Severe Corrosion of Modular Dual Mobility Acetabular Components Identified During Revision Total Hip Arthroplasty

Abstract

There has been a significant increase in the use of modular dual mobility (MDM) acetabular cups for primary and revision total hip arthroplasty (THA) secondary to decreased dislocation rate and increased impingement-free range of motion. Mating of dissimilar metals in THA can result in mechanically assisted crevice corrosion, with increased serum metal ion levels and potentially adverse local tissue reaction that can lead to revision surgery. In this case report, we present a patient who had THA using MDM components, and his follow-up laboratory testing showed asymptomatic elevated serum cobalt level. The patient subsequently developed an intraprosthetic dislocation that required revision surgery. At the time of revision, significant corrosion was noted on the backside of the modular acetabular liner and the inner surface of the titanium shell. Serum cobalt levels returned to normal after revision surgery. This case suggests that mechanically assisted crevice corrosion at the modular surface of MDM components does occur. In addition, we believe surgeons should judiciously use MDM technology only for patients at significantly increased risk of dislocation after THA.

Keywords

• Modular dual mobility
• Total hip arthroplasty
• Corrosion
• Intraprosthetic dislocation
• Revision