Do ceramic femoral heads reduce taper fretting corrosion in hip arthroplasty? A retrieval study.

Authors

Steven M Kurtz, Implant Research Center, School of Biomedical Engineering, Science, and Heath Systems, Drexel University; Exponent, Inc., Philadelphia, PAFollow
Sevi B Kocagöz, Implant Research Center, School of Biomedical Engineering, Science, and Heath Systems, Drexel University
Josa A Hanzlik, Implant Research Center, School of Biomedical Engineering, Science, and Heath Systems, Drexel University
Richard J Underwood, Exponent, Inc., Philadelphia, PAFollow
Jeremy L Gilbert, Syracuse Biomaterials Institute, Syracuse University
Daniel W MacDonald, Implant Research Center, School of Biomedical Engineering, Science, and Heath Systems, Drexel UniversityFollow
Gwo-Chin Lee, Penn Orthopaedics, Presbyterian Medical Center of PhiladelphiaFollow
Michael A Mont, Rubin Institute for Advanced Orthopedics, Sinai Hospital of BaltimoreFollow
Matthew J Kraay, University Hospitals Case Medical Center, Cleveland, OH
Gregg R Klein, Hartzband Center for Hip and Knee Replacement, Hackensack, NJFollow
Javad Parvizi, Rothman Institute, Thomas Jefferson University HospitalFollow
Clare M Rimnac, Mechanical and Aerospace Engineering, Case Western Reserve UniversityFollow

Document Type

Article

Publication Date

10-1-2013

Comments

This article has been peer reviewed. It was published in: Clinical Orthopaedics and Related Research.
Volume 471, Issue 10, October 2013, Pages 3270-3282.
The published version is available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773155/. DOI: 10.1007/s11999-013-3096-2

Copyright © 2013 The Author(s).

Abstract

BACKGROUND: Previous studies regarding modular head-neck taper corrosion were largely based on cobalt chrome (CoCr) alloy femoral heads. Less is known about head-neck taper corrosion with ceramic femoral heads.

QUESTIONS/PURPOSES: We asked (1) whether ceramic heads resulted in less taper corrosion than CoCr heads; (2) what device and patient factors influence taper fretting corrosion; and (3) whether the mechanism of taper fretting corrosion in ceramic heads differs from that in CoCr heads.

METHODS: One hundred femoral head-stem pairs were analyzed for evidence of fretting and corrosion using a visual scoring technique based on the severity and extent of fretting and corrosion damage observed at the taper. A matched cohort design was used in which 50 ceramic head-stem pairs were matched with 50 CoCr head-stem pairs based on implantation time, lateral offset, stem design, and flexural rigidity.

RESULTS: Fretting and corrosion scores were lower for the stems in the ceramic head cohort (p=0.03). Stem alloy (p=0.004) and lower stem flexural rigidity (Spearman's rho=-0.32, p=0.02) predicted stem fretting and corrosion damage in the ceramic head cohort but not in the metal head cohort. The mechanism of mechanically assisted crevice corrosion was similar in both cohorts although in the case of ceramic femoral heads, only one of the two surfaces (the male metal taper) engaged in the oxide abrasion and repassivation process.

CONCLUSIONS: The results suggest that by using a ceramic femoral head, CoCr fretting and corrosion from the modular head-neck taper may be mitigated but not eliminated.

CLINICAL RELEVANCE: The findings of this study support further study of the role of ceramic heads in potentially reducing femoral taper corrosion.

Recommended Citation

Kurtz, Steven M; Kocagöz, Sevi B; Hanzlik, Josa A; Underwood, Richard J; Gilbert, Jeremy L; MacDonald, Daniel W; Lee, Gwo-Chin; Mont, Michael A; Kraay, Matthew J; Klein, Gregg R; Parvizi, Javad; and Rimnac, Clare M, "Do ceramic femoral heads reduce taper fretting corrosion in hip arthroplasty? A retrieval study." (2013). Rothman Institute Faculty Papers. Paper 39.
https://jdc.jefferson.edu/rothman_institute/39