Arthroscopy as a diagnostic tool for painful trunnion corrosion after hip arthroplasty

Abstract

Purpose

Adverse local soft tissue reactions can occur in response to wear debris or corrosion products released from total hip arthroplasty (THA). Hip arthroscopy is a useful diagnostic adjunct in the investigation of painful THA.

Methods

A patient with a painful primary metal-on-highly cross-linked polyethylene THA underwent hip arthroscopy to confirm the diagnosis of trunnion corrosion.

Results

The prosthetic implants were well fixed and aligned with no indication of infection. Hip arthroscopy was used to confirm the presence of corrosion on the trunnion of a titanium stem at its junction with a cobalt-chrome head. Due to persistent symptoms, the patient subsequently underwent arthrotomy, which confirmed the diagnosis, and revision hip arthroplasty to a titanium adapter sleeve, ceramic head and liner exchange, with relief of his symptoms.

Conclusion

Hip arthroscopy may prove a useful additional diagnostic tool in the investigation of this emerging clinical entity.

Level of evidence

IV.

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Conflict of interest

One of the authors (CPD) certifies that they have or may receive payments or benefits (e.g. serve as a consultant) from a commercial entity (Zimmer, Inc, Warsaw, IN, USA) related to this work. One of the authors (MRW) certifies that they have no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article. The institution of the authors (MRW, CPD) has received funding from Zimmer, Inc.

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The subject of the case report gave informed consent for the submission of this case report.

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Correspondence to Michael R. Whitehouse.

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Whitehouse, M.R., Duncan, C.P. Arthroscopy as a diagnostic tool for painful trunnion corrosion after hip arthroplasty. Knee Surg Sports Traumatol Arthrosc 23, 2601–2604 (2015). https://doi.org/10.1007/s00167-014-3184-1

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Keywords

  • Corrosion Product
  • Anterior Capsule
  • Soft Tissue Reaction
  • Adverse Local Tissue Reaction
  • Composite Capsule