Modular neck vs. nonmodularfemoral stems in total hip arthroplasty – clinical outcome, metal ion levels, and radiological findings

Abstract Background Modular neck femoral stem (MNFS)1 for total hip arthroplasty (THA)2 was introduced to optimize the outcome, but created concerns about pain, elevated blood metal ion levels, and adverse reaction to metal debris (ARMD)3 such as pseudotumors (PT)4 , related to corrosion between fem...

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Bibliographic Details
Published in:The Journal of arthroplasty 2017
Main Authors: Mikkelsen, Rasmus T., M.D, Fløjstrup, Marianne, M.D, Lund, Christian, D.C, Kjærsgaard-Andersen, Per, M.D, Skjødt, Thomas, M.D, Varnum, Claus, M.D. Ph.D
Format: Article
Language:English
Subjects:
Orthopedics
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Summary:Abstract Background Modular neck femoral stem (MNFS)1 for total hip arthroplasty (THA)2 was introduced to optimize the outcome, but created concerns about pain, elevated blood metal ion levels, and adverse reaction to metal debris (ARMD)3 such as pseudotumors (PT)4 , related to corrosion between femoral neck and stem. We compared these outcomes in patients with MNFS or nonmodular femoral stem (NFS)5 THA. Methods Thirty-three patients with unilateral MNFS THA were compared with 30 patients with unilateral NFS THA. Levels of pain, serum cobalt, serum chromium were determined. Magnetic resonance imaging (MRI)6 was performed to describe PT and fatty atrophy of muscles. Results The MNFS and NFS group had a mean follow-up of 2.3 and 3.1 years, respectively. Four and 13 patients in the MNFS and NFS group had pain, respectively (p=0.005). The MNFS group had higher levels of serum cobalt (p
ISSN:0883-5403
DOI:10.1016/j.arth.2017.03.072