Quantification of trunnion damage in a series of intact total hip arthroplasty femoral stems previously identified to be at risk of catastrophic failure.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-05-01 Epub Date: 2023-10-02 DOI:10.1177/11207000231199941
Brent A Lanting, Olawale A Sogbein, Steven J MacDonald, Nirmit Shah, Tea-Lyn Kok, Ryan Willing, Matthew G Teeter
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引用次数: 0

Abstract

Background: Corrosion at the head-neck junction of femoral stems is a rare complication of total hip arthroplasty (THA) with manifestations ranging from subclinical wear to failure. Prior studies have identified a single femoral component design with an increased propensity for catastrophic trunnion failure. The purpose of the present study was to quantify trunnion damage of this femoral component retrieved from patients undergoing revision THA for non-trunnionosis indications.

Methods: 24 femoral components from a single manufacturer were identified for study inclusion. Each prosthesis underwent stereomicroscopic inspection. Corrosion and fretting scores were assigned per the Goldberg criteria to quadrants of the trunnion. Material loss was calculated based on cone angles across trunnion quadrants. This was carried out using a coordinate measuring machine that digitised each trunnion surface. Stems were compared to a series of femoral stems with the same trunnion design.

Results: 20 of the 24 (83%) trunnions demonstrated corrosion, all 24 trunnions demonstrated fretting. Corrosion scores did not statistically differ with respect to trunnion zone (p = 0.53), while fretting scores were higher in the inferior compared to the superior zones (p< 0.001). There was no significant difference in cone angles assessing material loss between stems (p = 0.25).

Conclusions: Evidence of trunnion damage was observed in each stem retrieved for non-trunnionosis revision. Fretting occurred more frequently about the inferior quadrants. However, digitised trunnion shapes were similar between compared stems exhibiting no material loss. Therefore, it is possible that previous reports of trunnion failures for this implant are not a systemic issue, and that further investigation is required.

一系列完整的全髋关节置换术股骨柄中耳轴损伤的量化先前被确定为具有灾难性失败风险。
背景:股骨干头颈交界处腐蚀是全髋关节置换术(THA)的一种罕见并发症,其表现从亚临床磨损到失败不等。先前的研究已经确定,单一股骨组件的设计增加了耳轴灾难性失效的倾向。本研究的目的是量化从接受非耳轴适应症翻修THA的患者身上取出的股骨组件的耳轴损伤。方法:从单一制造商中鉴定出24个股骨组件,纳入研究。每个假体都接受了立体显微镜检查。根据Goldberg标准将腐蚀和微动评分分配给耳轴的象限。根据耳轴象限的锥角计算材料损失。这是使用坐标测量机进行的,该坐标测量机对每个耳轴表面进行数字化。将股骨柄与一系列具有相同耳轴设计的股骨柄进行比较。结果:24个耳轴中有20个(83%)表现出腐蚀,所有24个耳轴承都表现出微动。耳轴区域的腐蚀评分没有统计学差异(p = 0.53),而与优势区相比,劣势区的微动得分更高(p  0.001)。评估茎间材料损失的锥角没有显著差异(p = 0.25)。下象限的微动发生频率更高。然而,数字化耳轴形状在比较的阀杆之间是相似的,没有表现出材料损失。因此,以前关于该植入物耳轴故障的报告可能不是系统性问题,需要进一步调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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