How to diagnose taper corrosion

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Taper junction corrosion in total hip replacements is a growing concern; it is also a multi-faceted problem. With both asymptomatic and symptomatic patient groups, what indications should a surgeon look for when corrosion is suspected? While there is not a single test to isolate corrosion problems, a spectrum of diagnostic tools have been suggested to make a diagnosis.

Corrosion of the head-neck or taper junction in modular total hip implants has increasingly been reported [1, 2]. While several co-mingling factors have been identified as contributors to the problem (see Part I of this article series), patients may or may not display symptoms, which can make it challenging to identify corrosion through symptoms. In some cases, corrosion has not been identified or confirmed until during revision, and these patients may experience higher rates of complications [3]. Symptoms patients may display cover a broad range and include, but are not limited to: pain, instability, elevated serum metal levels, adverse local tissue reactions (ALTR), swelling, in rare cases neurological changes, and more.

It can take upwards of eight months to establish corrosion as a diagnosis and perform retrieval [4] and Kwon cautions against overreliance on any single diagnostic tool [5]. Here we look at a selection of clinical indicators that may help identify or eliminate corrosion and/or associated metal toxicity as a cause for concern.

 

 

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  • When to suspect corrosion
  • Pain as a possible initial symptom
  • Is it an infection?
  • Serum metal levels may be elevated
  • Evidence of adverse local tissue reaction?
  • Use of imaging technology
  • Rare cases
  • Conclusion
  • References

Part 1 | Risk factors for taper corrosion in total hip arthroplasty

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Part 3 | Surgical options for addressing taper corrosion

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Contributing experts

This series of articles was created with the support of the following specialists (in alphabetical order):

Moussa Hamadouche

Cochin University Hospital
Paris, France

Michael Morlock

Hamburg University of Technology
Hamburg, Germany

Carsten Perka

Charité—University Medicine Berlin
Berlin, Germany

 

This issue was created by Word+Vision Media Productions, Switzerland

References

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  3. Lash NJ, Whitehouse MR, Greidanus NV, et al. Delayed dislocation following metal-on-polyethylene arthroplasty of the hip due to 'silent' trunnion corrosion. Bone Joint J. 2016 Feb;98-B(2):187-193.
  4. Cooper HJ, Della Valle CJ, Berger RA, et al. Corrosion at the head-neck taper as a cause for adverse local tissue reactions after total hip arthroplasty. J Bone Joint Surg Am. 2012 Sep 19;94(18):1655-1661.
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