Trunnionosis in Total Hip Arthroplasty

The etiology of clinically relevant trunnion corrosion remains to be fully understood, but appears to be multifactorial with synergy among implant-based, surgeon-based, and patient-based factors.Trunnion corrosion causing an adverse local tissue reaction (ALTR) typically manifests as delayed onset of groin, buttock, or thigh pain after primary total hip arthroplasty.Trunnionosis is probably underreported since it often causes osteolysis and loosening, and the awareness of the problem, although increasing, is not universal.Measurement of serum cobalt and chromium ions and advanced cross-sectional imaging, including metal artifact reduction sequence magnetic resonance imaging, can aid in diagnosis.Revision for trunnion corrosion-induced ALTR can often be accomplished with a head and liner exchange, with retention of the acetabular and femoral components.The surgeon should be aware of implant recalls and be cognizant of ongoing litigation against implant manufacturers.The surgeon should strive to preoperatively identify the angle and type of taper in the well-fixed stem and request that the proper implants are available for the revision total hip arthroplasty.