Late Hematogenous Total Hip Infection After Revision for Mechanically Assisted Crevice Corrosion With Adverse Local Tissue Reaction

Abstract

Mechanically assisted crevice corrosion (MACC) at the trunnion-bore junction of a total hip arthroplasty may cause adverse local tissue reaction (ALTR) with inflammatory reaction and tissue necrosis. Complications, including acute infection, continued pain, and instability, are therefore common after a revision surgery for MACC. We now present 2 cases of late hematogenous bacterial infection years after revision for MACC and ALTR, a previously unreported outcome in this population. We hypothesize that MACC-induced tissue necrosis does not heal over time, and some patients with metal-on-polyethylene total hip arthroplasty treated for ALTR are at long-term risk of hematogenous bacterial infection.

Keywords

• Mechanically assisted crevice corrosion (MACC)
• Adverse local tissue reaction (ALTR)
• Total hip arthroplasty (THA)
• Revision
• Infection
• Periprosthetic joint infection (PJI)