Trunnionosis: Is it really a problem?

Corrosion between the modular head and neck interface of uncemented femoral components was initially seen in retrieval studies of total hip implants in the mid- to late-1980s, but clinical symptoms related to these findings were relatively rare. Over the past 5-7 years, there has been a re-emergence of corrosion of the head-neck junction as an important symptomatic clinical entity and cause of revision of metal-on-polyethylene total hip arthroplasty. Trunnion or taper corrosion may be a multifactorial process, involving implant design, surgical technique, and patient characteristics. The clinical presentation of trunnion corrosion is variable and requires a high index of suspicion. Serum levels of cobalt and chromium ions and cross-sectional imaging are usually required to confirm the diagnosis. Treatment is revision surgery with femoral head exchange to a noncobalt-chromium alloy component. Complications after this procedure may be more frequent than expected.