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The Journal of Bone and Joint Surgery, Vol 76, Issue 9 1345-1359, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Migration of corrosion products from modular hip prostheses. Particle microanalysis and histopathological findings
RM Urban, JJ Jacobs, JL Gilbert and JO Galante
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Migration of solid corrosion products from the modular head-neck junction
of fifteen total hip replacements to the periprosthetic tissues was
studied. The devices and tissues were recovered at the time of a revision
procedure or at autopsy after a mean of sixty-four months (range, eight to
ninety-seven months). The prostheses had a cobalt-chromium-alloy head
coupled with a cobalt-chromium-alloy or a titanium-alloy stem. The solid
corrosion product was identified by electron microprobe analysis and
Fourier transform infrared microprobe spectroscopy as a chromium
orthophosphate hydrate-rich material. The product was present at the
junction of the modular head and neck and as particles within the
periprosthetic tissues as early as eight months postoperatively. In several
hips, it was also present on the polyethylene bearing surface. The
particles in the tissues ranged in size from less than one to 500
micrometers. They were present within histiocytes or were surrounded by
foreign-body giant cells in the pseudocapsule of the hip joint; in the
membranes of the femoral bone-implant interface; and at sites of femoral
endosteal erosions, with and without loosening of the femoral component.
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