Wear performance of metal and ceramic long-neck femoral head taper connections: an experimental ex vivo study
DOI:
https://doi.org/10.2340/17453674.2026.46301Keywords:
Arthroplasty, Biomechanics, Hip, ImplantsAbstract
Background and purpose: The wear performance of femoral head taper connections is important for the longevity of total hip replacement. Metal release may cause adverse tissue reactions. There are some clinical indications that long neck heads may show increased wear, but no laboratory tests have been published. We aimed to examine the wear performance of femoral head taper connections in long and extra-long neck heads.
Methods: Load frame and hip joint simulator wear tests were performed with the same stem designs as in the reference study. The CoCr and zirconia toughened alumina (ZTA) heads of 36 mm diameter were of the long or extra-long neck type. Optical and scanning electron microscopy were utilized to study wear marks, and mass spectrometry to estimate Ti and Co release. Head disassembly forces were measured.
Results: Our preclinical, design-specific results showed that, compared with medium necks, long and especially extra-long necks led to increased wear while maintaining an asymmetric wear pattern more widely distributed throughout the contact area. In the hip joint simulator tests, 1 neck fracture occurred.
Conclusion: The long and extra-long head taper connections showed increased wear compared with that of medium heads. Although no serious damage occurred, CoCr head tapers were the most affected compared with ZTA.
Downloads
References
Mistry J B, Chughtai M, Elmallah R K, Diedrich A, Le S, Thomas M, et al. Trunnionosis in total hip arthroplasty: a review. J Orthop Trauma 2016; 17(1): 1-6. doi: 10.1007/S10195-016-0391-1. DOI: https://doi.org/10.1007/s10195-016-0391-1
Weiser M C, Lavernia C J. Trunnionosis in total hip arthroplasty. J Bone Joint Surg Am 2017; 99(17): 1489-1501. doi: 10.2106/JBJS.17.00345. DOI: https://doi.org/10.2106/JBJS.17.00345
Ribeiro de Sousa M, Neuvonen P, Saikko V. Wear of femoral head taper connections of contemporary total hip prostheses: an experimental study. Med Devices-Evid Res 2025; 18: 595-613. doi: 10.2147/MDER.S552499. DOI: https://doi.org/10.2147/MDER.S552499
Del Balso C, Teeter M G, Tan S C, Lanting B A, Howard J L. Taperosis: does head length affect fretting and corrosion in total hip arthroplasty? Bone Joint J 2015; 97(7): 911-16. doi: 10.1302/0301-620X.97B7.35149. DOI: https://doi.org/10.1302/0301-620X.97B7.35149
Wight C M, Lanting B, Schemitsch E H. Evidence based recommendations for reducing head-neck taper connection fretting corrosion in hip replacement prostheses. HIP Int 2017; 27(6): 523-31. doi: 10.5301/hipint.5000545. DOI: https://doi.org/10.5301/hipint.5000545
Bhalekar R M, Smith S L, Joyce T J. Wear at the taper–trunnion junction of contemporary ceramic-on-ceramic hips shown in a multistation hip simulator. J Biomed Mater Res B 2019; 107(4): 1199-209. doi: 10.1002/jbm.b.34213. DOI: https://doi.org/10.1002/jbm.b.34213
Langton D J, Sidaginamale R, Lord J K, Nargol A V F, Joyce T J. Taper junction failure in large-diameter metal-on-metal bearings. Bone Joint Res 2012; 1(4): 56-63. doi: 10.1302/2046-3758.14.2000047. DOI: https://doi.org/10.1302/2046-3758.14.2000047
Wendler T, Prietzel T, Möbius R, Fischer J P, Roth A, Zajonz D. Quantification of assembly forces during creation of head–neck taper junction considering soft tissue bearing: a biomechanical study. Arthroplasty 2021; 3(1): 20. doi: 10.1186/s42836-021-00075-7. DOI: https://doi.org/10.1186/s42836-021-00075-7
International Standard ISO 7206-6. Implants for surgery — Partial and total hip joint prostheses — Part 6: Endurance properties testing and performance requirements of neck region of stemmed femoral components. Geneva: International Organization for Standardization; 2013.
