Assessment of wear on the cones of modular stainless steel Exeter hip stems

The wear on the stem cones of retrieved Exeter Universal hip stems has been assessed using scanning electron microscopy (SEM), energy-dispersive X-ray analysis (EDX) and surface profilometry. The in-service life of these prosthetic stems varied, up to a maximum of 7 years. A combination of SEM, EDX and visual assessment indicates that the stem cones have not suffered from any corrosion. SEM scans indicate that damage to stem cones (excluding extraction and post-removal damage) can be categorised into insertion marks and fretting marks. In some cases there are signs of material being deposited on the cone surface. Surface profilometry suggests that the levels of debris generation at the cone/internal head interface are very low relative to those that are likely to be associated with head articulation against the acetabular cup. A total of 20 stem cones underwent SEM scans. From these, 10 subsequently have undergone surface profilometry along with the corresponding internal head surfaces. There is a good correlation between surface roughness measured by surface profilometry and the topography observed in the SEM images. The surface roughness of each stem cone is similar to that of the corresponding internal head surface.