Corrosion of a hip stem with a modular neck taper junction: a retrieval study of 16 cases

Since the early 1990s, there has been a dramatic increase in modular total hip designs ranging from a stem with a proximal taper and modular head, to a distal stem, double taper proximal neck, and modular head. Clinical advantages of the modular neck include intraoperative adjustment of leg length via the neck-head taper and femoral anteversion via the neck-stem taper. Sixteen cases of a double tapered cone, Margron hip prosthesis, were presented for retrieval analysis. Macroscopic inspection, corrosion testing, light microscopy, and scanning electron microscopy were conducted to elucidate mechanisms of failure. In this regard, 6 neck components showed significant fretting, and crevice corrosion of the neck-stem taper with an average implantation time of 39 months compared with the remaining retrievals, which showed no corrosion with and average time in situ of 2.7 months. This retrieval study demonstrates that even with a modern taper design and corrosion-resistant materials, increased modularity can lead to fretting and crevice corrosion, metal ion generation, and particulate debris that may contribute to periprosthetic osteolysis and loosening.