Diagnosis and management of METS-Stanmore Morse taper failure

Grégoire Rougereau; François Gouin; Jean-Camille Mattei; Sébastien Raux; Alexandre Hardy; David Biau

doi:10.1016/j.otsr.2023.103659

Diagnosis and management of METS-Stanmore Morse taper failure

Orthop Traumatol Surg Res. 2023 Nov;109(7):103659. doi: 10.1016/j.otsr.2023.103659. Epub 2023 Jul 13.

Authors

Grégoire Rougereau¹, François Gouin², Jean-Camille Mattei³, Sébastien Raux⁴, Alexandre Hardy⁵, David Biau⁶

Affiliations

¹ Département de chirurgie orthopédique et traumatologique, Hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France; Département de chirurgie orthopédique et traumatologique, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France. Electronic address: greg.rougereau@gmail.com.
² Département de chirurgie, centre Léon Bérard, 28, promenade Léa and Napoléon Bullukian, 69008 Lyon, France.
³ Département de chirurgie orthopédique et traumatologique 3A, université Aix-Marseille, Hôpital Nord, AP-HM, chemin des Bourrély, 13015 Marseille, France.
⁴ Département de chirurgie orthopédique infantile, hôpital Mère Enfant, 59, boulevard Pinel, 69500 Bron, France.
⁵ Département de chirurgie orthopédique et traumatologique, Hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France; Département de chirurgie orthopédique, clinique du Sport, 36, boulevard Saint-Marcel, 75005 Paris, France.
⁶ Département de chirurgie orthopédique et traumatologique, Hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.

PMID: 37451341
DOI: 10.1016/j.otsr.2023.103659

Abstract

We describe clinical semiology in 6 cases of METS-Stanmore distal femoral Morse taper impaction failure: from obvious forms with intraprosthetic dislocation to chronic forms with less obvious symptoms: instability, piston sensation, rotational disorder in gait. The diagnostic procedure in chronic forms is described, notably with dynamic examination under fluoroscopy. Reduction and re-impaction by external maneuver can be attempted; in case of failure or of any suspicion of taper disassembly, the 2 modular implant components have to be replaced. Finally, we provide a review of the literature on this rare but serious complication. LEVEL OF EVIDENCE: IV.

Keywords: Knee reconstruction; Megaprosthesis; Modular knee prosthesis; Morse taper disassembly.

Publication types

Review

MeSH terms

Arthroplasty, Replacement, Hip*
Femur
Hip Prosthesis*
Humans
Prosthesis Design
Prosthesis Failure
Reoperation