Corrosion and wear are commonly found at the taper-trunnion connection of modular total hip arthroplasty (THA) explanted devices. While metal/metal (M/M) modular taper-trunnion connections exhibit more wear/corrosion than ceramic/metal (C/M) modular taper-trunnion connections, damage is present in both, regardless of material. This study used a combination of assessment techniques including clinical data, visual scoring assessment, optical imaging, profilometry, and x-ray photoelectron microscopy (XPS), to investigate wear mechanisms and damage features at the modular taper-trunnion connection of 10 M/M and 8 C/M explanted THAs. No correlation was found between any demographic variable and corrosion wear and assessment scores. All assessment techniques demonstrated that the stem trunnions had more damage than head tapers for both explant groups and agreed that C/M explants had less corrosion and wear compared to M/M explants. However, visual assessment scores differed between assessment techniques when evaluating the tapers and trunnions within the two groups. Profilometry showed an increase (p <.05) in surface roughness for stem trunnions compared to head tapers for both explant groups. X-ray photoelectron spectroscopy performed on deposits from two M/M explants found chromium and molybdenum carbides beneath the surface while chromium sulfate and aged bone mineral were found on the surface suggesting that the debris is a result of corrosion rather than wear. These results indicate that taper-trunnion damage is more prevalent for M/M explants, but C/M explants are still susceptible to damage. More comprehensive analysis of damage is necessary to better understand the origins of taper-trunnion damage.

中文翻译：

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金属/金属和陶瓷/金属锥形耳轴模块化连接在外植全髋​​关节置换物中的比较

腐蚀和磨损常见于模块化全髋关节置换术 (THA) 外植装置的锥形耳轴连接处。虽然金属/金属 (M/M) 模块化锥形耳轴连接比陶瓷/金属 (C/M) 模块化锥形耳轴连接表现出更多的磨损/腐蚀，但无论材料如何，两者都存在损坏。本研究结合使用包括临床数据、视觉评分评估、光学成像、轮廓测量和 X 射线光电子显微镜 (XPS) 在内的评估技术，研究 10 M/M 模块化锥形耳轴连接处的磨损机制和损坏特征和 8 C/M 移植了 THA。没有发现任何人口统计变量与腐蚀磨损和评估分数之间存在相关性。所有评估技术都表明，对于两个外植体组，茎耳轴的损伤都大于锥头，并同意 C/M 外植体与 M/M 外植体相比具有更少的腐蚀和磨损。然而，在评估两组内的锥度和耳轴时，视觉评估分数在评估技术之间存在差异。轮廓测量显示增加（p <.05) 与两个外植体组的头部锥度相比，茎耳轴的表面粗糙度。对来自两个 M/M 外植体的沉积物进行的 X 射线光电子能谱在表面下方发现了铬和碳化钼，而在表面上发现了硫酸铬和老化的骨矿物，这表明碎片是腐蚀而不是磨损的结果。这些结果表明，锥形耳轴损伤在 M/M 外植体中更为普遍，但 C/M 外植体仍然容易受到损伤。有必要对损伤进行更全面的分析，以更好地了解锥形耳轴损伤的起源。