The choice between different surgical options depends on bone defect dimension and characteristics but are also patient-related. Reestablishment of well-aligned and stable implants is necessary for successful reconstruction, but this can't be accomplished without a sufficient restoration of an eventual bone loss.

Modular neck hip prosthesis born in the 1990 with the aim of allowing the surgeon to modify CCD angle, offset and femoral anteversion intra-operatively restoring patient’s original biomechanics. In order to achieve the best biomechanics of the reconstructed hip, preoperative planning is essential. In the last few years modularity has been questioned and an argument made for the return to mono block stems due to events of breakage or disconnection of modular components. Fretting or crevice corrosion may lead to failure of such modular device due to the contamination inside the modular coupling or to high loads. We present a case of repetitive modular femoral neck prosthesis fracture.

The increasing duration of life with total hip arthroplasties and trend toward indication for surgery at younger ages, will increase the amount and complexity of revision surgery. Cementless acetabular components have shown improved long term survival over cemented components. Sometimes peripheral acetabular circumference (RIM) and acetabular wall integrity aren't enough preserved to guarantee a new implant good stability. Usually the treatment options for III A and III B Paprosky defects are: cage implant with cemented polyethylene liner, cementless implants with augmentation using, big revision shell implant with biological/metal augmentation or the stemmed cup implant. The LIMA acetabular revision system born to make possible the combination between cage benefit with all the primary implant shell advantages. This solution gives the same stability of a cage and more options than a primary cup to restore the hip rotation centre without cement using. We analyze a consecutive 34 THR executed between 2009-2013 with at least 5 years follow up.

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