Advance of head taper corrosion after metal on polyethylene total hip arthroplasty / 中华骨科杂志

ABSTRACT

Total hip arthroplasty is currently an important surgical method for the treatment of hip diseases.The modular design of the head and neck taper facilitates the adjustment of limb length and femoral offset during surgery,however,complications such as wear,corrosion and looseness of the modular interface are also inevitable old problems.In recent years,with the changes in the design of prostheses,the trend that patients becomes younger and active,and the development of minimally invasive surgery,taper corrosion has again become a problem that needs to be solved and cannot be ignored,which is causing the attention of joint surgeons.There have been many studies on the complications associated with metal-on-metal prosthesis modular interfaces,such as increased metal ion level,taper corrosion and adverse local tissue reactions,while there are few studies on the complications of metal-on-polyethylene total hip arthroplasty,and metal-on-polyethylene prosthesis has similar problems such as increased local metal ion level and adverse tissue reactions caused by taper corrosion,which may also lead to complications such as prosthesis loosening,dislocation and fracture.Currently there are few reports about head and neck taper corrosion of metal-onpolyethylene prosthesis in China and there are still controversies about its manifestation and mechanism.In this paper,we summarized the above problems through literature reviewto expound the concept,research history,assessment methods,and incidence of metal-on-polyethylene prosthesistaper corrosion and the effect of material composition,diameter of the metal head,neck length,femoral offset,geometry of the taper,surgical factors,in vivo time,and patient factors on taper corrosion are analyzed.In summary,there are still many problems in the researches about the specific forming mechanism that have not been solved,thus it is very important for the prevention of taper corrosionchoosing the same material or ceramic material,avoiding overlarge diameter of the femoral head and femoral offset,avoiding too small taper degree,paying attention to the strength of tapping and cleaning of the taper are the current viable options.