AI Article Synopsis
- A study was conducted to compare the use of modular vs. monoblock splined titanium stems in femoral revisions during total hip arthroplasty (THA), focusing on complication rates, functional outcomes, and radiographic measures.
- The research included 145 femoral revisions over an average follow-up of 5.12 years, analyzing 67 modular and 78 monoblock stem cases.
- Results showed no significant differences in complication rates, functional outcomes, or radiographic measures between the two types of stems, indicating they perform similarly; however, further research is needed for cases with more severe femoral bone loss.
Article Abstract
Background: Proposed benefits of modularity for femoral revisions in total hip arthroplasty (THA) include more precise biomechanical restoration and improved stability, but this has not been proven with use of a splined, tapered design. This study's purpose is to compare (1) complication rates, (2) functional outcomes, and (3) radiographic measures of subsidence, offset, and leg length discrepancy with the use of modular vs monoblock splined, tapered titanium stems in revision THA.
Methods: We retrospectively reviewed 145 femoral revisions with minimum 2-year follow-up (mean, 5.12 years; range, 2-17.3 years). Patients receiving a modular (67) or monoblock (78) splined, tapered titanium stem for femoral revision were included.
Results: There were no statistically significant differences in rates of reoperation (22.3% vs 17.9%; P = .66), intraoperative fracture (9.0% vs 3.8%; P = .30), postoperative fracture (3.0% vs 1.3%; P = .47), dislocation (11.9% vs 5.1%; P = .23), or aseptic loosening (4.5% vs 6.4%; P = .73) between the modular and monoblock cohorts, respectively. There were similar results regarding subsidence >5 mm (10.4% vs 12.8%; P = .22), LLD >1 cm (35.8% vs 38.5%; P = .74), restoration of hip offset (-5.88 ± 10.1 mm vs -5.07 ± 12.1 mm; P = .67), and Harris Hip Score (70.7 ± 17.9 vs 73.9 ± 19.7; P = .36) between groups. Multivariate regression showed no differences in complications (P = .44) or reoperations (P = .20) between groups.
Conclusion: Modular and monoblock splined, tapered titanium stems demonstrated comparable complication rates, functional outcomes, and radiographic parameters for femoral revisions. However, a limited number of patients with grade IIIB or IV femoral bone loss received a monoblock stem. Future investigations are required to determine whether modularity is beneficial for more complex femoral defects.
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| http://dx.doi.org/10.1016/j.arth.2019.12.041 | DOI Listing |
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Article Synopsis
- A study was conducted to compare the use of modular vs. monoblock splined titanium stems in femoral revisions during total hip arthroplasty (THA), focusing on complication rates, functional outcomes, and radiographic measures.
- The research included 145 femoral revisions over an average follow-up of 5.12 years, analyzing 67 modular and 78 monoblock stem cases.
- Results showed no significant differences in complication rates, functional outcomes, or radiographic measures between the two types of stems, indicating they perform similarly; however, further research is needed for cases with more severe femoral bone loss.
The fate of sagittal alignment in tapered uncemented femoral components in total hip arthroplasty: 889 hips followed for a minimum of 10 years.
Hip Int
July 2021
Orthopaedic Surgery Department, Hospital La Paz-Idi Paz, Madrid, Spain.
Purpose: Aseptic loosening is rare after primary total hip arthroplasty (THA) with mostly uncemented tapered stems; however, different factors can modify the results. We question whether 3 different current femoral components and/or the surgical technique affect the clinical and radiological outcome after a minimum follow-up of 10 years.
Methods: 889 uncemented tapered stems implanted from 1999 to 2007 were evaluated for a minimum follow-up of 10 years.
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