Result of Modular Necks in Primary Total Hip Arthroplasty with a Average Follow-up of Four Years

Jemin, Yi; Han, Kye Young; Nam, Young Jun; Kim, Keun Woo

doi:10.5371/hp.2016.28.3.142

Cited by 3 publications

(4 citation statements)

References 29 publications

(32 reference statements)

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“…In our series, the mean postoperative HHS was 93.6±8.2 at a mean follow-up of 9.4 years, which is greater than other results reported by several authors (between 85 and 91 at 2-8 years of follow-up) (1,6,9,21,26). The mean postoperative PMA score at final follow-up was 17.0±1.6, which is as good as the results reported in the literature by Table 2).…”

Section: Discussioncontrasting

confidence: 37%

“…Over the past three decades, total hip arthroplasty (THA) implants evolved with increasing options to restore or correct femoral offset, anteversion and limb length (1)(2)(3)(4)(5)(6). This led to production of multiple models of monolithic femoral stems, with different neck lengths and angles, as well as modular femoral stems that allow flexible adjustments intra-operatively (3,7,8).…”

Section: Introductionmentioning

confidence: 99%

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Midterm outcomes of titanium modular femoral necks in total hip arthroplasty

Collet¹,

Atanasiu

Cussac³

et al. 2017

Annals of Translational Medicine

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Background: Modular femoral necks present surgical and biomechanical advantages in total hip arthroplasty (THA), but their benefits remain controversial due to risks of corrosion and fracture at the additional junction. This study aimed to report 10-year survival and clinical outcomes of a titanium femoral stem with a titanium modular neck in consecutive series. Methods:The authors reviewed the records of 97 patients (99 THAs) using uncemented modular stem and ceramic-on-ceramic acetabular components. Patients were evaluated at minimum follow-up of 5 years using the Harris Hip Score (HHS) and Postel Merle-D'Aubigné score (PMA). Survival was calculated using the Kaplan-Meier (KM) method with any reoperation or revision as endpoint.Results: From the original cohort, 14 patients died, 6 were lost to follow-up, and 5 had revision operations with exchange of the femoral stem. The KM survival at 10 years was 94.2% (CI, 86.5-97.5). Clinical assessment was performed on 67 of the 72 patients (69 of the 74 hips) presently living with their original THA components. At mean follow-up of 9.4±1.0 years (median, 10; range, 5-11), the HHS was 93.6±8.2 and the PMA score 17.0±1.6. The X-rays revealed no signs of adverse reactions or bone loss. Conclusions:The uncemented titanium hip stem with modular titanium neck provided a satisfactory 10-year survival and clinical outcomes. Neck modularity enabled restoration of patient-specific femoral offset and limb length thanks to five possible neck configurations, though greater follow up is required to confirm the long-term benefits and safety of this design concept.

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Section: Discussioncontrasting

confidence: 37%

Section: Introductionmentioning

confidence: 99%

Midterm outcomes of titanium modular femoral necks in total hip arthroplasty

Collet¹,

Atanasiu

Cussac³

et al. 2017

Annals of Translational Medicine

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“…There are only a few cases of junctional problems in the Ti–Ti modular neck [ 9 , 11 ]. In addition, several clinical studies have shown that the Ti–Ti modular neck femoral stem has good clinical results [ 6 , 7 , 34 ]. This finding is in accordance with our findings.…”

Section: Discussionmentioning

confidence: 99%

Mid-term results of titanium–titanium modular neck femoral stem in primary total hip arthroplasty

