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Modular femoral neck failure after revision of a total hip arthroplasty: a finite element analysis

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Abstract

The authors report on a case of modular femoral neck fracture which appeared 21 months after revision of acetabular component. The revision surgery was performed 8 years after the primary total hip arthroplasty due to aseptic loosening of the acetabular component. During acetabular revision, the primary implanted short (S, − 3.5 mm) femoral head was also exchanged with extra-long (XL, + 7.0 mm) femoral head fitting the modular femoral neck with a longer lever arm. Numerical analysis has shown that this has resulted in a 19.9% increase in tensile stress at the neck–stem coupling during normal walking cycle. This could result in microcrack initiation and propagation and finally lead to modular neck failure of the otherwise well-fixed stem. Surgeons should avoid excessive loading of the exchangeable neck (dual-modular) femoral stem designs as the stem–neck couplings are subject to corrosion and are not as reliable as monoblock stems.

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Authors and Affiliations

  1. Faculty of Medicine, University of Maribor, Maribor, Slovenia

    Jan Zajc

  2. Faculty of Mechanical Engineering, University of Maribor, Maribor, Slovenia

    Jožef Predan & Nenad Gubeljak

  3. Department for Orthopaedic Surgery, University Medical Center Maribor, Ljubljanska 5, 2000, Maribor, Slovenia

    Andrej Moličnik & Samo K. Fokter

Authors
  1. Jan Zajc
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  2. Jožef Predan
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  3. Nenad Gubeljak
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  4. Andrej Moličnik
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  5. Samo K. Fokter
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Correspondence to Samo K. Fokter.

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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.

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Informed consent was obtained from all individual participants included in the study.

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Zajc, J., Predan, J., Gubeljak, N. et al. Modular femoral neck failure after revision of a total hip arthroplasty: a finite element analysis. Eur J Orthop Surg Traumatol 29, 717–723 (2019). https://doi.org/10.1007/s00590-018-2314-8

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  • DOI: https://doi.org/10.1007/s00590-018-2314-8

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