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Material loss at the femoral head taper: A comparison study of the Exeter Metal-on-Polyethylene and contemporary Metal-on-Metal total hip arthroplasty

Lookup NU author(s): Professor Tom Joyce, Professor David Deehan

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Abstract

© 2018 The British Editorial Society of Bone & Joint Surgery. Aims There are limited published data detailing the volumetric material loss from tapers of conventional metal-on-polyethylene (MoP) total hip arthroplasties (THAs). Our aim was to address this by comparing the taper wear rates measured in an explanted cohort of the widely used Exeter THA with those measured in a group of metal-on-metal (MoM) THAs. Patients and Methods We examined an existing retrieval database to identify all Exeter V40 and Universal MoP THAs. Volumetric wear analysis of the taper surfaces was conducted using previously validated methodology. These values were compared with those obtained from a series of MoM THAs using non-parametric statistical methodology. A number of patient and device variables were accounted for using multiple regression modelling. Results A total of 95 Exeter MoP and 249 MoM THAs were examined. The median volumetric loss from the MoM cohort was over four times larger than that from the MoP cohort (1.01 mm3 vs 0.23 mm3, p < 0.001), despite a significantly shorter median period in vivo for the MoM group (48 months vs 90 months, p < 0.001). Multiple regression modelling indicated that the dominant variables leading to greater female taper material loss were bearing diameter (p < 0.001), larger female taper angles (p < 0.001), and male titanium stem tapers (p < 0.001). Conclusion Consistent with the long-term clinical success of the device, the volumetric material loss from Exeter femoral head tapers was, in general, small compared with that from largerdiameter MoM head tapers.


Publication metadata

Author(s): Langton DJ, Wells SR, Joyce TJ, Bowsher JG, Deehan D, Green S, Nargol AVF, Holland JP

Publication type: Article

Publication status: Published

Journal: Bone and Joint Journal

Year: 2018

Volume: 100B

Issue: 10

Pages: 1310-1319

Print publication date: 01/10/2018

Online publication date: 08/10/2018

Acceptance date: 02/04/2018

ISSN (print): 2049-4394

ISSN (electronic): 2049-4408

Publisher: British Editorial Society of Bone and Joint Surgery

URL: https://doi.org/10.1302/0301-620X.100B10.BJJ-2017-0406.R3

DOI: 10.1302/0301-620X.100B10.BJJ-2017-0406.R3

PubMed id: 30295525


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