Femoral head disengagement from Accolade femoral stem in MOM Arthroplasty: a case study and literature review

Review: Trunnionosis leading to modular femoral head dissociation

Component dissociation secondary to trunnionosis is rare, and its causes are multifactorial. It is a major complication of total hip replacement, in most cases requiring revision arthroplasty. In this paper, we present a case of taper/head modular interface dissociation in a metal-on-metal total hip replacement. We review the literature of both trunnionosis, as well as a systematic review of modular dissociation of the femoral component in total hip arthroplasty, identifying commonalities with our own case.

Gross Stem Taper Failure with Head Dissociation in a Very Active Patient with an Uncemented Femoral Stem

CASE

We report a case of gross taper failure (GTF) in a very active 81-year-old man 14 years after index operation. The patient presented with acute hip pain and shortening of the left leg. X-rays showed the dissociation of the head. The stem had to be revised because of the massive stem taper damage.

CONCLUSION

This case demonstrates that GTF at the head-stem taper junction following mechanically assisted crevice corrosion is not limited to a specific taper design and material. Other risk factors such as high activity level can lead to this failure pattern also in established stem and taper designs.