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Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis

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Abstract

Introduction

Revision of a well-fixed stem due to unexpected modular neck fracture is a catastrophe for the patient and a challenge for the surgeon. This study aimed to test the possibility of predicting interchangeable neck fracture from serum levels of the stem/neck alloy-consisting metals.

Materials and methods

Nineteen patients at high risk for interchangeable neck fracture were randomly selected out of a cohort of 680 bimodular stems made from Ti6Al4V alloy. Serum levels of titanium, aluminium and vanadium were determined. Nine age- and gender-matched patients were used as controls.

Results

Mean serum levels of Ti were 6.04 ± 2.52 μg/L, of Al 3.89 ± 1.68 μg/L and of V 0.07 ± 0.04 μg/L in the high-risk group, and 8.22 ± 4.74 μg/L, 4.99 ± 3.98 μg/L and 0.27 ± 0.44 μg/L in the low-risk group, respectively. No statistically significant differences were found between the groups.

Discussion

Interchangeable neck fracture of bimodular femoral stems cannot be predicted from serum trace element analysis.

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Funding

This study was funded by the senior author’s institution (Grant No. IRP-2017/01-01).

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Authors and Affiliations

  1. Department for Orthopaedic Surgery, University Medical Centre Maribor, 5 Ljubljanska Street, SLO-2000, Maribor, Slovenia

    Samo K. Fokter & Matjaž Merc

  2. Faculty of Medicine, University of Maribor, 8 Taborska Street, SLO-2000 Maribor, Slovenia

    Jan Zajc

Authors
  1. Samo K. Fokter
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  2. Jan Zajc
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Correspondence to Samo K. Fokter.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from the patients included in the study.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board (IRB) approval was obtained to perform this study.

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Fokter, S.K., Zajc, J. & Merc, M. Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis. International Orthopaedics (SICOT) 45, 877–881 (2021). https://doi.org/10.1007/s00264-020-04812-6

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  • DOI: https://doi.org/10.1007/s00264-020-04812-6

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