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Materials 2017, 10(7), 733; https://doi.org/10.3390/ma10070733

In Vivo Damage of the Head-Neck Junction in Hard-on-Hard Total Hip Replacements: Effect of Femoral Head Size, Metal Combination, and 12/14 Taper Design

Istituto Ortopedico Rizzoli, Laboratorio di Tecnologia Medica, 40136 Bologna, Italy
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Academic Editor: J. Paulo Davim
Received: 7 May 2017 / Revised: 24 June 2017 / Accepted: 25 June 2017 / Published: 1 July 2017
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Abstract

Recently, concerns have been raised about the potential effect of head-neck junction damage products at the local and systemic levels. Factors that may affect this damage process have not been fully established yet. This study investigated the possible correlations among head-neck junction damage level, implant design, material combination, and patient characteristics. Head-neck junctions of 148 retrieved implants were analysed, including both ceramic-on-ceramic (N = 61) and metal-on-metal (N = 87) bearings. In all cases, the male taper was made of titanium alloy. Damage was evaluated using a four-point scoring system based on damage morphology and extension. Patient age at implantation, implantation time, damage risk factor, and serum ion concentration were considered as independent potential predicting variables. The damage risk factor summarises head-neck design characteristics and junction loading condition. Junction damage correlated with both implantation time and damage factor risk when the head was made of ceramic. A poor correlation was found when the head was made of cobalt alloy. The fretting-corrosion phenomenon seemed mainly mechanically regulated, at least when cobalt alloy components were not involved. When a component was made of cobalt alloy, the role of chemical phenomena increased, likely becoming, over implantation time, the damage driving phenomena of highly stressed junctions. View Full-Text
Keywords: total hip replacements; hard-on-hard bearings; head-neck junction; fretting corrosion total hip replacements; hard-on-hard bearings; head-neck junction; fretting corrosion
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Baleani, M.; Erani, P.; Bordini, B.; Zuccheri, F.; Mąkosa, M.K.; De Pasquale, D.; Beraudi, A.; Stea, S. In Vivo Damage of the Head-Neck Junction in Hard-on-Hard Total Hip Replacements: Effect of Femoral Head Size, Metal Combination, and 12/14 Taper Design. Materials 2017, 10, 733.

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