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Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls

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Abstract

The management of the patient with a recalled, modular neck-body total hip arthroplasty can be complex, as it involves a combination of clinical, technical, and medicolegal challenges. Management begins with a thorough history and physical exam, radiographic evaluation, infection workup, and serum metal ion levels. Three-dimensional imaging is obtained based on patient symptomatology and metal ion levels and is used to evaluate for the presence of an adverse local tissue response as well as the integrity of the existing soft tissue envelope. The decision to perform revision surgery is based on a combination of patient symptomatology, laboratory values, and imaging findings. Revision surgery involves the entire armamentarium of femoral revision techniques, and the acetabulum may need to be revised at the surgeon’s discretion. The femoral implant can often be removed without disrupting the femoral bone envelope; however, the surgeon should have a low threshold to perform an extended trochanteric osteotomy.

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Author information

Correspondence to Darwin D. Chen.

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Conflict of interest

Mitchell C. Weiser reports that he is a member of the AAOS Biomedical Engineering Committee.

Darwin D. Chen reports personal fees from KCI Acelity, outside the submitted work.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Hip: Metal-on-Metal

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Weiser, M.C., Chen, D.D. Revision for taper corrosion at the neck-body junction following total hip arthroplasty: pearls and pitfalls. Curr Rev Musculoskelet Med 9, 75–83 (2016). https://doi.org/10.1007/s12178-016-9322-2

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Keywords

  • Corrosion
  • Modular neck
  • Revision hip arthroplasty
  • Adverse local tissue reaction