The Taper Disaster - How Could it Happen?

Author:

Morlock Michael M.1

Affiliation:

1. Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg - Germany

Abstract

Corrosion of metallic implants in contact with body fluids is unavoidable, especially at interfaces where movement occurs or in gaps. Corrosion became clinically relevant with the introduction of large modular metal-on-metal total hip joint articulations (MoM THA) early in the 21st century. This review attempts to summarise the scientific knowledge about taper problems available at the time of introduction of these bearings, why this “disaster” could happen. It is speculated that changes to the taper connection made in the 1990s to increase the range of motion with small heads (28 and 32 mm) reduced the mechanical strength of this connection, which did not matter for small heads. With the use of large and very large metal heads in MoM articulations, which have a larger lever arm and can generate high friction in unfavourable situations, suddenly the taper interface exhibited corrosion problems on a previously unknown scale. It is speculated that due to the higher mechanical loading with larger heads, the taper connection became less forgiving with respect to assembly conditions, contamination, manufacturing tolerances and other factors, which are yet not known. Since no major clinical problems had been reported before the introduction of these bearings and the pre-clinical testing was very successful, the disaster took its course. The patient-implant-surgeon system is a very complex intrinsically hazardous system. Pre-clinical testing addresses few and defined factors and such, good results cannot be directly transferred to the clinical reality. A controlled stepwise introduction of innovations is required.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

Cited by 33 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Morse taper and femoral head modularity: a technical note;HIP International;2022-03

2. Taper Material Loss in Total Hip Replacements;Journal of Bone and Joint Surgery;2022-02-15

3. Experimental validation of the abrasive wear stage of the gross taper failure mechanism in total hip arthroplasty;Medical Engineering & Physics;2021-09

4. Fretting-corrosion in hip taper modular junctions: The influence of topography and pH levels – An in-vitro study;Journal of the Mechanical Behavior of Biomedical Materials;2021-06

5. Fatal vascular complication due to metallosis;Journal of Vascular Surgery Cases, Innovations and Techniques;2021-06

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