Abstract：
BACKGROUND: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extra-large metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general.
OBJECTIVE: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem.
METHODS: The search criteria \"(corrosion) AND (hip arthroplasty) AND (taper OR trunnion)\" and \"(hip arthroplasty) AND ((pseudotumor) OR (pseudo-tumor))\" in PubMed and the JAAOS were used for the literature search. In addition, the arthroplasty registers were considered.
RESULTS: Most studies acknowledge the multifactorial nature of the problem but concentrate their analysis on taper and implant design aspects, since this is the only factor that can be easily quantified. The sometimes conflicting results in the literature could be due to the fact that the other two decisive factors are not sufficiently considered: the loading situation in the patient and the assembly situation by the surgeon. All three factors together determine the fate of a taper junction in THA. There is no single reason as a main cause for taper corrosion. The combined \"outcome\" of these three factors has to be in a \"safe range\" to achieve a successful long-term taper fixation.
CONCLUSIONS: No, this is not the beginning of an epidemic. It is rather the consequence of disregarding known mechanical and electrochemical relationships, which in combination have recently caused a more frequent occurrence-and mainly reporting-of corrosion issues.
OBJECTIVE: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem.
METHODS: The search criteria \"(corrosion) AND (hip arthroplasty) AND (taper OR trunnion)\" and \"(hip arthroplasty) AND ((pseudotumor) OR (pseudo-tumor))\" in PubMed and the JAAOS were used for the literature search. In addition, the arthroplasty registers were considered.
RESULTS: Most studies acknowledge the multifactorial nature of the problem but concentrate their analysis on taper and implant design aspects, since this is the only factor that can be easily quantified. The sometimes conflicting results in the literature could be due to the fact that the other two decisive factors are not sufficiently considered: the loading situation in the patient and the assembly situation by the surgeon. All three factors together determine the fate of a taper junction in THA. There is no single reason as a main cause for taper corrosion. The combined \"outcome\" of these three factors has to be in a \"safe range\" to achieve a successful long-term taper fixation.
CONCLUSIONS: No, this is not the beginning of an epidemic. It is rather the consequence of disregarding known mechanical and electrochemical relationships, which in combination have recently caused a more frequent occurrence-and mainly reporting-of corrosion issues.
摘要：
背景：模块化的头部锥形接头极大地促进了全髋关节置换术（THA）的成功。大型和超大型金属对金属轴承以及双模块化THA阀杆的锥度腐蚀和磨损问题使人们对锥度接口的好处产生了怀疑。目前,据报道，几乎所有包含金属头的人造髋关节都存在腐蚀问题，质疑锥度连接一般。
目的：本研究旨在回顾可能导致锥度腐蚀的机械和电化学关系，这在最近的文献中被报道得更普遍，并回顾患者特征和锥形组件中可能导致该问题的外科技术的贡献。
方法：使用PubMed中的“（腐蚀）和（髋关节置换术）和（锥度或耳轴）”和“（髋关节置换术）和（（假瘤）或（假瘤））”和JAAOS进行文献检索。此外,考虑了关节成形术的记录.
结果：大多数研究承认问题的多因素性质，但将分析集中在锥度和植入物设计方面，因为这是唯一可以轻松量化的因素。文献中有时相互矛盾的结果可能是由于以下事实：未充分考虑其他两个决定性因素：患者的负载情况和外科医生的组装情况。所有三个因素共同决定了THA中锥形接头的命运。没有单一的原因作为锥形腐蚀的主要原因。这三个因素的综合“结果”必须在“安全范围”内才能成功实现长期锥度固定。
结论：不，这不是流行病的开始。这是忽视已知的机械和电化学关系的结果，这些组合最近引起了更频繁的腐蚀问题的发生，主要是报告。
目的：本研究旨在回顾可能导致锥度腐蚀的机械和电化学关系，这在最近的文献中被报道得更普遍，并回顾患者特征和锥形组件中可能导致该问题的外科技术的贡献。
方法：使用PubMed中的“（腐蚀）和（髋关节置换术）和（锥度或耳轴）”和“（髋关节置换术）和（（假瘤）或（假瘤））”和JAAOS进行文献检索。此外,考虑了关节成形术的记录.
结果：大多数研究承认问题的多因素性质，但将分析集中在锥度和植入物设计方面，因为这是唯一可以轻松量化的因素。文献中有时相互矛盾的结果可能是由于以下事实：未充分考虑其他两个决定性因素：患者的负载情况和外科医生的组装情况。所有三个因素共同决定了THA中锥形接头的命运。没有单一的原因作为锥形腐蚀的主要原因。这三个因素的综合“结果”必须在“安全范围”内才能成功实现长期锥度固定。
结论：不，这不是流行病的开始。这是忽视已知的机械和电化学关系的结果，这些组合最近引起了更频繁的腐蚀问题的发生，主要是报告。
