Migration of solid corrosion products from the modular head-neck
junction of fifteen total hip replacements to the periprosthetic tissues
was studied. The devices and tissues were recovered at the time of a
revision procedure or at autopsy after a mean of sixty-four months (range,
eight to ninety-seven months). The prostheses had a cobalt-chromium-alloy
head coupled with a cobalt-chromium-alloy or a titanium-alloy stem. The
solid corrosion product was identified by electron microprobe analysis and
Fourier transform infrared microprobe spectroscopy as a chromium
orthophosphate hydrate-rich material. The product was present at the
junction of the modular head and neck and as particles within the
periprosthetic tissues as early as eight months postoperatively. In several
hips, it was also present on the polyethylene bearing surface. The
particles in the tissues ranged in size from less than one to 500
micrometers. They were present within histiocytes or were surrounded by
foreign-body giant cells in the pseudocapsule of the hip joint; in the
membranes of the femoral bone-implant interface; and at sites of femoral
endosteal erosions, with and without loosening of the femoral
component.