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International Orthopaedics

Erschienen in:

16.09.2020 | Original Paper

Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis

verfasst von: Samo K. Fokter, Jan Zajc, Matjaž Merc

Erschienen in: International Orthopaedics | Ausgabe 4/2021

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Abstract

Introduction

Revision of a well-fixed stem due to unexpected modular neck fracture is a catastrophe for the patient and a challenge for the surgeon. This study aimed to test the possibility of predicting interchangeable neck fracture from serum levels of the stem/neck alloy-consisting metals.

Materials and methods

Nineteen patients at high risk for interchangeable neck fracture were randomly selected out of a cohort of 680 bimodular stems made from Ti6Al4V alloy. Serum levels of titanium, aluminium and vanadium were determined. Nine age- and gender-matched patients were used as controls.

Results

Mean serum levels of Ti were 6.04 ± 2.52 μg/L, of Al 3.89 ± 1.68 μg/L and of V 0.07 ± 0.04 μg/L in the high-risk group, and 8.22 ± 4.74 μg/L, 4.99 ± 3.98 μg/L and 0.27 ± 0.44 μg/L in the low-risk group, respectively. No statistically significant differences were found between the groups.

Discussion

Interchangeable neck fracture of bimodular femoral stems cannot be predicted from serum trace element analysis.

Wright C, Sporer S, Urban R, Jacobs J (2010) Fracture of a modular femoral neck after total hip arthroplasty. J Bone Jt Surg Am 92(6):1518–1521CrossRef

Gerhardt DM, Bisseling P, de Visser E, van Susante JL (2014) Modular necks in primary hip arthroplasty without anatomical deformity: no clear benefit on restoration of hip geometry and dislocation rate. An exploratory study. J Arthroplast 29(8):1553–1558. https://doi.org/10.1016/j.arth.2014.02.009CrossRef

Kovač S, Mavčič B, Kotnik M, Levašič V, Sirše M, Fokter S (2019) What factors are associated with neck fracture in one commonly used bimodular THA design? A multicenter, nationwide study in Slovenia. Clin Orthop Relat Res 477(6):1324–1332CrossRefPubMedPubMedCentral

Zajc J, Predan J, Gubeljak N, Moličnik A, Fokter S (2018) Modular femoral neck failure after revision of a total hip arthroplasty: a finite element analysis. Eur J Orthop Surg Traumatol 29(3):717–723CrossRefPubMed

Duwelius P, Burkhart B, Carnahan C, Branam G, Ko L, Wu Y, Froemke C, Wang L, Grunkemeier G (2013) Modular versus nonmodular neck femoral implants in primary total hip arthroplasty: which is better? Clin Orthop Relat Res 472(4):1240–1245CrossRefPubMedPubMedCentral

Pelayo-de-Tomás J, Rodrigo-Pérez J, Novoa-Parra C, Lizaur-Utrilla A, Morales-Suárez-Varela M, Blas-Dobón J (2017) Cementless modular neck stems: are they a safe option in primary total hip arthroplasty? Eur J Orthop Surg Traumatol 28(3):463–469CrossRefPubMed

Toni A, Giardina F, Guerra G, Sudanese A, Montalti M, Stea S, Bordini B (2016) 3rd generation alumina-on-alumina in modular hip prosthesis: 13 to 18 years follow-up results. Hip Int 27(1):8–13CrossRefPubMed

Fitch DA, Ancarani C, Bordini B (2015) Long-term survivorship and complication rate comparison of a cementless modular stem and cementless fixed neck stems for primary total hip replacement. Int Orthop 39(9):1827–1832. https://doi.org/10.1007/s00264-015-2894-4CrossRefPubMed

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(5):455–459. https://doi.org/10.5301/hipint.5000486CrossRefPubMedPubMedCentral

10.

Fokter S, Levašič V, Kovač S (2017) The inovation trap: modular neck in total hip arthroplasty. Zdrav Vest 86:115–126 (accessible on: https://vestnik.szd.si/index.php/ZdravVest/article/view/2156)

11.

