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模块化股骨部件当前设计中头颈界面的腐蚀:与模块化头颈连接处腐蚀相关的关键问题及解答

Corrosion at the head-neck interface of current designs of modular femoral components: essential questions and answers relating to corrosion in modular head-neck junctions.

作者信息

Osman K, Panagiotidou A P, Khan M, Blunn G, Haddad F S

机构信息

Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.

University College London, 170 Tottenham Court Road, London W1T 7HA, UK.

出版信息

Bone Joint J. 2016 May;98-B(5):579-84. doi: 10.1302/0301-620X.98B5.35592.

Abstract

There is increasing global awareness of adverse reactions to metal debris and elevated serum metal ion concentrations following the use of second generation metal-on-metal total hip arthroplasties. The high incidence of these complications can be largely attributed to corrosion at the head-neck interface. Severe corrosion of the taper is identified most commonly in association with larger diameter femoral heads. However, there is emerging evidence of varying levels of corrosion observed in retrieved components with smaller diameter femoral heads. This same mechanism of galvanic and mechanically-assisted crevice corrosion has been observed in metal-on-polyethylene and ceramic components, suggesting an inherent biomechanical problem with current designs of the head-neck interface. We provide a review of the fundamental questions and answers clinicians and researchers must understand regarding corrosion of the taper, and its relevance to current orthopaedic practice. Cite this article: Bone Joint J 2016;98-B:579-84.

摘要

全球对于第二代金属对金属全髋关节置换术后金属碎屑不良反应及血清金属离子浓度升高的认识日益增加。这些并发症的高发生率很大程度上可归因于头颈界面处的腐蚀。锥度严重腐蚀最常发现于较大直径股骨头相关病例中。然而,越来越多的证据表明,在取出的较小直径股骨头部件中也观察到了不同程度的腐蚀。在金属对聚乙烯及陶瓷部件中也观察到了同样的电偶腐蚀和机械辅助缝隙腐蚀机制,这表明当前头颈界面设计存在内在的生物力学问题。我们针对锥度腐蚀相关的基本问题及答案进行综述,这些是临床医生和研究人员必须了解的,以及其与当前骨科实践的相关性。引用本文:《骨与关节杂志》2016年;98-B:579 - 84。

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