Outcomes of neck modularity in total hip arthroplasty: an Italian perspective

Abstract

Background

The aim of this study is to conduct a systematic review of clinical outcomes and complications of modular neck THA among Italian cohorts.

Methods

Only reviewed publications focused on Italian cohort patients in English language were considered for inclusion. Studies were included if they involved patients who underwent total hip replacement surgery with modular necks, and reported aetiology or survival rate or bone stability or clinical scores or complications.

Results

The studies included in our search reported data on 3714 patients and 3856 hips. Most of the studies were from high-volume surgery centres. The most frequent diagnosis was osteoarthritis that occurred in 2910 cases (75.9%). The average survival rate and average bone stability were 97.20% and 99.37%, respectively. The average HHS improved from 42.1 prior to surgery to 89.52 after surgery. Studies included in our search reported 40 complications. The most frequently reported complication was dislocation (40%).

Conclusion

This review showed excellent survival rate and bone stability and good clinical outcomes in Italian cohort patients treated with modular neck THA, and these clinical results are comparable with international cohort rates. This review suggests that modular implants represent a very satisfying choice when practised by expert orthopaedic joint surgeons.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Walker JA (2010) Total hip replacement: improving patients’ quality of life. Nurs Stand 24:51–57. https://doi.org/10.7748/ns2010.02.24.23.51.c7552 (quiz 58)

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Ibrahim MS, Raja S, Haddad FS (2013) Acetabular impaction bone grafting in total hip replacement. Bone Joint J 95-B:98–102. https://doi.org/10.1302/0301-620X.95B11.32834

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Ceretti M, Falez F (2016) Modular titanium alloy neck failure in total hip replacement: analysis of a relapse case. SICOT J 2:20. https://doi.org/10.1051/sicotj/2016009

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Goyal N, Hozack WJ (2010) Neck-modular femoral stems for total hip arthroplasty. Surg Technol Int 20:309–313

    PubMed  Google Scholar 

  5. 5.

    Pallini F, Cristofolini L, Traina F, Toni A (2007) Modular hip stems: determination of disassembly force of a neck-stem coupling. Artif Organs 31:166–170. https://doi.org/10.1111/j.1525-1594.2007.00359.x

    Article  PubMed  Google Scholar 

  6. 6.

    Traina F, De Clerico M, Biondi F, Pilla F, Tassinari E, Toni A (2009) Sex differences in hip morphology: is stem modularity effective for total hip replacement? J Bone Joint Surg Am 91(Suppl 6):121–128. https://doi.org/10.2106/JBJS.I.00533

    Article  PubMed  Google Scholar 

  7. 7.

    De Fine M, Romagnoli M, Toscano A, Bondi A, Nanni M, Zaffagnini S (2017) Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review. Orthop Traumatol Surg Res 103:349–355. https://doi.org/10.1016/j.otsr.2016.12.013

    Article  PubMed  Google Scholar 

  8. 8.

    Osman K, Panagiotidou AP, Khan M, Blunn G, Haddad FS (2016) Corrosion at the head-neck interface of current designs of modular femoral components: essential questions and answers relating to corrosion in modular head-neck junctions. Bone Joint J 98-B:579–584. https://doi.org/10.1302/0301-620X.98B5.35592

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Ellman MB, Levine BR (2013) Fracture of the modular femoral neck component in total hip arthroplasty. J Arthroplasty 28(196):e191–e195. https://doi.org/10.1016/j.arth.2011.05.024

    Article  Google Scholar 

  10. 10.

    Toni A, Sudanese A, Paderni S, Guerra E, Bianchi G, Antonietti B, Giunti A (2001) Cementless hip arthroplasty with a modular neck. Chir Organi Mov 86:73–85

    CAS  PubMed  Google Scholar 

  11. 11.

