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Modern trunnions are more flexible: a mechanical analysis of THA taper designs.

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Modern trunnions are more flexible: a mechanical analysis of THA taper designs.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Porter, David A. Urban, Robert M. Jacobs, Joshua J. Gilbert, Jeremy L. Rodriguez, José A. Cooper, H. John
Spatial Coverage	Chicago New York City
Description	Country affiliation: United States Author Affiliation: Porter DA ( Department of Orthopaedic Surgery, Lenox Hill Hospital, 130 East 77th Street, 11th Floor, New York, NY, 10024, USA.)
Abstract	BACKGROUND: There is renewed concern surrounding the potential for corrosion at the modular head-neck junction to cause early failure in contemporary THAs. Although taper corrosion involves a complex interplay of many factors, a previous study suggested that a decrease in flexural rigidity of the femoral trunnion may be associated with an increased likelihood of corrosion at retrieval. QUESTIONS/PURPOSES: By analyzing a large revision retrieval database of femoral stems released during a span of three decades, we asked: (1) how much does flexural rigidity vary among different taper designs; (2) what is the contribution of taper geometry alone to flexural rigidity of the femoral trunnion; and (3) how have flexural rigidity and taper length changed with time in this group of revised retrievals? METHODS: A dual-center retrieval analysis of 85 modular femoral stems released between 1983 and 2012 was performed, and the flexural rigidity and length of the femoral trunnions were determined. These stems were implanted between 1991 and 2012 and retrieved at revision or removal surgery between 2004 and 2012. There were 10 different taper designs made from five different metal alloys from 16 manufacturers. Digital calipers were used to measure taper geometries by two independent observers. RESULTS: Median flexural rigidity was 228 N-m(2); however, there was a wide range of values among the various stems spanning nearly an order of magnitude between the most flexible (80 N-m(2)) and most rigid (623 N-m(2)) trunnions, which was partly attributable to the taper geometry and to the material properties of the base alloy. There was a negative correlation between flexural rigidity and length of the trunnion and release date of the stem. CONCLUSIONS: There is wide variability in flexural rigidity of various taper designs, with a trend toward trunnions becoming shorter and less rigid with time. CLINICAL RELEVANCE: This temporal trend may partly explain why taper corrosion is being seen with increasing frequency in modern THAs.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-014-3965-3
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	12
Volume Number	472
Language	English
Publisher	Springer
Publisher Date	2014-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Arthroplasty, Replacement, Hip Instrumentation Femur Surgery Hip Joint Hip Prosthesis Prosthesis Failure Adverse Effects Biomechanical Phenomena Corrosion Databases, Factual Device Removal Elastic Modulus Equipment Failure Analysis Physiopathology Prosthesis Design Reoperation Stress, Mechanical Time Factors Comparative Study Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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