SYMPOSIA PAPER Published: 29 January 2016

Is Taper Fretting Corrosion a Threat to the Clinical Performance of Large-Diameter Hips with Highly Crosslinked Polyethylene Bearings?


Modular head-neck taper corrosion has been studied with historical implant designs from the 1980s and 1990s. Less is known about the prevalence of taper corrosion in contemporary hip bearings incorporating highly crosslinked polyethylene (HXLPE) with large head diameters. We asked (1) what is the prevalence and severity of fretting and corrosion damage at the head-neck modular interfaces in HXLPE total hip arthroplasty (THA) with large head diameters, (2) what device and patient factors influence taper fretting corrosion in contemporary metal-on-polyethylene (MoP) THA, and (3) is taper corrosion associated with increased wear of the HXLPE bearing surface? Between 2000 and 2014, 890 THA systems were collected in a multi-institutional retrieval program. From these, 508 cobalt-chromium (CoCr) alloy heads, ranging in diameter from 22 mm to 44 mm, from six manufacturers were analyzed along with 216 metallic (CoCr, Ti-6Al-4V, or Ti-Mo-Zr-Fe) femoral stems. Head with diameters ≥36 mm were considered large diameter. The components were cleaned and scored for fretting and corrosion damage at the head and stem taper interfaces, in accordance with a previously established semiquantitative method. Linear penetration of the femoral head into the retrieved HXLPE liners was assessed directly to determine linear penetration rate (mm/yr). Mild to severe taper fretting corrosion (score ≥2) was found in 78 % of the head taper interfaces and 53 % of femoral stem tapers. The fretting corrosion scores were positively correlated to implantation time (p < 0.001). No correlation, however, was found between head taper interface damage and head diameter (p ≥0.09). Fretting corrosion scores were not correlated with head penetration rate into the HXLPE liners (p > 0.38). The results of this study do not support the hypothesis that large (≥ 36 mm) CoCr femoral heads articulating on HXLPE liners are associated with increased risk of fretting corrosion damage when compared with smaller diameter heads.

Author Information

Kurtz, Steven
Implant Research Center, Drexel University, Philadelphia, PA, US
MacDonald, Daniel
Implant Research Center, Drexel University, Philadelphia, PA, US
Gilbert, Jeremy
Syracuse University, Biomedical and Chemical Engineering, Syracuse, NY, US
Mont, Michael
Center for Joint Preservation and Replacement, The Rubin Institute of Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, US
Klein, Gregg
Hartzband Center for Hip & Knee Replacement, Paramus, NJ, US
Chen, Antonia
Rothman Institute at Jefferson, Philadelphia, PA, US
Kraay, Matthew
Joint Reconstruction and Arthritis Surgery, University Hospitals Case Medical Center, Cleveland, OH, US
Hamlin, Brian
The Bone and Joint Center-CMI, Magee-Womens Hospital of UPMC, Pittsburgh, PA, US
Rimnac, Clare
Case Western Reserve University, Center for the Evaluation of Implant Performance, Cleveland, OH, US
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Developed by Committee: F04
Pages: 45–58
DOI: 10.1520/STP159120140153
ISBN-EB: 978-0-8031-7628-7
ISBN-13: 978-0-8031-7627-0