Journal of Bone and Joint Surgery - British Volume · 1991 · 151 citations · 24 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryCorrosion ScienceMetallurgyProstheticsComplications Of Implant ProsthesesCorrosion MechanismsJoint Replacement MaterialsMetallic BiomaterialsProsthetic Joint InfectionProsthetic MaterialsBiomedical CorrosionCorrosion-related ComplicationsFemoral LooseningFemoral Stem DesignImplant LooseningModular DesignModular Junction CorrosionThreaded Joint Corrosion
Nine uncemented modular hip prostheses were revised for infection, stem loosening or fracture, cup loosening, or cup protrusion. The study proposes that the head‑neck crevice in modular designs is a likely corrosion site. Corrosion and metal‑particle‑induced necrosis were found at the head‑neck junction in four prostheses, with metallographic evidence of structural defects and metal inhomogeneity.
Nine uncemented hip prostheses of modular design were revised because of late infection (2 cases), femoral stem loosening or fracture (2), loosening of threaded cups (3) and protrusion of bipolar cups (2). At surgery we found tissue discoloration and macroscopic corrosion in four of the nine prostheses, located at the head-neck junction. Histological examination in most cases showed extensive necrosis associated with metal particles, indicating metal toxicity. Metallographic examination of the prosthetic heads revealed structural imperfections and inhomogeneity of the metal. We suggest that the crevice between the head and neck is a potential site of corrosion in modular designs.
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The incidence of cancer following total hip replacement
WJ Gillespie, C. Frampton, RJ Henderson et al. · Journal of Bone and Joint Surgery - British Volume · 1988 · 228 citations