Dual-modular versus single-modular stems for primary total hip arthroplasty: a long-term survival analysis

Samo K. Fokter (Author), Nejc Noč (Author), Vesna Levašič (Author), Marko Hanc (Author), Jan Zajc (Author)

Abstract

Background and Objectives: Increased revision rate of dual-modular (DM) femoral stems in primary total hip arthroplasty (THA) because of modular-neck breakage and adverse local tissue reactions (ALTRs) to additional junction damage products is well established and some designs have been recalled from the market. However, some long-term studies of specific DM stems did not confirm the inferiority of these stems compared to standard single-modular (SM) stems, and a head-to-head comparison THA is missing. The objectives of this multicentre study were to determine the survivorship and complication rates of a common DM stem design compared to a similar SM stem. Materials and Methods: In a time frame from January 2012 to November 2015, a cohort of 807 patients (882 hips) consecutively underwent primary cementless THAs at two orthopaedic centres. 377 hips were treated with a Zweimüller-type DM stem THA system and 505 hips with a similar SM stem THA system, both including a modern press-fit acetabulum. Kaplan-Meier survivorship and complication rates were compared between both groups in a median follow-up of 9.0 years (maximum, 9.9 years). Results: The 9-year survivorship of the DM stem THA system (92.6%, 95% CI 89.9–95.3) was significantly lower than that of the SM stem THA system (97.0%, 95% CI 95.2–98.8). There were no differences in revision rates for septic loosening, dislocation, and periprosthetic fractures between the two groups. One ceramic inlay and one Ti-alloy modular neck breakage occurred in the DM stem THA system group, but the main reason for revision in this group was aseptic loosening of components. Conclusions: The survivorship of the DM stem THA system was lower than the similar SM stem THA system in a comparable clinical environment with long-term follow-up. Our results confirmed that no rationale for stem modularity exists in primary THAs.

Keywords

total hip arthroplasty;modular necks;exchangeable necks;survival rate;primary hip replacement;prosthesis;Ti-alloy;

Data

Language:	English
Year of publishing:	2023
Typology:	1.01 - Original Scientific Article
Organization:	UM - University of Maribor
Publisher:	MDPI
UDC:	617.3
COBISS:	141004291
ISSN:	1648-9144
Views:	40
Downloads:	0
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	Slovenian
Secondary keywords:	endoproteza kolka;modularni vratovi;zamenljivi vratovi;stopnja preživetja;zapleti;stopnja revizije;primarna endoproteza kolka;proteza;
Type (COBISS):	Scientific work
Pages:	str. [1]-10
Volume:	ǂVol. ǂ59
Issue:	ǂissue ǂ2, [article no.] 290
Chronology:	2023
DOI:	10.3390/medicina59020290
ID:	23171176