title: Corrosion at the head-neck interface of current designs of modular femoral components: essential questions and answers relating to corrosion in modular head-neck junctions.
abstract: There is increasing global awareness of adverse reactions to metal debris and elevated serum metal ion concentrations following the use of second generation metal-on-metal total hip arthroplasties. The high incidence of these complications can be largely attributed to corrosion at the head-neck interface. Severe corrosion of the taper is identified most commonly in association with larger diameter femoral heads. However, there is emerging evidence of varying levels of corrosion observed in retrieved components with smaller diameter femoral heads. This same mechanism of galvanic and mechanically-assisted crevice corrosion has been observed in metal-on-polyethylene and ceramic components, suggesting an inherent biomechanical problem with current designs of the head-neck interface. We provide a review of the fundamental questions and answers clinicians and researchers must understand regarding corrosion of the taper, and its relevance to current orthopaedic practice. Cite this article: Bone Joint J 2016;98-B:579-84.
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
authors.forename: K
authors.initials: K
authors.lastname: Osman
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Panagiotidou
authors.affiliation: University College London, 170 Tottenham Court Road, London W1T 7HA, UK.
authors.forename: M
authors.initials: M
authors.lastname: Khan
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
authors.forename: G
authors.initials: G
authors.lastname: Blunn
authors.affiliation: University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D003343:Corrosion; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D061825:Metal-on-Metal Joint Prostheses / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure
keywords: Total hip arthroplasty; corrosion; crevice; failure; fretting; head-neck junction; modular; taper; trunnion; wear