Mid-Term Results of an Uncemented Femoral Stem with Modular Neck Options

Abstract

We prospectively assessed the results of 239 primary total hip replacements performed using a conical stem combined with modular necks of different lengths and inclinations (Modulus System, Lima Corporate San Daniele Del Friuli, Udine, Italia) in 222 patients (50 men, 172 women), undergoing surgery between October 2001 and December 2006 and presenting with anatomical deformities of the proximal femur and/or acetabulum, including developmental dysplasia (DDH), ankylosis, and sequelae of osteotomies or fractures. Such conditions can make hip replacement problematic.

The mean age at the time of surgery was 57.6 years (22 ÷ 83). No patients were lost to follow-up. 3 femoral components underwent revision.

At a mean of 5 years follow-up the Harris Hip Score showed a significant improvement, increasing from 35 preoperatively to a mean of 96.6. Using Kaplan-Meier analysis the survival rate at 5 years was 98.28%.

The Modulus stem showed good mid-term results in terms of survival, as well as clinical and radiographic outcome.

Keywords

Arthroplasty DDH Hip Modularity

Get full access to this article

View all access options for this article.

References

Crowe

J.F.

, Mani

V.J.

, Ranawat

C.S.

. Total hip replacement in congential dislocation and dysplasia of the hip. J Bone Joint Surg Am 1979; 61: 15–23.

Perka

, Fischer

, Taylor

W.R.

, Matziolis

. Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup. J Bone Joint Surg Am 2004; 86: 312–9.

Klapach

A.S.

, Callaghan

J.J.

, Miller

K.A.

. Total hip arthroplasty with cement and without acetabular bone graft for severe hip dysplasia. J Bone Joint Surg Am 2005; 87: 280–5.

Numair

, Joshi

A.B.

, Murphy

J.C.

, Porter

M.L.

, Hardinge

. Total hip arthroplasty for congenital dysplasia or dislocation of the hip. J Bone Joint Surg Am 1997; 79: 1352–60.

Traina

, De Fine

, Biondi

, Tassinari

, Galvani

, Toni

. The influence of the centre of rotation on implant survival using a modular stem hip prosthesis., Int Orthop. 2009; 33: 1513–8.

Engh

C.A.

, Hooten

J.P.

Jr. , Zettl-Schaffer

K.F.

. Porous-coated total hip replacement. Clin Orthop Relat Res 1994; 298: 89–96.

Goetz

D.D.

, Smith

E.J.

, Harris

W.H.

. The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. A retrospective matched-pair series. J Bone Joint Surg Am 1994; 76: 1121–9.

Gruen

T.A.

, McNeice

G.M.

, Amstutz

H.C.

. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; 141: 17–27.

Brooker

A.F.

, Bowerman

J.W.

, Robinson

R.A.

, Riley

L.H.

Jr. . Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55: 1629–32.

10.

Noble

P.C.

, Alexander

J.W.

, Lindahl

L.J.

, Yew

D.T.

, Granberry

W.M.

, Tullos

H.S.

. The anatomic basis of femoral component design. Clin Orthop Relat Res 1988; 235: 148–65.

11.

Cameron

H.U.

, Keppler

, McTighe

. The role of modularity in primary total hip arthroplasty. J Arthroplasty 2006; 21(Suppl 1): 89–92.

12.

Hartofilakidis

, Karachalios

. Total hip arthroplasty for congenital hip disease. J Bone Joint Surg Am 2004; 86: 242–50.

13.

Christie

M.J.

, DeBoer

D.K.

, Trick

L.W.

. Primary total hip arthroplasty with use of the modular S-ROM prosthesis. Four to seven-year clinical and radiographic results. J Bone Joint Surg Am 1999; 81: 1707–16.

14.

Tanzer

, Chan

, Brooks

C.E.

, Bobyn

J.D.

. Primary cementless total hip arthroplasty using a modular femoral component: a minimum 6-year follow-up. J Arthroplasty 2001; 16(8 suppl 1): 64–70.

15.

Mattingly

D.A.

. The S-ROM modular stem for femoral deformities. Orthopedics 2005; 28(9 suppl): 1059–62.

16.

Biant

L.C.

, Bruce

W.J.

, Assini

J.B.

, Walker

P.M.

, Walsh

W.R.

. The anatomically difficult primary total hip replacement: medium-to long-term results using a cementless modular stem. J Bone Joint Surg Br 2008; 90: 430–5.

17.

Biant

L.C.

, Bruce

W.J.

, Assini

J.B.

, Walker

P.M.

, Walsh

W.R.

. Primary Total Hip Arthroplasty in Severe Developmental Dysplasia of the Hip. Ten-Year Results Using a Cementless Modular Stem. J Arthroplasty 2009; 24: 27–32.