The evolution of the trunnion.

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device engineering

Background:

• Implant modularity, particularly the femoral stem trunnion, faces scrutiny due to wear, corrosion, and adverse reactions to metal debris.
• Existing trunnion designs show significant variations despite apparent similarities across manufacturers, indicating a lack of standardization.

Purpose of the Study:

• To review the evolution and development of the femoral stem trunnion.
• To relate design history to current issues of wear, corrosion, and adverse reactions.
• To discuss potential solutions and preventative measures for these implant-related problems.

Main Methods:

• Literature review of femoral stem trunnion design evolution.
• Analysis of contemporary issues related to implant modularity.
• Discussion of wear, corrosion, and adverse reactions to metal debris.

Main Results:

• Lack of standardization in femoral stem trunnion designs persists.
• Increased prevalence of wear and corrosion issues linked to design changes and larger metal head sizes.
• Potential for adverse reactions to metal debris necessitates careful consideration.

Conclusions:

• Standardization of femoral stem trunnion design is crucial.
• Addressing wear and corrosion requires attention to design modifications and head size.
• Mitigating adverse reactions to metal debris is essential for patient safety.