Abstract
Background
Many exchangeable neck hip systems have been withdrawn because of fretting corrosion
at the neck/stem coupling.
Method
Our prospective randomized study evaluating stem stability (Roentgen stereophotogrammetric
analysis, dual-energy x-ray absorptiometry) and clinical outcomes between the K2/Apex
hip systems was ceased early because of a withdrawal of the stems which had an unfavorably
high early revision rate reported in the Australian Orthopaedic Association National
Joint Registry (9.3% at 3 years).
Results
At 2 years, there are no clinical differences between the stems. Roentgen stereophotogrammetric
analysis has identified a high proportion of potentially concerning subsidence and
retroversion in both groups, more marked in the K2 stem, although mostly in asymptomatic
patients. Dual-energy x-ray absorptiometry has shown similar bone density around the
stems. Retrieval analysis of 3 study patients showed fretting corrosion of the antirotation
pin and aseptic lymphocyte-dominated vasculitis-associated lesion, with no relationship
to bearing type or size. Analysis of 7 further nonstudy K2/Apex stems confirmed similar
corrosion.
Conclusion
This study shows potentially concerning subsidence of both stems and is the first
to describe corrosion at the neck-stem interface and a relationship to metal-related
pathology.
Keywords
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Article info
Publication history
Published online: October 27, 2015
Accepted:
October 13,
2015
Received in revised form:
September 29,
2015
Received:
August 22,
2015
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.10.004.
Identification
Copyright
© 2016 Published by Elsevier Inc. All rights reserved.
