Background: Modular stems have been widely studied as they allow intraoperative adjustments (offset, anteversion, limb length) to better restore hip biomechanics. Many authors reported outcomes of revision total hip arthroplasty (THA) using modular stems with metaphyseal-diaphyseal junctions, however, little is known about modular neck femoral stems (MNFS) with metaphyseal-epiphyseal junctions. We therefore aimed to report outcomes and implant survival of a MNFS in a consecutive series of revision THA at a minimum follow-up of 5 years. Methods: We reviewed a consecutive series of 28 revision THAs performed between February 2010 and March 2012 using an uncemented MNFS. The final study cohort included 25 patients living with their original components, at a mean follow-up of 68.4±7.4 months and aged 67.7±11.6 years at index operation. Results: The Harris Hip Score (HHS) improved from 39.1±19.2 pre-operatively to 78.1±18.3 postoperatively, and the Postel Merle d'Aubigné score (PMA) improved from 9.8±3.0 pre-operatively to 14.8±2.8 post-operatively. The postoperative limb length discrepancy (LLD) was >10 mm in 18% of the hips. There were no significant differences of femoral offset and neck shaft angle (NSA) between operated and contralateral hips. Two hips (8.0%) showed new periprosthetic radiolucent lines. Periprosthetic fractures (PPF) occurred in 3 hips (12%). No subluxations, dislocations or implant breakages were reported. One revision (3.6%) was performed with retrieval of the revision stem for infection. The Kaplan-Meier (KM) survival at 5 years, using stem revision as endpoint, was 96.0%. Conclusions: The Optimal ® MNFS provided a satisfactory survival and clinical outcomes at 5 years, with no noticeable adverse effects resulting from the additional modular junction.

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A first series of experiments showed that the passage of a direct current along a positive electrode immersed in heparinised blood caused the formation of an adhering clot whose diameter increased with time and current intensity. A second series of experiments was done on 10 rabbits as follows: under general anaesthesia, a catheter used as a guide to the positive electrode was surgically inserted in the abdominal aorta. The negative electrode was placed on the thigh. A direct current (10 mA, 10V) was applied for 10-20 min. The first two clinical applications in man of this new method of treatment by electric current thrombosis were carried out using catheterisation of branches of the external carotid and cervical arteries.

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