SYMPOSIA PAPER Published: 29 January 2016
STP159120140141

Histological Characterization of Chromium Orthophosphate Corrosion Products from Modular Total Hip Replacements

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Deposits of chromium orthophosphate with a greenish-gold color and flaky texture have been reported in the past literature in tissues from metal-onpolyethylene total hips and more recently in metal-on-metal total hips. It has been suggested that these deposits may contribute to adverse local tissue reactions. The aim of this study was to characterize these corrosion products and the local tissue reaction to them in a group of revised hip tissues from modular total hips. Periprosthetic tissues from 13 modular hip arthroplasties were histologically examined and debris was characterized by size, shape, color, contacting cell histology, and the surrounding tissue histology. Tapers were examined for evidence of tribocorrosion at the femoral tapers using a visual corrosion scoring criteria. Yellow-gold or silvery-green elongated or roughly rectangular debris ranged in size from 27 to 240 μm in length. These particles were typically in contact with foreign-body giant cells or an encapsulating layer of fibrous tissue. The surrounding tissue was variable but usually included histiocytic inflammation. Necrosis, microgranuloma formation, and lymphocytic inflammation were seen but were not prominent features. The tapers were ranked moderate to severe on the visual corrosion scale, and there was evidence of corrosion products outside of the main contact zone, typically in a thin, dark band distal to the taper contact area. Although modular interface corrosion can produce particulate debris, this is rarely identified within retrieval tissues. Because we examined mostly metal-on-metal hips, the presence of metal from the bearings in these tissues precluded a clear interpretation of the local reaction to the chromium orthophosphate debris. More extensive examination of tissues associated with corroded tapers from polyethylene or ceramic bearings may provide more information on reactivity of these tribocorrosion products.

Author Information

Kung, Michael
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US
Campbell, Pat
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US
Markantonis, John
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US UCLA, Dept. of Orthopaedic Surgery, Los Angeles, CA, US
Knutsen, Ashleen
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US UCLA, Dept. of Bioengineering, Los Angeles, CA, US
Ameri, Bijan
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US UCLA, Dept. of Orthopaedic Surgery, Los Angeles, CA, US
Park, Sang-Hyun
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US
Ebramzadeh, Edward
UCLA, Orthopaedic Biomechanics and Mechanobiology Research Lab, Orthopaedic Institute for Children, Los Angeles, CA, US
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Developed by Committee: F04
Pages: 428–439
DOI: 10.1520/STP159120140141
ISBN-EB: 978-0-8031-7628-7
ISBN-13: 978-0-8031-7627-0