2021
DOI: 10.1177/11207000211004383
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Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

Abstract: Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality … Show more

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Cited by 18 publications
(22 citation statements)
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“…In addition to implant design aspects, it should be considered that revision stems lacking medial proximal bone support generally are at higher risk for failure. 7,10,17,18 Modular failure due to contaminated taper surfaces has also been described, 24 as well as problems relating to non-adherence to the manafacturer's surgical technique for implantation and assembly. 16 Finally, patient-specific factors such as activity or body weight certainly play an important role.…”
Section: Discussionmentioning
confidence: 99%
See 2 more Smart Citations
“…In addition to implant design aspects, it should be considered that revision stems lacking medial proximal bone support generally are at higher risk for failure. 7,10,17,18 Modular failure due to contaminated taper surfaces has also been described, 24 as well as problems relating to non-adherence to the manafacturer's surgical technique for implantation and assembly. 16 Finally, patient-specific factors such as activity or body weight certainly play an important role.…”
Section: Discussionmentioning
confidence: 99%
“…In a systematic review comparing monobloc and modular revision hip stems, similar re-revision rates, dislocation rates, periprosthetic fracture rates, and infection rates were observed. 7 Significant differences were only detected in rates of subsidence and rates of intraoperative fracture. The authors, however, remarked that this may be influenced by selection bias, with more patients with a higher degree of bone loss potentially included in the studies on modular stems.…”
Section: Introductionmentioning
confidence: 93%
See 1 more Smart Citation
“…In the second step, the selection of the proximal component allows an adaptation to the proximal bone situation for maximal proximal support, with the possibility for adjustment of offset and anteversion [ 2 , 3 ]. Despite these technical features, the superiority of modular over monobloc hip revision stems has not yet been convincingly proven: In a systematic review of studies of monobloc and modular tapered fluted hip stems with over 4,000 stem revisions, similar re-revision rates, dislocation rates, periprosthetic fracture rates and infection rates were observed in both groups [ 4 ]. Significant differences were only detected in rates of subsidence (in favor of modular stems) and rates of periprosthetic fracture (where monobloc stems showed better results).…”
Section: Introductionmentioning
confidence: 99%
“…On the other hand, MTTSs increase the intraoperative fracture risk, adverse reaction to metal debris (ARMD), and modular component failure at the neck-stem junction ( 9 - 11 ). Non-modular stems do not exhibit the above specific complications but, based on data reported in the literature, are characterized by a higher postoperative dislocation risk and femoral stem subsidence ( 12 , 13 ). Modular and monoblock TFT stems have become increasingly popular, especially when bone stock is limited.…”
Section: Introductionmentioning
confidence: 99%