Can severity of trunnion damage be estimated by visual inspection alone?

Aims Taper corrosion has been widely reported to be problematic for modular total hip arthro-plasty implants. A simple and systematic method to evaluate taper damage with sufficient resolution is needed. We introduce a semiquantitative grading system for modular femoral tapers to characterize taper corrosion damage. Methods After examining a unique collection of retrieved cobalt-chromium (CoCr) taper sleeves (n = 465) using the widely -used Goldberg system, we developed an expanded six -point visual grading system intended to characterize the severity, visible material loss, and absence of direct component contact due to corrosion. Female taper sleeve damage was evaluated by three blinded observers using the Goldberg scoring system and the expanded system. A subset (n = 85) was then re-evaluated following destructive cleaning, using both scoring systems. Material loss for this subset was quantified using metrology and correlated with both scoring systems. Results There was substantial agreement in grading among all three observers with uncleaned (n = 465) and with the subset of cleaned (n = 85) implants. The expanded scoring criteria provided a wider distribution of scores which ultimately correlated well with corrosion ma-terial loss. Cleaning changed the average scores marginally using the Goldberg criteria (p = 0.290); however, using the VGS, approximately 40% of the scores for all observers changed, increasing the average score from 4.24 to 4.35 (p = 0.002). There was a strong correlation between measured material loss and new grading scores. Conclusion The expanded scoring criteria provided a wider distribution of scores which ultimately cor-related well with corrosion material loss. This system provides potential advantages for as-sessing taper damage without requiring specialized imaging devices.