Radiographic Risk Factors Associated With Adverse Local Tiss
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Adverse local tissue reactions (ALTRs) in metal-on-polyethylene (MoP) total hip arthroplasty (THA) with head-neck taper corrosion are multifactorial, involving implant and patient factors. This study aimed to identify any potential clinical risk factors associated with failed MoP THA due to head-neck taper corrosion.

A series of 146 MoP THA patients was investigated: (1) ALTR (n = 42) on metal artifact sequence MRI and (2) non-ALTR (n = 104). Both cohorts were compared regarding femoral neck shaft angle, acetabular implant orientation, component size, femoral head offset, measurement of medial and vertical femoral offsets, and femoral stem alloy.

Results:
--The occurrence of ALTR was associated with increased radiographic femoral stem offset (36.0 ± 7.7 mm versus 40.8 ± 7.3 mm), increased femoral head offset (0.7 ± 3.4 versus 4.5 ± 3.7), and the use of Ti-12Mo-6Zr-2Fe alloy stems.

--The presence of ALTR was notably associated with higher chromium (2.0 versus 0.5 ?g/L) and cobalt (7.4 versus 0.7 ?g/L).

Increased femoral head and stem offset, as well as the use of Ti-12Mo-6Zr-2Fe alloy stems, were found to be risk factors for clinically significant ALTR in MoP THA patients due to head-neck taper corrosion in this study. This provides surgeons with evidence-based practical information for recognizing “at-risk” symptomatic MoP THA patients with head-neck taper corrosion and stratifying their risk.

Read more: https://journals.lww.com/jaaos/Abstract/2021/04150/Radiographic_Risk_Factors_Associated_With_Adverse.9.aspx
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