Colas S, Allalou A, Poichotte A, Piriou P, Dray-Spira R, Zureik M (2017) Exchangeable femoral neck (dual-modular) THA prostheses have poorer survivorship than other designs: a nationwide cohort of 324,108 patients. Clin Orthop Relat Res 475(8):2046–2059CrossRefPubMedPubMedCentral

12.

Lex JR, Welch MD, Abbas S, Edwards TC, Stavropoulos NA, Babis GC (2020) Systematic review of primary total hip arthroplasty using titanium-titanium modular-neck prostheses: the true risk of revision. Hip Int 16:1120700020916870

13.

Sharan D (1999) The problem of corrosion in orthopaedic implant materials. Orthopaedic Update (India) 9(1):1–5

14.

Fokter S, Moličnik A, Kavalar R, Pelicon P, Rudolf R, Gubeljak N (2017) Why do some titanium-alloy total hip arthroplasty modular necks fail? J Mech Behav Biomed Mater 69:107–114CrossRefPubMed

15.

Rasquinha VJ, Ranawat CS, Weiskopf J, Rodriguez JA, Skipor AK, Jacobs JJ (2006) Serum metal levels and bearing surfaces in total hip arthroplasty. J Arthroplast 21(6 Suppl 2):47–52CrossRef

16.

Elmallah RK, Cherian JJ, Meneghini RM, Hozack WJ, Westrich GH, Mont MA (2016) How to approach a recalled dual modular hip implant: an update. J Arthroplast 31(11):2646–2652. https://doi.org/10.1016/j.arth.2016.06.059CrossRef

17.

Kwon YM, Tsai TY, Leone WA, Liow MHL (2017) Sensitivity and specificity of metal ion levels in predicting “pseudotumors” due to taper corrosion in patients with dual taper modular total hip arthroplasty. J Arthroplast 32(3):996–1000. https://doi.org/10.1016/j.arth.2016.08.040CrossRef

18.

Cooper HJ, Urban RM, Wixson RL, Meneghini RM, Jacobs JJ (2013) Adverse local tissue reaction arising from corrosion at the femoral neck-body junction in a dual-taper stem with a cobalt-chromium modular neck. J Bone Joint Surg Am 95(10):865–872CrossRefPubMedPubMedCentral

19.

Norman P, Iyengar S, Svensson I, Flivik G (2014) Fatigue fracture in dual modular revision total hip arthroplasty stems: failure analysis and computed tomography diagnostics in two cases. J Arthroplast 29(4):850–855. https://doi.org/10.1016/j.arth.2013.09.008CrossRef

20.

Fokter SK, Rudolf R, Moličnik A (2016) Titanium alloy femoral neck fracture--clinical and metallurgical analysis in 6 cases. Acta Orthop 87(2):197–202. https://doi.org/10.3109/17453674.2015.1047289CrossRefPubMed

21.

Barlow BT, Ortiz PA, Boles JW, Lee YY, Padgett DE, Westrich GH (2017) What are normal metal ion levels after total hip arthroplasty? A serologic analysis of four bearing surfaces. J Arthroplast 32(5):1535–1542. https://doi.org/10.1016/j.arth.2016.11.024CrossRef

22.

Omlor GW, Kretzer JP, Reinders J, Streit MR, Bruckner T, Gotterbarm T, Aldinger PR, Merle C (2013) In vivo serum titanium ion levels following modular neck total hip arthroplasty--10 year results in 67 patients. Acta Biomater 9(4):6278–6282. https://doi.org/10.1016/j.actbio.2012.12.001CrossRefPubMed

23.

Morlock MM, Bünte D, Ettema H, Verheyen CC, Hamberg Å, Gilbert J (2016) Primary hip replacement stem taper fracture due to corrosion in 3 patients. Acta Orthop 87(2):189–192. https://doi.org/10.3109/17453674.2015.1128780CrossRefPubMedPubMedCentral

Titel: Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis
verfasst von: Samo K. Fokter
Jan Zajc
Matjaž Merc
Publikationsdatum: 16.09.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 4/2021
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04812-6

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Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis

Abstract

Introduction

Materials and methods

Results

Discussion

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Introduction

Materials and methods

Results

Discussion

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