title: Ten-Year Cross-Sectional Study of Mechanically Assisted Crevice Corrosion in 1352 Consecutive Patients With Metal-on-Polyethylene Total Hip Arthroplasty.
abstract: Mechanically assisted crevice corrosion (MACC) in metal-on-polyethylene total hip arthroplasty (THA) is of concern, but its prevalence, etiology, and natural history are incompletely understood.
  
  
  
  From January 2003 to December 2012, 1352 consecutive THA surgeries using a titanium stem, cobalt-chromium alloy femoral head, and highly cross-linked polyethylene liner from a single manufacturer were performed. Patients were followed at 1-year and 5-year intervals for surveillance, but also seen earlier if they had symptoms. Any patient with osteolysis >1 cm (n = 3) or unexplained pain (n = 85) underwent examination, radiographs, complete blood count, erythrocyte sedimentation rate, and C-reactive protein, as well as tests for serum cobalt and chromium levels.
  
  
  
  Symptomatic MACC was present in 43 of 1352 patients (3.2%). Prevalence of MACC by year of implant ranged from 0% (0 of 61, 2003; 0 of 138, 2005) to 10.5% (17 of 162; 2009). The M/L Taper stem had a greater prevalence (4.9%) of MACC than all other Zimmer (Zimmer, Inc, Warsaw, IN) 12/14 trunnion stem types combined (1.2%; P < .001). Twenty-seven of 43 (62.8%) patients have undergone revision surgery, and 16 of 43 (37.2%) patients have opted for ongoing surveillance. Comparing symptomatic THA patients with and without MACC, no demographic, clinical, or radiographic differences were found. MACC was significantly more common in 0 length femoral heads (compared with both -3.5 mm and +3.5 mm heads).
  
  
  
  The prevalence of MACC in metal-on-polyethylene hips is higher in this cross-sectional study than previously reported. A significantly higher prevalence was found in patients with M/L Taper style stem and THA performed both in 2009 and also between 2009 and 2012 with this manufacturer.
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts; Maine Medical Center Research Institute, Scarborough, Maine.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Hussey
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts; Maine Joint Replacement Institute, Portland, Maine; Division of Joint Replacements, Maine Medical Center, Falmouth, Maine.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: McGrory
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002097:C-Reactive Protein; D002857:Chromium / Q000097:blood*; D002858:Chromium Alloys; D003035:Cobalt / Q000097:blood*; D003343:Corrosion; D003430:Cross-Sectional Studies; D005260:Female; D005270:Femur Head; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008281:Maine / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D020959:Polyethylene; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D014025:Titanium / Q000097:blood
chemical_list: D002858:Chromium Alloys; D002857:Chromium; D003035:Cobalt; D020959:Polyethylene; D002097:C-Reactive Protein; D014025:Titanium
keywords: MACC; THA; adverse local tissue reaction; failure; hip; metal-on-polymer