Clinical Impact of Trunnion Wear After Total Hip Arthroplasty.
Trunnionosis, characterized by corrosion and fretting of the taper, is a well-known entity commonly demonstrated in retrieval specimens. While there have been a number of recent reports regarding the potential for adverse local tissue reactions related to trunnionosis, it remains a relatively infrequent cause for failure of total hip replacement implants. A number of factors, including both biomechanical and bioelectrochemical factors, have a known impact on the development and severity of trunnionosis. Furthermore, specific implant design and material-related factors have been shown to influence the risk of trunnionosis leading to adverse local tissue reactions. Retention of a well-fixed femoral stem, in spite of corrosion of the male taper junction, is acceptable in the majority of cases. A ceramic head, often in combination with a titanium adaptor sleeve, is the most common replacement reported in the current literature to treat trunnionosis. In patients with modular-neck total hip replacements, revision of the femoral stem is likely required if corrosion at the modular neck-stem junction is encountered.
Division of Orthopaedics, Department of Surgery, Schulich School of Medicine, Western University, London, Ontario, Canada.|Joint Replacement Institute, London Health Sciences Center, University Hospital, London, Ontario, Canada.
Brent
B
Lanting
Division of Orthopaedics, Department of Surgery, Schulich School of Medicine, Western University, London, Ontario, Canada.|Joint Replacement Institute, London Health Sciences Center, University Hospital, London, Ontario, Canada.
Douglas D R
DDR
Naudie
Division of Orthopaedics, Department of Surgery, Schulich School of Medicine, Western University, London, Ontario, Canada.|Joint Replacement Institute, London Health Sciences Center, University Hospital, London, Ontario, Canada.
Richard W
RW
McCalden
D019644:Arthroplasty, Replacement, Hip; D003343:Corrosion; D006622:Hip Prosthesis; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure