Diagnosing Taper Corrosion: When Is It the Taper and When Is It Something Else?

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Diagnostics

Background:

• Modularity in total hip arthroplasty (THA) aims to replicate native anatomy for better function.
• Corrosion at the modular head-neck junction, particularly in metal-on-polyethylene bearings, can cause adverse local tissue reactions (ALTR).
• ALTR due to taper corrosion is an emerging concern in THA patients presenting with hip pain and gait disturbance.

Purpose of the Study:

• To provide a comprehensive overview of taper corrosion in THA.
• To discuss the diagnosis, etiology, management, and prevention of ALTR caused by taper corrosion.
• To differentiate ALTR from other potential causes of hip pain and dysfunction.

Main Methods:

• Review of literature and clinical symposium findings on taper corrosion.
• Description of diagnostic approaches including patient history, physical examination, imaging (plain and advanced), and laboratory tests.
• Emphasis on differential diagnosis, considering conditions like periprosthetic joint infection, instability, and aseptic loosening.

Main Results:

• Serum metal levels are identified as a key screening tool for detecting taper corrosion.
• ALTR from taper corrosion can present with symptoms similar to other common hip pathologies.
• Radiographs and standard laboratory tests are crucial for excluding alternative diagnoses before confirming ALTR due to corrosion.

Conclusions:

• Taper corrosion and subsequent ALTR are increasingly recognized complications in THA.
• A systematic diagnostic approach is essential, integrating clinical evaluation, imaging, and specific biomarkers.
• Prompt identification and management are critical for addressing hip pain and functional decline in affected patients.