Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI.
Department of Orthopaedic Research, Beaumont Health, Royal Oak, MI.
J Arthroplasty. 2021 Jul;36(7S):S386-S394.e4. doi: 10.1016/j.arth.2021.02.041. Epub 2021 Feb 23.
Decreased fretting and corrosion damage at the taper interface of retrieved ceramic-on-polyethylene total hip arthroplasty (THA) implants has been consistently reported; however, resultant fretting corrosion as a function of femoral head size and taper geometry has not been definitively explained.
Eight cohorts were defined from 157 retrieved THA implants based on femoral head composition (n = 95, zirconia-toughened alumina, ZTA vs n = 62, cobalt-chromium alloy, CoCr), head size (n = 56, 32mm vs n = 101, 36mm), and taper geometry (n = 84, 12/14 vs n = 73, V40). THA implants were evaluated and graded for taper fretting and corrosion. Data were statistically analyzed, including via a 2 factorial modeling.
Factorial-based analysis indicated the significant factors related to both resultant (summed) fretting and corrosion damage were head material and taper geometry; head material-taper geometry interaction was also a significant factor in resultant corrosion damage. Lower rates of moderate-to-severe fretting and corrosion damage were exhibited on ZTA heads (ZTA = 13%, CoCr = 38%), smaller heads (32mm = 18%, 36mm = 26%), and 12/14 tapers (12/14 = 13%, V40 = 35%). ZTA+32mm heads demonstrated the lowest rates of moderate-to-severe fretting and corrosion damage (12/14 = 2%, V40 = 7%), whereas CoCr heads with V40 tapers demonstrated the greatest rates of moderate-to-severe damage (32mm = 47%, 36mm = 59%).
In this series, retrieved implants with ZTA, 32-mm heads paired with 12/14 tapers exhibited lower rates of moderate-to-severe damage. Factorial analysis showed head material, taper geometry, and their interactions were the most significant factors associated with resultant damage grades. Isolating implant features may provide additional information regarding factors leading to fretting and corrosion damage in THA.
IV (case series).
在已回收的陶瓷-聚乙烯全髋关节置换术（THA）植入物的锥面接口处，磨损和腐蚀损伤明显减少，这一现象已得到持续报道；然而，由于股骨头尺寸和锥面几何形状导致的磨损腐蚀还没有得到明确的解释。
根据股骨头成分（氧化锆增韧氧化铝，ZTA，n=95；钴铬合金，CoCr，n=62）、股骨头尺寸（32mm，n=56；36mm，n=101）和锥面几何形状（12/14，n=84；V40，n=73），将 157 例已回收的 THA 植入物分为 8 个队列。对锥面磨损和腐蚀情况进行评估和分级。对数据进行了统计学分析，包括基于 2 因素模型的分析。
基于因素的分析表明，与磨损和腐蚀的综合结果相关的显著因素是股骨头材料和锥面几何形状；股骨头材料与锥面几何形状的相互作用也是导致腐蚀综合结果的一个显著因素。ZTA 头（ZTA=13%，CoCr=38%）、小头（32mm=18%，36mm=26%）和 12/14 锥面（12/14=13%，V40=35%）表现出较低的中重度磨损和腐蚀损伤发生率。ZTA+32mm 头显示出最低的中重度磨损和腐蚀损伤发生率（12/14=2%，V40=7%），而 V40 锥面的 CoCr 头显示出最高的中重度损伤发生率（32mm=47%，36mm=59%）。
在本研究中，与 CoCr 头和 36mm 股骨头配对的 V40 锥面组合，其中重度损伤发生率最高。与综合损伤等级相关的最重要因素是股骨头材料、锥面几何形状及其相互作用。分离植入物特征可能会提供有关 THA 中导致磨损和腐蚀损伤因素的更多信息。
IV（病例系列研究）。