    Capanna R, Biagini R, Ruggieri P, Bettelli G, Campanacci M (1985) The Rizzoli Orthopedic Institute modular-type prosthesis for the proximal femur; preliminary results. Chir Organi Mov 70:45–51

    CAS  PubMed  Google Scholar 

  12. 12.

    Toni A, Giardina F, Guerra G, Sudanese A, Montalti M, Stea S, Bordini B (2017) 3rd generation alumina-on-alumina in modular hip prosthesis: 13 to 18 years follow-up results. Hip Int 27:8–13. https://doi.org/10.5301/hipint.5000429

    Article  PubMed  Google Scholar 

  13. 13.

    Cristante L, Herrmann HD (1994) Surgical management of intramedullary spinal cord tumors: functional outcome and sources of morbidity. Neurosurgery 35:69–74 (discussion 74–66)

    CAS  Article  Google Scholar 

  14. 14.

    Chillemi M, Placella G, Caraffa A, Cerulli G, Antinolfi P (2017) Serologic and radiographic outcome of total hip arthroplasty with CoCr modular neck at mid-term follow-up. Musculoskelet Surg 101:51–58. https://doi.org/10.1007/s12306-016-0429-9

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Bellomo F, Bertignone L, Morino L, Milano P, Schiavone E, Barale M (2002) MP-Link cementless distal fixation modular prosthesis for revision total hip arthroplasty. J Orthop Traumatol 2:121–124. https://doi.org/10.1007/s101950200011

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Antonietti B, Paderni S, Sama D, Comitini V, Sudanese A (2003) Anatomic cementless total hip arthroplasty with ceramic bearings and modular necks: 3 to 5 years follow-up. Chir Organi Mov 88:259–265

    CAS  PubMed  Google Scholar 

  17. 17.

    Benazzo F, Cuzzocrea F, Stroppa S, Ravasi F, Dalla Pria P (2007) Modular stems in DDH. Hip Int 17(Suppl 5):S138–S141

    Article  Google Scholar 

  18. 18.

    Benazzo F, Rossi SM, Cecconi D, Piovani L, Ravasi F (2010) Mid-term results of an uncemented femoral stem with modular neck options. Hip Int 20:427–433

    Article  Google Scholar 

  19. 19.

    Traina F, De Fine M, Tassinari E, Sudanese A, Calderoni PP, Toni A (2011) Modular neck prostheses in DDH patients: 11-year results. J Orthop Sci 16:14–20. https://doi.org/10.1007/s00776-010-0018-y

    Article  PubMed  Google Scholar 

  20. 20.

    Bistolfi A, Massazza G, Rosso F, Ventura S, Lagalla F, Crova M (2012) Modular cementless cup for total hip arthroplasty: results at 4-year follow-up. Musculoskelet Surg 96:89–94. https://doi.org/10.1007/s12306-011-0177-9

    Article  PubMed  Google Scholar 

  21. 21.

    Dagnino A, Grappiolo G, Benazzo FM, Learmonth ID, Spotorno L, Portinaro N (2012) Medium-term outcome in patients treated with total hip arthroplasty using a modular femoral stem. Hip Int 22:274–279. https://doi.org/10.5301/HIP.2012.9245

    Article  PubMed  Google Scholar 

  22. 22.

    Traina F, De Fine M, Abati CN, Bordini B, Toni A (2012) Outcomes of total hip replacement in patients with slipped capital femoral epiphysis. Arch Orthop Trauma Surg 132:1133–1139. https://doi.org/10.1007/s00402-012-1538-z

    Article  PubMed  Google Scholar 

  23. 23.

    Benazzo FM, Piovani L, Combi A, Perticarini L (2015) MODULUS stem for developmental hip dysplasia: long-term follow-up. J Arthroplasty 30:1747–1751. https://doi.org/10.1016/j.arth.2015.04.021

    Article  PubMed  Google Scholar 

  24. 24.

