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Pain in the well-fixed, aseptic titanium hip replacement

THE ROLE OF CORROSION

¹ Department of Orthopaedics, Middlesex Hospital, Mortimer Street, London W1T 3AA, UK.
² Middlesex and University College London Hospitals, Mortimer Street, London W1T 3AA, UK.

Correspondence should be sent to Mr F. Haddad at 224 Belsize Road, London NW1 4SN, UK.

We have investigated nine patients with cemented Furlong (JRI, London, UK) titanium hip replacements who presented with early pain despite a well-fixed, aseptic prosthesis. All were followed up clinically and radiologically at regular intervals. Pain was located in the thigh and was worse at night. Radiographs showed cortical hypertrophy of the femur around the tip of the stem. Eight of the nine patients subsequently required single-stage revision using an uncemented prosthesis, which relieved the pain. At revision, the pH of the tip of the stem was found to be highly acidic with macroscopic evidence of corrosion consisting of multiple layers of titanium oxides when studied by X-ray dispersive analysis. Cemented titanium implants have a potential for crevice corrosion leading to cortical hypertrophy and intractable pain.

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				M. A. EDGAR and F. HADDAD Pain in the well-fixed, aseptic titanium hip replacement: the role of corrosion J Bone Joint Surg Br, May 1, 2005; 87-B(5): 745 - 746. [Full Text] [PDF]