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

• Published in: Current reviews in musculoskeletal medicine 2016-03, Vol.9 (1), p.75-83
• Main Authors: Weiser, Mitchell C., Chen, Darwin D.
• Format: Article
• Language: English
• Subjects: Hip: Metal-on-Metal (J Cooper; Hip: Metal-on-Metal (J Cooper, Section Editor); Medicine; Medicine & Public Health; Minimally Invasive Surgery; Orthopedics; Rehabilitation Medicine; Section Editor; Sports Medicine; Surgery; Surgical Orthopedics; Topical Collection on Hip: Metal-on-Metal
• ISSN: 1935-973X; 1935-9748
• DOI: 10.1007/s12178-016-9322-2

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.