Basic principles and uniform terminology for the head-neck juncton in hip replacement

Recent problems with large head metal on metal hip replacements have spiked renewed interest in the head-neck juncton. A thorough knowledge of the principles of the locking mechanism, the assembly technique and afectng factors on the strength of this juncton is needed. Currently a confusing variability in terms is used to describe this juncton. This overcomplicates an already complex issue. The purpose of this literature review is to collect and list the diferent terms used and to propose a uniform terminology. Two authors independently searched the electronic databases of PubMed, CINAHL and MEDLINE with specific key words and combinatons according to the PRISMA guidelines. The inital search yielded a total of 518 artcles with ultmately 53 artcles included in the present analysis. No consensus for a uniform term for the 2 sides of the head-stem juncton was found. Since there is already pronounced variability in taper designs between diferent manufacturers (even so similarly named, e.g. “12/14”), a uniform terminology could be the frst step to simplify the situaton. “Male” and “female taper” is proposed as the appropriate terminology for the stem and head juncton in hip replacement, respectvely. The importance of the assembly technique understanding the principles of the locking mechanism is emphasised.

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Basic principles and uniform terminology for the head-neck juncton in hip replacement