This retrospective case series describes 10 patients with metal-on-polyethylene THA who developed adverse local tissue reactions from corrosion at the modular femoral head-neck taper. It asks: what is the clinical presentation, diagnostic workup, and early outcome of revision surgery for this complication? X-rays were normal in every case, making this a diagnosis that requires metal ion testing and advanced imaging.
Taper corrosion was considered a historical concern largely solved by modern manufacturing — this paper proved it still causes clinically significant soft-tissue destruction, even with polyethylene bearings.
When a patient with any THA presents with unexplained hip pain, swelling, or instability and normal radiographs, check serum cobalt and chromium. A cobalt level disproportionately elevated above chromium should prompt MRI and consideration of taper corrosion as the diagnosis, regardless of bearing surface.
At revision, assess abductor integrity before committing to a liner choice. If significant muscle necrosis is present, use a constrained liner. The authors placed one prophylactically in their final case based solely on intraoperative findings, with no prior instability history.
A ceramic head on a titanium sleeve converts the interface away from cobalt alloy and avoids direct ceramic impaction onto a potentially damaged trunnion. This is the preferred reconstruction strategy described in this series.
This retrospective case series describes 10 patients with metal-on-polyethylene THA who developed adverse local tissue reactions from corrosion at the modular femoral head-neck taper. It asks: what is the clinical presentation, diagnostic workup, and early outcome of revision surgery for this complication? X-rays were normal in every case, making this a diagnosis that requires metal ion testing and advanced imaging.
Taper corrosion was considered a historical concern largely solved by modern manufacturing — this paper proved it still causes clinically significant soft-tissue destruction, even with polyethylene bearings.
When a patient with any THA presents with unexplained hip pain, swelling, or instability and normal radiographs, check serum cobalt and chromium. A cobalt level disproportionately elevated above chromium should prompt MRI and consideration of taper corrosion as the diagnosis, regardless of bearing surface.
At revision, assess abductor integrity before committing to a liner choice. If significant muscle necrosis is present, use a constrained liner. The authors placed one prophylactically in their final case based solely on intraoperative findings, with no prior instability history.
A ceramic head on a titanium sleeve converts the interface away from cobalt alloy and avoids direct ceramic impaction onto a potentially damaged trunnion. This is the preferred reconstruction strategy described in this series.