Metallic Modular Taper Junctions in Total Hip Arthroplasty

  • Timothy McTighe JISRF
  • Declan Brazil Signature Orthopaedics, Ltd NSW, Australia JISRF Chagrin Falls, Ohio, USA
  • Louis Keppler St. Vincent Medical Group Cleveland, Ohio JISRF Chagrin Falls, Ohio
  • John Keggi Orthopaedics New England Middlebury, CT Connecticut Joint Replacement Institute Hartford, Ct JISRF Chagrin Falls, Ohio
  • Edward McPherson L.A. Orthopaedic Institute L.A., CA JISRF Chagrin Falls, Ohio
Keywords: hip, arthroplasty, debis, fretting, modularity, taper, metallurgy

Abstract

The emergence of modularity in total hip arthroplasty (THA) in the 1980s and 1990s was based on the fact that the benefit of these design features outweighed the risk. The use of metallic modular junctions presents a unique set of advantages and problems for use in THA. The advantages include improvement in fit and fill of the implant to bone, restoration of joint mechanics, reduced complications in revision surgery and reduction of costly inventory. However, the risks or concerns are a little harder to identify and deal with. Certainly corrosion, and fatigue failure are the two most prevalent concerns but now the specifics of fretting wear and corrosive wear increasing particulate debris and the potential biological response is having an impact on the design and potential longevity of the reconstructed hip. Material and designs are facing a shorter life expectancy than what was previously thought, mostly due to an increasing level of physical activity by the patient. Because there are no accurate laboratory test whereby the service life and performance of these implants can be predicted, early controlled clinical evaluations are necessary. Early publication of testing and clinical impressions should be encouraged in an attempt to reduce exposure to potential at risk patients, implants and material. The reduction and possible elimination of risks will require a balancing of all the variables requiring a multidisciplinary endeavor.


This paper is designed to review the risk factors, and benefits of modular junctions in total hip arthroplasty (THA). Also some basic engineering principals that can reduce risk factors and improve functionality of modular junctions.

Author Biographies

Timothy McTighe, JISRF

Dr. H.S. (hc)

Executive Director JISRF

Declan Brazil, Signature Orthopaedics, Ltd NSW, Australia JISRF Chagrin Falls, Ohio, USA

PhD, Founder Signature Orthopaedics, Ltd

NSW, Australia

 

Co-Director Research, JISRF

Chagrin Falls, Ohio, USA

Louis Keppler, St. Vincent Medical Group Cleveland, Ohio JISRF Chagrin Falls, Ohio
MD, Orthopaedic Surgeon
John Keggi, Orthopaedics New England Middlebury, CT Connecticut Joint Replacement Institute Hartford, Ct JISRF Chagrin Falls, Ohio
MD, Orthopaedic Surgeon
Edward McPherson, L.A. Orthopaedic Institute L.A., CA JISRF Chagrin Falls, Ohio
Dr. McPherson is a member of The American Academy of Orthopaedic Surgeons, The American College of Surgeons, The Musculoskeletal Infection Society, The Societe Internationale Chirgue and Orthopaedic Traumatologie (SICOT), The Charleston County Medical Society, and The Association of Military Surgeons of the United States. He is also a Board member for JISRF

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Published
2015-08-12
How to Cite
McTighe, T., Brazil, D., Keppler, L., Keggi, J., & McPherson, E. (2015). Metallic Modular Taper Junctions in Total Hip Arthroplasty. Reconstructive Review, 5(2). https://doi.org/10.15438/rr.5.2.108
Section
Controversial Issues (i.e. modularity, tapers, MoM, etc.)