title: Corrosion and Adverse Local Tissue Reaction in One Type of Modular Neck Stem.
abstract: Modular neck stems allow for optimization of joint biomechanics by restoring anteversion, offset, and limb length. A potential disadvantage is the generation of metal ions from fretting and crevice corrosion. We identified 118 total hip arthroplasty implanted with one type of dual-modular femoral component. Thirty-six required revision due to adverse local tissue reaction. Multivariate analysis isolated females and low offset necks as risk factors for failure. Kaplan-Meir analysis revealed small stem sizes failed at a higher rate during early follow-up period. Although the cobalt/chrome levels were higher in the failed group, these tests had low diagnostic accuracy for ALTR, while MRI scan was more sensitive. We conclude that the complications related to the use of dual modular stems of this design outweigh the potential benefits.
authors.affiliation: Department of Orthopedic Surgery, Geisinger Health System, Danville, Pennsylvania.
authors.forename: Elie
authors.initials: E
authors.lastname: Ghanem
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Ward
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Robbins
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
authors.forename: Sumon
authors.initials: S
authors.lastname: Nandi
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
authors.forename: James V
authors.initials: JV
authors.lastname: Bono
authors.affiliation: Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
authors.forename: Carl T
authors.initials: CT
authors.lastname: Talmo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D002858:Chromium Alloys / Q000032:analysis; D003343:Corrosion; D005260:Female; D005269:Femur / Q000473:pathology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007596:Joints / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys
keywords: Rejuvenate stem; corrosion; dual modular stem; pseudotumor