Fracture of Cementless Femoral Stems at the Mid-Stem Junction in Modular Revision Hip Arthroplasty Systems

Lakstein, Dror; Eliaz, Noam; Levi, Ofer; Backstein, David; Kosashvili, Yona; Safir, Oleg; Gross, Allan E.

doi:10.2106/jbjs.i.01589

Cited by 170 publications

(127 citation statements)

References 21 publications

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“…The literature is lacking midterm followup of these TFMT stems currently being used for revision hip arthroplasty. There seems to be concern over the potential long-term failure of these TFMT implants over time, especially dealing with the issue of implant fracture at the level of the modular junction [19,27,32]. In the context of poor proximal femoral bony support around the modular junction, these concerns seem to be further warranted.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High Survival of Modular Tapered Stems for Proximal Femoral Bone Defects at 5 to 10 Years Followup

Houwelingen

Duncan

Masri

et al. 2013

Clinical Orthopaedics &Amp; Related Research

123

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Background Currently, the two most commonly used options for the revision of femoral components in North America are: cylindrical, nonmodular, cobalt-chromium stems and tapered, fluted, modular, titanium (TFMT) stems. Previous reports have cited high failure rates with cylindrical cobalt chrome stems in large femoral defects but the longer term survival of the fluted stems is unknown. Questions/PurposesWe examined the 5-to 10-year survival of TFMT stems implanted for severe femoral defects. Methods We reviewed all 65 patients with severe proximal bone defects revised with the TMFT stem between January 2000 and 2006. Ten were lost to followup and seven were dead, leaving 48 patients for followup at 5 to 10 years (mean, 84 months; range, 60-120 months). All patients completed five quality-of-life (QOL) questionnaires. Radiographs were evaluated for loosening, subsidence, and preservation of proximal host bone stock.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown a risk of implant fracture at the level of the modular junction [19,27,32] (Table 1). Concern seems to be heightened where there is poor proximal femoral bony support around the modular junction.…”

Section: Introductionmentioning

confidence: 96%

High Survival of Modular Tapered Stems for Proximal Femoral Bone Defects at 5 to 10 Years Followup

Houwelingen

Duncan

Masri

et al. 2013

Clinical Orthopaedics &Amp; Related Research

123

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“…The optimal stem design in these patients is unknown. A number of studies have reported that modular prostheses such as the S-ROM (DePuy, Inc) can help deal with these anatomical challenges [2,5,6,11,19,30]; however, a theoretical disadvantage includes the potential for metal corrosion with modularity [9,20]. The Wagner Cone stem can accommodate small or deformed femora because of its proximal conical, tapered design.…”

Section: Discussionmentioning

confidence: 99%

Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup

Zhang

Goodman

Maloney

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Total hip arthroplasty (THA) in patients with small or abnormal proximal femoral anatomy is challenging as a result of complex anatomic deformities in the hip. It is unclear which stem is the most appropriate for these patients. One possible implant design that may help meet this need is the modified Wagner Cone prosthesis, whose design consists of monoblock cone with splines; however, to our knowledge, no clinical results have been published using this implant. Questions/purposes We evaluated the hip scores and radiographic results (including signs of osseointegration and subsidence) of complex primary THA using the modified Wagner Cone cementless femoral component in patients with small or abnormal proximal femoral anatomic proportions.

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“…Early to midterm results of modular tapered stems used for femoral revision are now being published [5,6,[11][12][13][14][15][16][17][18]. One study documented success in achieving implant stability and osteointegration, as well as restoring leg length and offset across all Paprosky classifications [15].…”

Section: Discussionmentioning

confidence: 99%

“…Cortical deficiency extending to between lesser trochanter and isthmus the modular junction are reported in the literature on multiple stem designs [3][4][5][6][7]. Manufacturers have developed methods for strengthening the taper junction.…”

Section: Cmentioning

confidence: 99%

Modular Femoral Tapered Revision Stems in Total Hip Arthroplasty

Frye¹,

Berend²,

Morris³

et al. 2013

Reconstructive Review

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Background: Modular component options can assist the surgeon in addressing complex femoral reconstructions in total hip arthroplasty by allowing for customization of version control and proximal to distal sizing. We review the early clinical results of a single modular femoral revision system that offers 3 proximal body types, 5 distal stem geometries, and a wide range of offset, sizing and auxiliary options.Methods: A query of our practice's arthroplasty registry revealed 60 patients (61 hips) who signed an IRB-approved general research consent allowing retrospective review, and underwent total hip arthroplasty performed with the modular femoral revision system between December 2009 and April 2012. There were 35 men (58%) and 25 women (42%). Mean age was 65.1 years (range, 35-94) and BMI was 31.3 kg.m2 (range, 14-53). Procedures were complex primary in 1 hip, conversion in 6 (10%), revision in 32 (53%), and two-staged exchange for infection in 22 (33%). Two-thirds of procedures included complete acetabular revision (n=40), while 31% (19) involved liner change only and 2 were isolated femoral revisions.Results: At an average follow-up of 1.5 years (maximum: 3.7 years) there have been no revisions or failures of the femoral component. Average Harris hip scores (0 to 100 possible) improved from 44.2 preoperatively to 66.0 at most recent evaluation, while the pain component (0 to 44 possible) improved from 15.8 to 31.2. Complications requiring surgical intervention included intraoperative periprosthetic femur fracture in one patient returned to the operating suite same day for open reduction internal fixation, which further required incision and debridement for super-

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Fracture of Cementless Femoral Stems at the Mid-Stem Junction in Modular Revision Hip Arthroplasty Systems

Cited by 170 publications

References 21 publications

High Survival of Modular Tapered Stems for Proximal Femoral Bone Defects at 5 to 10 Years Followup

High Survival of Modular Tapered Stems for Proximal Femoral Bone Defects at 5 to 10 Years Followup

Can a Conical Implant Successfully Address Complex Anatomy in Primary THA? Radiographs and Hip Scores at Early Followup

Modular Femoral Tapered Revision Stems in Total Hip Arthroplasty

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