Han,

Jang,

Kim

2024

BMC Musculoskelet Disord

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Background Modular neck femoral stems are advantageous because they can accurately restore the ideal hip geometry using various options in terms of offset, length, and version. However, there are concerns regarding junctional problems. Despite several reports on such issues, there is a lack of study on mid- to long-term results of these stems. The current study evaluated the mid-term results of patients who underwent primary total hip arthroplasty using a titanium–titanium (Ti–Ti) modular neck femoral stem. Methods In total, data on 47 hips (42 patients) that could be followed-up for ≥ 5 years after primary total hip arthroplasty using the Ti–Ti modular neck femoral stem from 2011 to 2015 were reviewed. There were 22 male and 20 female patients, and their mean age was 56.3 (range: 31–76) years. The mean follow-up period was 8 (range: 5–12) years. Functional and radiological outcomes, complications, and reoperations were investigated. In addition, we conducted a comparative analysis of the outcomes between those who underwent surgery using the Ti–Ti modular neck femoral stem and 41 hips (35 patients, 19 males and 16 females) that underwent primary total hip arthroplasty using nonmodular femoral stems as a control. Results In all Ti–Ti cases, the mean Harris Hip Scores were 50.6 (range: 6–59) preoperatively and 92.7 (range: 78–99) at the last follow-up (P < 0.001). Regarding the neck component’s modularity, straight neck components were used in all Ti–Ti cases, and an anteverted or a retroverted neck was not used in any case. Stem revision was performed in one hip due to aseptic loosening. One hip underwent open reduction and internal fixation due to periprosthetic fracture without stem loosening. There were no cases of osteolysis and periprosthetic joint infection and clinically detectable junctional problems. The stem survival rate, with any stem revision as the endpoint, at 12 years was 96.6%. No significant difference was observed in the functional and radiological outcomes beween the Ti–Ti and nonmodular groups. Conclusions The Ti–Ti modular neck femoral stem had comparable results with broadly used nonmodular femoral stems; hence, it can be a reliable option in primary total hip arthroplasty. However, in terms of the modularity itself of the modular neck femoral stem, whether the modular neck femoral stem is useful in uncomplicated primary total hip arthroplasty is unclear.

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“…Less common reasons for revision surgery include implant failure, osteolysis, fracture, and wear of the bearing surface [23,24]. Commonly affected prostheses are those made of titanium alloy, which can fracture causing surface cracks due to fretting corrosion [11,25]. On the other hand, a cobalt/chromium alloy prosthesis could reduce the risk of fracture due to less micromotion [10,26].…”

Section: Introductionmentioning

confidence: 99%

How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery

Bruschetta¹,

Palco

Fenga

et al. 2023

JCM

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Background: Adverse local tissue reactions to metal debris are due to a metal-on-metal bearing complication caused by micromotions at modular interfaces that induce corrosion of the protective oxide layer. This process could lead to wear, fretting, and abrasion with the release of metal ions locally and systemically, which may cause adverse local reactions in nearby tissues. The aim of this study is to describe a series of patients with painful local adverse tissue reactions secondary to corrosion at the modular neck–body interface, to document the clinical presentation, diagnostic workup, and surgical findings of our research, and to search for a possible correlation between metallosis and infection. Methods: A retrospective study of patients with adverse local tissue reactions due to metal surface corrosion was performed. Blood samples were collected to identify erythrocyte sedimentation rate, C reactive protein, and procalcitonin, and a magnetic resonance imaging protocol was performed. Results: Serum cobalt and chromium levels of the 43 patients tested were significantly higher on average. However, both erythrocyte sedimentation rate and C-reactive protein were significantly elevated. Magnetic resonance imaging showed adverse reactions to metal debris with large soft tissue masses and surrounding tissue damage. Conclusions: Corrosion in hip prosthesis can lead to the release of metal ions and debris locally and systemically, resulting in local soft tissue changes. A “tumor-like” debridement can reduce this complication.

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Result of Modular Necks in Primary Total Hip Arthroplasty with a Average Follow-up of Four Years

Cited by 3 publications

References 29 publications

Midterm outcomes of titanium modular femoral necks in total hip arthroplasty

Midterm outcomes of titanium modular femoral necks in total hip arthroplasty

Mid-term results of titanium–titanium modular neck femoral stem in primary total hip arthroplasty

How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery

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