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Trunnionosis: the latest culprit in adverse reactions to metal debris following hip arthroplasty

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Abstract

The imaging findings of periprosthetic soft tissue lesions (pseudotumours) have been typically defined in the context of newer second-generation metal-on-metal hip arthroplasty. More recently, similar findings have been described in the setting of non-metal-on-metal prostheses. Although uncommon, wear and corrosion between the metal surfaces at the head-neck (‘trunnionosis’) and neck-stem interfaces are the potential culprits. With modular junctions containing at least one cobalt chromium component frequently present in hip arthroplasty prostheses, the incidence of this mode of adverse wear may be higher than previously thought (irrespective of the specific bearing couple used). In the present report, we described a case of a severe adverse local tissue reaction secondary to suspected corrosion at the head-neck taper in a metal-on-polyethylene total hip arthroplasty and reviewed the literature. Knowledge of this topical entity should help radiologists facilitate early diagnosis and ensure early management of this potentially serious complication.

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Conflict of interest

No external funding support was provided for the production of this manuscript. The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON, Canada, M5G 1X5

    Ryan M. Shulman & David C. Salonen

  2. Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, 399 Bathurst Street Room 1E449, Toronto, ON, Canada, M5T 2S8

    Michael G. Zywiel, Rajiv Gandhi & J. Roderick Davey

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  1. Ryan M. Shulman
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  2. Michael G. Zywiel
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Correspondence to Ryan M. Shulman.

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Written consent for publication was obtained from the patient whose findings are described in the present report.

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Shulman, R.M., Zywiel, M.G., Gandhi, R. et al. Trunnionosis: the latest culprit in adverse reactions to metal debris following hip arthroplasty. Skeletal Radiol 44, 433–440 (2015). https://doi.org/10.1007/s00256-014-1978-3

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  • DOI: https://doi.org/10.1007/s00256-014-1978-3

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