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Article Details
Case Report
Volume 4, Issue 8 (August Issue)

Gross Trunnion Failure of the Accolade I Femoral Stem with Metal-on Polyethylene Eccentric Wear: A Report of 2 Cases

Anthony D’Abarno1*, Andrew O’Reilly1, Sabit Ejub2 and Henry Finn3

1Orthopedic Surgery, Franciscan Health Olympia Fields, Olympia Fields, IL, United States of America

2Orthopedic Surgery, Ascension Genesys Hospital, Grand Blanc, MI, United States of America

3Orthopedic Surgery, University of Chicago and Weiss Memorial Hospital, Chicago, IL, United States of America

*Corresponding author: Anthony D’Abarno, Orthopedic Surgery, Franciscan Health Olympia Fields, Olympia Fields, IL, United States of America. E-mail: adabarno77@gmail.com

Received: July 14, 2022; Accepted: August 01, 2022; Published: August 12, 2022

Citation: Abarno AD, Reilly AO, Ejub S, Finn H. Gross Trunnion Failure of the Accolade I Femoral Stem with Metal-on-Polyethylene Eccentric Wear: A Report of 2 Cases. Clin Image Case Rep J. 2022; 4(8): 257.

Abstract

This report presents two cases of gross trunnion failure (GTF) following total hip arthroplasty (THA) that demonstrate dissociation of the femoral head from the trunnion, as well as elevated serum ion levels and metal-on-polyethylene eccentric wear. Risk factors for GTF including body mass index (BMI) >30 kg/m2, male sex, low angled neck, high offset femoral stems, and large alloy metal heads were present in both patients. Patients that have risk factors or specific components prone to GTF should be monitored closely for symptoms, elevated serum ion levels, and radiographic signs of GTF to avoid catastrophic failure necessitating revision arthroplasty.

Keywords: Elderly; Male and female; Gross trunnion failure; Trunnionosis; Stryker accolade I femoral stem; Metallosis; Adverse local tissue reaction; Obesity; Inability to ambulate; Pain; Elevated cobalt and chromium serum ion levels; Dissociation of modular femoral head; Revision total hip arthroplasty; Accolade TMZF