학술논문

Clinical significance of corrosion of cemented femoral stems in metal-on-metal hips: a retrieval study.
Document Type
Journal Article
Source
International Orthopaedics. Nov2016, Vol. 40 Issue 11, p2247-2254. 8p.
Subject
*HIP surgery
*CORROSION potential
*COBALT alloys
*ORTHOPEDIC implants
*CHROMIUM alloys
*FEMUR
*ALLOYS
*ARTIFICIAL joints
*BONE cements
*CHEMISTRY
*CHROMIUM
*COBALT
*METALS
*PROSTHETICS
*COMPLICATIONS of prosthesis
*TOTAL hip replacement
*RETROSPECTIVE studies
FEMUR surgery
Language
ISSN
0341-2695
Abstract
Purpose: The clinical significance of corrosion of cemented femoral stems is unclear. The purpose of this retrieval study was to: (1) report on corrosion at the stem-cement interface and (2) correlate these findings with clinical data.Methods: We analysed cemented stems (n = 36) composed of cobalt-chromium (CoCr) and stainless steel (SS) in a series of revised metal-on-metal hips. We performed detailed inspection of each stem to assess the severity of corrosion at the stem-cement interface using a scale of 1 (low) to 5 (severe). We assessed the severity of corrosion at each stem trunnion and measured wear rates at the head taper and bearing surfaces. We used non-parametric tests to determine the significance of differences between the CoCr and SS stems in relation to: (1) pre-revision whole blood Co and Cr metal ion levels, (2) trunnion corrosion, (3) bearing surface wear and (4) taper material loss.Results: The corrosion scores of CoCr stems were significantly greater than SS stems (p < 0.01). Virtually all stem trunnions in both alloy groups had minimal evidence of corrosion. The median pre-revision Co levels of implants with CoCr stems were significantly greater than the SS stems (p < 0.01). There was no significant difference in relation to pre-revision Cr levels (p = 0.521). There was no significant difference between the two stem types in relation to bearing wear (p = 0.926) or taper wear (p = 0.148).Conclusions: Severe corrosion of cemented femoral stems is a common finding at our retrieval centre; surgeons should consider corrosion of CoCr stems as a potential source of metal ions when revising a hip. [ABSTRACT FROM AUTHOR]