Relat Res. 2013 Mar;471(3):965-70
references.pmid: 23054529
references.citation: J Bone Joint Surg Am. 2013 May 15;95(10):865-72
references.pmid: 23677352
references.citation: J Bone Joint Surg Am. 2001 Mar;83-A(3):428-36
references.pmid: 11263649
references.citation: J Bone Joint Surg Am. 2014 Mar 19;96(6):481-7
references.pmid: 24647504
references.citation: J Arthroplasty. 2014 Sep;29(9):1768-73
references.pmid: 24895065
references.citation: Acta Orthop. 2009 Dec;80(6):646-52
references.pmid: 19995314
references.citation: J Arthroplasty. 2015 May;30(5):822-6
references.pmid: 25573180
references.citation: J Arthroplasty. 2005 Jan;20(1):79-83
references.pmid: 15660064
references.citation: J Arthroplasty. 2013 Feb;28(2):292-5
references.pmid: 22810010
references.citation: Clin Orthop Relat Res. 2014 Feb;472(2):523-8
references.pmid: 23572349
references.citation: J Arthroplasty. 2005 Jun;20(4):536-41
references.pmid: 16124973
references.citation: J Arthroplasty. 2013 Aug;28(7):1218-23
references.pmid: 23523216
references.citation: J Arthroplasty. 2015 Jul;30(7):1191-6
references.pmid: 25820117
references.citation: J Arthroplasty. 2014 Apr;29(4):653-6
references.pmid: 24655608
references.citation: Clin Orthop Relat Res. 2004 Mar;(420):18-25
references.pmid: 15057074
references.citation: J Bone Joint Surg Am. 2005 Jan;87(1):28-36
references.pmid: 15637030
references.citation: Orthop Clin North Am. 2014 Jan;45(1):1-8
references.pmid: 24267202
references.citation: Acta Orthop. 2012 Dec;83(6):566-71
references.pmid: 23116439
references.citation: Clin Orthop Relat Res. 2014 Feb;472(2):509-16
references.pmid: 23846604
references.citation: J Bone Joint Surg Am. 2012 Sep 19;94(18):1655-61
references.pmid: 23289127
references.citation: J Arthroplasty. 2014 Jan;29(1):1-6
references.pmid: 24090661
references.citation: J Bone Joint Surg Am. 2014 Mar 19;96(6):488-93
references.pmid: 24647505
references.citation: J Orthop Surg Res. 2013 May 16;8:12
references.pmid: 23680415
references.citation: Orthop Clin North Am. 2014 Jan;45(1):9-18
references.pmid: 24267203
references.citation: J Bone Joint Surg Br. 2012 Aug;94(8):1126-34
references.pmid: 22844057
references.citation: Biomed Res Int. 2015;2015:137287
references.pmid: 25883940
references.citation: J Arthroplasty. 2009 Oct;24(7):1019-23
references.pmid: 18835686
references.citation: J Arthroplasty. 2014 Nov;29(11):2060-4
references.pmid: 25189673