Factors Associated With Trunnionosis in the Metal-on-Metal Pinnacle Hip

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• 作者：Harry S. Hothi ; BEng ; MSc ; PhD^a ; ; Antti P. Eskelinen ; MD ; PhD^b ; Reshid Berber ; BSc ; MBBS ; MRCS (Eng)^a ; Olli S. Lainiala ; MD^b ; Teemu P.S. Moilanen ; MD ; PhD^b ; John A. Skinner ; MBBS ; FRCS (Eng) ; FRCS (Orth)^a ; Alister J. Hart ; MA ; MD ; FRCS (Orth)^a
• 关键词：taper ; material loss ; corrosion ; retrieval ; metal-on-metal
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：32
• 期：1
• 页码：286-290
• 全文大小：580 K
• 卷排序：32

文摘

Trunnionosis of the tapered head-stem junction of total hip arthroplasties, either through corrosion or mechanical wear, has been implicated in early implant failure. Retrieval analysis of large numbers of failed implants can help us better understand the factors that influence damage at this interface.MethodsIn this study, we examined 120 retrieved total hip arthroplasties of one bearing design, the 36-mm diameter metal-on-metal, DePuy Pinnacle, that had been paired with 3 different stems. We measured material loss of the bearing and head-trunnion taper surfaces and collected clinical and component data for each case. We then used multiple linear regression analysis to determine which factors influenced the rate of taper material loss.ResultsWe found 4 significant variables: (1) longer time to revision (P = .004), (2) the use of a 12/14 taper for the head-trunnion junction (P < .001), (3) decreased bearing surface wear (P = .003), and (4) vertical femoral offset (P = .05). These together explained 29% of the variability in taper material loss.ConclusionOur most important finding is the effect of trunnion design. Of the 3 types studied, we found that S-ROM design was the most successful at minimizing trunnionosis.