title: Midterm results of a femoral stem with a modular neck design: clinical outcomes and metal ion analysis.
abstract: Modular neck femoral stems have a higher-than-anticipated rate of failure in registry results, but large single-center cohort studies are lacking. This is a retrospective cohort of 152 hips implanted with a single titanium stem with a modular titanium neck, presenting clinical, radiographic, and metal ion results at a mean 4.5-year follow-up. Five hips were revised during the study period, for an overall Kaplan-Meier survival of 0.894 at 8 years. There was one modular neck fracture (0.66%), but others demonstrated corrosion or adverse tissue reaction. Serum metal levels demonstrated wide variability. Despite good clinical results in the majority of patients, we confirmed an increased rate of femoral revision at mid-term follow-up, and therefore urge caution in the use of this particular stem design.
authors.affiliation: Department of Orthopaedic Surgery, Henry Ford Hospital, Henry Ford Health System, Detroit, Michigan.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Silverton
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Jacobs
authors.affiliation: Department of Orthopaedic Surgery, Henry Ford Hospital, Henry Ford Health System, Detroit, Michigan.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Devitt
authors.affiliation: Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York.
authors.forename: H John
authors.initials: HJ
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D003343:Corrosion; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007477:Ions / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000401:mortality / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D014025:Titanium / Q000097:blood*; D055815:Young Adult
chemical_list: D007477:Ions; D014025:Titanium
keywords: corrosion; femoral stem; metal ions; modular neck; neck fracture; total hip arthroplasty