    Wirtz DC, Gravius S, Ascherl R, Thorweihe M, Forst R, Noeth U, Maus UM, Wimmer MD, Zeiler G, Deml MC (2014) Uncemented femoral revision arthroplasty using a modular tapered, fluted titanium stem: 5- to 16-year results of 163 cases. Acta Orthop 85:562–569. https://doi.org/10.3109/17453674.2014.958809

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Holt G, McCaul J, Jones B, Ingram R, Stark A (2011) Outcome after femoral revision using the restoration cone/conical femoral revision stem. Orthopedics 34:11. https://doi.org/10.3928/01477447-20101123-02

    Article  PubMed  Google Scholar 

  26. 26.

    Collet T, Atanasiu JP, de Cussac JB, Oufroukhi K, Bothorel H, Saffarini M, Badatcheff F (2017) Midterm outcomes of titanium modular femoral necks in total hip arthroplasty. Ann Transl Med 5:395. https://doi.org/10.21037/atm.2017.07.36

    Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Silverton CD, Jacobs JJ, Devitt JW, Cooper HJ (2014) Midterm results of a femoral stem with a modular neck design: clinical outcomes and metal ion analysis. J Arthroplasty 29:1768–1773. https://doi.org/10.1016/j.arth.2014.04.039

    Article  PubMed  Google Scholar 

  28. 28.

    Cossetto DJ, Goudar A (2012) Mid-term outcome of a modular, cementless, proximally hydroxyapatite-coated, anatomic femoral stem. J Orthop Surg (Hong Kong) 20:322–326. https://doi.org/10.1177/230949901202000311

    Article  Google Scholar 

  29. 29.

    Blakey CM, Eswaramoorthy VK, Hamilton LC, Biant LC, Field RE (2009) Mid-term results of the modular ANCA-Fit femoral component in total hip replacement. J Bone Joint Surg Br 91:1561–1565. https://doi.org/10.1302/0301-620X.91B12.22638

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Vanbiervliet J, Somers JFA (2017) Excellent mid-term results of a new polished tapered modular cemented stem: a study of 113 hip replacements with minimum 5-year follow-up. Hip Int 27:455–459. https://doi.org/10.5301/hipint.5000486

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Hashem A, Al-Azzawi A, Riyadh H, Mukka S, Sayed-Noor A (2018) Cementless, modular, distally fixed stem in hip revision arthroplasty: a single-center study of 132 consecutive hips. Eur J Orthop Surg Traumatol 28:45–50. https://doi.org/10.1007/s00590-017-2013-x

    Article  PubMed  Google Scholar 

  32. 32.

    Kouzelis A, Georgiou CS, Megas P (2012) Dissociation of modular total hip arthroplasty at the neck-stem interface without dislocation. J Orthop Traumatol 13:221–224. https://doi.org/10.1007/s10195-011-0172-9

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Barlow BT, Boles JW, Lee YY, Ortiz PA, Westrich GH (2016) Short-term outcomes and complications after rejuvenate modular total hip arthroplasty revision. J Arthroplasty 31:857–862. https://doi.org/10.1016/j.arth.2015.10.041

    Article  PubMed  Google Scholar 

  34. 34.

    Konan S, Garbuz DS, Masri BA, Duncan CP (2016) Modular tapered titanium stems in revision arthroplasty of the hip: the risk and causes of stem fracture. Bone Joint J 98-B:50–53. https://doi.org/10.1302/0301-620X.98B1.36442

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Takemoto S, Vail TP, Houman J, Barnes CL (2015) What defines a high-volume hip or knee surgeon in the United States? J Surg Orthop Adv 24:87–90

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to A. Di Martino.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Papalia, R., Di Martino, A., Caldaria, A. et al. Outcomes of neck modularity in total hip arthroplasty: an Italian perspective. Musculoskelet Surg 103, 215–220 (2019). https://doi.org/10.1007/s12306-019-00589-z

Download citation

Keywords

  • Total hip arthroplasty
  • Modular neck
  • Modular stem
  • Modular implants
  • Complications
  • Outcomes
  • Italian cohorts