title: Early Outcomes of Revision Surgery for Taper Corrosion of Dual Taper Total Hip Arthroplasty in 187 Patients.
abstract: Modular dual taper femoral neck designs have been associated with taper corrosion requiring revision surgery. However, outcomes after revision dual taper total hip arthroplasty in patients with symptomatic adverse local tissue reaction due to taper corrosion remain largely unknown.
  
  
  
  A total of 198 revision surgeries in 187 patients with dual taper femoral stem total hip arthroplasty with minimum 12-month follow-up were evaluated.
  
  
  
  At mean follow-up of 18 months, at least 1 complication had occurred in 39 patients (20%) of 198 revisions. Single episode of dislocation, treated with close reduction, occurred in 16, whereas 2 patients required rerevision due to multiple dislocations. Infection requiring rerevision occurred in 3 patients. Adverse local tissue reaction recurrence requiring reoperation occurred in 6 patients. Implant survivorship for revision for any cause was 86% at 30 months. The reoperation rate of revised dual taper was 8% (16 out of 198 hips). The median serum levels of cobalt, chromium, and cobalt/chromium ratio decreased (P < .01) from 5.3 μg/L (range: 2.3-48.5 μg/L), 2.6 μg/L (range: 0.2-64 μg/L), and 4.7 (range: 2.1-35) prerevision to 1.4 μg/L (range: 0.2-8.8 μg/L), 0.7 μg/L (range: 0.1-3.9 μg/L), and 2.2 (range: 0.4-8.8) postrevision, respectively.
  
  
  
  This pilot study demonstrates that intraoperative tissue necrosis was associated with a high rate of early complications (20%) and revisions (8%), suggesting the importance of a systematic evaluation of these patients including metal ion levels and metal artifact reduction sequence magnetic resonance imaging in optimizing revision outcome, as early diagnosis will facilitate the initiation of appropriate treatment before significant adverse tissue necrosis.
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Dimitriou
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Ming Han Lincoln
authors.initials: MH
authors.lastname: Liow
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Tsung-Yuan
authors.initials: TY
authors.lastname: Tsai
authors.affiliation: Department of Orthopaedic Surgery, Holy Cross Hospital Orthopedic Center, Fort Lauderdale, Florida.
authors.forename: William A
authors.initials: WA
authors.lastname: Leone
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Guoan
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002857:Chromium / Q000097:blood; D003035:Cobalt / Q000097:blood; D003343:Corrosion; D005260:Female; D005269:Femur; D005272:Femur Neck / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007432:Intraoperative Period; D004204:Joint Dislocations; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010865:Pilot Projects; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods*; D013530:Surgical Wound Infection; D016896:Treatment Outcome
chemical_list: D002857:Chromium; D003035:Cobalt
keywords: clinical outcomes; dual taper; modular femoral neck stem; revision total hip arthroplasty; systematic evaluation; taper corrosion