Trunnionosis: A pain in the neck
Philip S Pastides1, Matthew Dodd, Khaled M Sarraf
1Philip S Pastides, Department of Trauma and Orthopedics, Charing Cross Hospital, Imperial NHS Trust, London W6 8RF, United Kingdom.
World Journal of Orthopedics
|October 23, 2013
Summary
Metal-on-metal hip replacements have failed due to unexpected wear. New research highlights "trunnionosis," wear at the prosthesis junction, as a significant contributor to metal ion release and implant failure.
Area of Science:
- Orthopaedic Surgery
- Biomaterials Science
- Wear Debris Analysis
Background:
- Metal-on-metal (MoM) hip replacements initially promised durability but led to significant failures.
- Unanticipated wear rates and metal ion release caused soft tissue complications and early implant failure.
- Revision surgeries and implant extractions became common due to MoM failures.
Purpose of the Study:
- To introduce and explain the phenomenon of trunnionosis in hip prostheses.
- To summarize current evidence regarding trunnionosis.
- To investigate trunnion wear as a source of metal debris and ion release.
Main Methods:
- Review of existing literature on hip prosthesis wear.
- Analysis of debris generated at the trunnion junction.
- Comparison of wear patterns in MoM, non-MoM, and resurfacing hip procedures.
Main Results:
- Trunnion wear is an emerging concern, contributing to metallosis in MoM implants.
- Trunnionosis can also release metal ions in non-MoM hip designs.
- Debris particle types and generation mechanisms at the trunnion are being investigated.
Conclusions:
- Trunnionosis is a critical factor in hip implant failure, beyond articulation wear.
- Understanding trunnion wear is essential for improving future hip implant designs.
- Further research is needed to fully elucidate the impact of trunnionosis across different hip replacement types.
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