Mechanically Assisted Crevice Corrosion in a Metal-on-Polyethylene Total Hip Presenting With Lower Extremity Vascular Compromise

Thomas M Zink; Brian J McGrory

doi:10.1016/j.artd.2020.04.015

Mechanically Assisted Crevice Corrosion in a Metal-on-Polyethylene Total Hip Presenting With Lower Extremity Vascular Compromise

Arthroplast Today. 2020 Jun 25;6(3):445-450. doi: 10.1016/j.artd.2020.04.015. eCollection 2020 Sep.

Authors

Thomas M Zink^{1

2

3}, Brian J McGrory^{1

2

3}

Affiliations

¹ Tufts University School of Medicine, Boston, MA, USA.
² Maine Medical Center, Division of Joint Replacements, Portland, ME, USA.
³ Maine Joint Replacement Institute, Portland, ME, USA.

Abstract

Mechanically assisted crevice corrosion in modular total hip replacements may lead to an adverse local tissue reaction (ALTR) with a variety of sequelae. Although an ALTR is most commonly recognized with metal-on-metal modular hip constructs, tribocorrosion at the head-neck junction of metal-on-polyethylene (MoP) total hip arthroplasties may also lead to an ALTR. We present a case of a 79-year-old woman with a history of MoP total hip arthroplasty who presented with unilateral leg swelling, joint pain, and stiffness and subsequently underwent revision for an ALTR secondary to mechanically assisted crevice corrosion. This unique case of lower extremity vascular compromise resulting from an ALTR is important because clinicians should consider corrosion-related ALTRs when treating patients with an MoP hip prosthesis presenting with new-onset lower extremity swelling.

Keywords: Adverse local tissue reaction (ALTR); Mechanically assisted crevice corrosion (MACC); Revision total hip replacement; Swelling; Thrombosis; Tribocorrosion.

Publication types

Case Reports