Clinically Significant Corrosion at the Head-Neck Taper Interface in Total Hip Arthroplasty: A Systematic Review and Case Series

Corrosion of the head-neck junction of the femoral component in total hip arthroplasty has been associated with symptomatic adverse local tissue reactions, trunion fracture and elevated serum metal ions. An analysis of risk factors and treatment strategies for corrosion at this interface is lacking in the literature. We therefore performed a systematic review of AAOS proceedings, MEDLINE and EMBASE databases, and included our own case series. A total of 24 articles representing 776 cases of head-neck corrosion met inclusion criteria. The combination of large femoral head sizes and small taper dimensions comprised the majority of published corrosion cases. Revision to ceramic head and ceramic/polyethylene liner was the most commonly utilised treatment. Coating precipitation, mixed alloy coupling and head-neck modulus mismatch collectively appear to contribute to the corrosive process.