International Standard ISO 14242-1. Implants for surgery — Wear of total hip-joint prostheses — Part 1: Loading and displacement parameters for wear-testing machines and corresponding environmental conditions for test. Geneva: International Organization for Standardization; 2014.
Saikko V. A 12-station anatomic hip joint simulator. Proc Inst Mech Eng Part H 2005; 219(6): 437-48. doi: 10.1243/095441105X34419. DOI: https://doi.org/10.1243/095441105X34419
Goldberg J R, Gilbert J L, Jacobs J J, Bauer T W, Paprosky W, Leurgans S. A multicenter retrieval study of the taper interfaces of modular hip prostheses. Clin Orthop Relat Res 2002; 401: 149-61. DOI: https://doi.org/10.1097/00003086-200208000-00018
Bologna F A, Putame G, Audenino A L, Terzini M. Understanding the role of head size and neck length in micromotion generation at the taper junction in total hip arthroplasty. Sci Rep 2024; 14, 6397. doi: 10.1038/s41598-024-57017-x. DOI: https://doi.org/10.1038/s41598-024-57017-x
Kocagoz S B, Underwood R J, MacDonald D W, Gilbert J L, Kurtz S M. Ceramic heads decrease metal release caused by head-taper fretting and corrosion. Clin Orthop Relat Res 2016; 474(4): 985-94. doi: 10.1007/s11999-015-4683-1. DOI: https://doi.org/10.1007/s11999-015-4683-1
Silva M, Shepherd E F, Jackson W O, Dorey F J, Schmalzried T P. Average patient walking activity approaches 2 million cycles per year: pedometers under-record walking activity. J Arthroplasty 2002; 17(6): 693-7. doi: 10.1054/ARTH.2002.32699. DOI: https://doi.org/10.1054/arth.2002.32699
Bhalekar R M, Smith S L, Joyce T J. Hip simulator testing of the taper–trunnion junction and bearing surfaces of contemporary metal-on-cross-linked-polyethylene hip prostheses. J Biomed Mater Res B 2020; 108(1): 156-66. doi: 10.1002/jbm.b.34374. DOI: https://doi.org/10.1002/jbm.b.34374
Ashkanfar A, Langton D J, Joyce T J. A large taper mismatch is one of the key factors behind high wear rates and failure at the taper junction of total hip replacements: a finite element wear analysis. J Mech Behav Biomed Mater 2017; 69: 256-66.doi: 10.1016/j.jmbbm.2017.01.018. DOI: https://doi.org/10.1016/j.jmbbm.2017.01.018
Martelli A, Erani P, Pazzagli N, Cannillo V, Baleani M. Surface analysis of Ti-alloy micro-grooved 12/14 tapers assembled to non-sleeved and sleeved ceramic heads: a comparative study of retrieved hip prostheses. Materials 2023; 16(3): 1067. doi: 10.3390/ma16031067. DOI: https://doi.org/10.3390/ma16031067
Turnbull G S, Soete S, Akhtar M A, Ballantyne J A. Risk factors for femoral stem fracture following total hip arthroplasty: a systematic review and meta analysis. Arch Orthop Trauma Surg 2024; 144(5): 2421-8. doi: 10.1007/s00402-024-05281-x. DOI: https://doi.org/10.1007/s00402-024-05281-x
Moharrami N, Langton D J, Sayginer O, Bull S J. Why does titanium alloy wear cobalt chrome alloy despite lower bulk hardness: a nanoindentation study? Thin Solid Films 2013; 549: 79-86. doi: 10.1016/j.tsf.2013.06.020. DOI: https://doi.org/10.1016/j.tsf.2013.06.020
Bone M C, Sidaginamale R P, Lord J K, Scholes S C, Joyce T J, Nargol A V F, et al. Determining material loss from the femoral stem trunnion in hip arthroplasty using a coordinate measuring machine. Proc Inst Mech Eng Part H 2015; 229(1): 69-76. doi: 10.1177/0954411914567552. DOI: https://doi.org/10.1177/0954411914567552
Additional Files
Published
How to Cite
License
Copyright (c) 2026 Margarida Ribeiro de Sousa, Perttu Neuvonen, Vesa Saikko

This work is licensed under a Creative Commons Attribution 4.0 International License.
PlumX (by Elsevier) is an altmetrics platform that tracks and visualizes the online attention, usage, captures, citations, and social media engagement.
