Cancellous allograft in revision total hip arthroplasty. A clinical review.

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Abstract

[Indexed for MEDLINE] 14. J Arthroplasty. 2023 Feb;38(2):376-382. doi: 10.1016/j.arth.2022.08.023. Epub 2022 Sep 7. What Patient and Implant Factors Affect Trunnionosis Severity? An Implant Retrieval Analysis of 664 Femoral Stems. Codirenzi AM(1), Lanting BA(2), Teeter MG(3). Author information: (1)School of Biomedical Engineering, Western University, London, Ontario, Canada. (2)Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. (3)School of Biomedical Engineering, Western University, London, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. BACKGROUND: Corrosion at the modular head-neck taper interface of total and hemiarthroplasty hip implants (trunnionosis) is a cause of implant failure and thus a clinical concern. Patient and device factors contributing to the occurrence of trunnionosis have been investigated in prior implant retrieval studies but generally with limited sample sizes and a narrow range of models. The purpose of the present investigation was to determine which patient and device factors were associated with corrosion damage on the femoral stem taper across a large collection of different implant models retrieved following revision hip arthroplasty. METHODS: A retrieval study of 664 hip arthroplasty modular stem components was performed. Patient and device information was collected. Trunnions were imaged under digital microscopy and scored for corrosion damage using a scaling system. Damage was related to patient and device factors using regression analyses. RESULTS: Greater duration of implantation (P = .005) and larger head size (P < .001) were associated with an elevated corrosion class. Older age at index surgery (P = .035), stainless steel stem material (P = .022), indication for revision as bone or periprosthetic fracture (P = .017), and infection (P = .018) and certain larger taper geometries were associated with a decreased corrosion class. CONCLUSION: Factors identified as contributing to a higher or lower risk of more severe corrosion are consistent with most prior smaller retrieval studies. Surgeons should be aware of these risk factors when selecting implants for their patients and when diagnosing trunnionosis in symptomatic hip arthroplasty patients. Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2022.08.023