A multicenter retrieval study of the taper interfaces of modular hip prostheses.

Abstract

A multicenter retrieval analysis of 231 modular hip implants was done to investigate the effects of material combination, metallurgic condition, flexural rigidity, head and neck moment arm, neck length, and implantation time on corrosion and fretting of modular taper surfaces. Scores for corrosion and fretting were assigned to medial, lateral, anterior, and posterior quadrants of the necks, and proximal and distal regions of the heads. Neck and head corrosion and fretting scores were found to be significantly higher for mixed alloy versus similar alloy couples. Moderate to severe corrosion was observed in 28% of the heads of similar alloy couples and 42% of the heads of mixed alloy couples. Differences in corrosion scores were observed between components made from the same base alloy, but of different metallurgic conditions. Corrosion and fretting scores tended to be higher for heads than necks. Implantation time and flexural rigidity of the neck were predictors of head and neck corrosion and head fretting. The results of this study suggest that in vivo corrosion of modular hip taper interfaces is attributable to a mechanically-assisted crevice corrosion process. Larger diameter necks will increase neck stiffness and may reduce fretting and subsequent corrosion of the taper interface regardless of the alloy used. Increasing neck diameter must be balanced, however, with the resulting loss of range of motion and joint stability.