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Abstract

Background:

Fretting corrosion at modular junctions contributes to arthroplasty failure. Currently, no evidence-based guidelines are available regarding the acceptable level of trunnion corrosion that can occur in vivo. We aimed to examine the relationship between trunnion corrosion and risk of re-revision to assist surgeons with intraoperative decision making.

Method:

Grading by 3 independent examiners of revised and re-revised head components was performed using a modified Goldberg corrosion scale. Samples were separated into low-grade (LG) and high-grade (HG) corrosion. Mechanical testing determined the relationship between corrosion severity and pull-off strength at the head-stem junction.

Results:

529 retrieved femoral heads were analysed. A positive association was detected between males and HG corrosion (OR 2.07; 95% CI, 1.45–2.94; p < 0.001). No difference between the survivorship of LG and HG heads was detected (p-value = 0.247). In the re-revised sample, the first implant had a time in situ that was on average 7.97 years longer (95% CI, 5.4–10.6) than that of the subsequent re-revised femoral head. Severe corrosion on the first head was associated with a 37.5 (95% CI, 4.00–1944) fold increase of HG on the subsequent head (p < 0.001). Femoral disassembly force had a positive correlation with stem taper corrosion grade (p = 0.001).

Conclusions:

A well-fixed stem with corrosion may remain in situ.

Keywords

Hip arthroplasty re-revision taper corrosion

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