Revision of Recalled Modular Neck Rejuvenate and ABG Femoral Implants

• Published in: The Journal of arthroplasty Vol. 30; no. 5; pp. 822 - 826
• Main Authors: Walsh, Christopher P., MD, Hubbard, James C., BS, Nessler, Joseph P., MD, Markel, David C., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2015
• Subjects: ABG; adverse local tissue reaction; Arthroplasty, Replacement, Hip - adverse effects; Chromium - blood; Cobalt - blood; Corrosion; Female; Femur Neck - surgery; Hip Prosthesis - adverse effects; Humans; Male; Medical Device Recalls; metal ion level; Orthopedics; Osteotomy; Prosthesis Design; Prosthesis Failure; recalled modular neck hip implants; rejuvenate; Reoperation; Retrospective Studies; metal ion level; rejuvenate; recalled modular neck hip implants; ABG; adverse local tissue reaction
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2014.12.002

Abstract Modular neck femoral stems have been associated with adverse local tissue reactions (ALTR), leading to a voluntary recall, but these effects have not been well-characterized. A retrospective review of intraoperative findings and cobalt/chromium levels was performed in 103 hips undergoing revision for ALTR. The average preoperative serum cobalt level was 7.6 μg/L (range 1.1–23 μg/L) and chromium level was 1.8 μg/L (range 0.1–6.8 μg/L). Metallic sludge was noted in 100%, synovitis in 98%, pericapsular rind in 82%, and calcar erosion in 85%. An osteotomy was required for removal in 44%. We concluded that revision of modular neck femoral stems is associated with increased preoperative metal ion levels and stem-neck corrosion. Despite advanced stem explantation techniques, osteotomy was frequently required, leading to increased morbidity.