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  • modular neck stem x
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M M Morlock Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany

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E Gomez-Barrena Department of Orthopaedic Surgery and Traumatology, Universidad Autónoma de Madrid, Madrid, Spain

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D C Wirtz Department of Orthopaedics and Traumatology, University Hospital Bonn, Bonn, Germany

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A Hart London Implant Retrieval Centre, Royal National Orthopaedic Hospital, Stanmore, UK

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J P Kretzer Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany

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Fracture of the neck piece of a bi-modular hip stem. All the above-mentioned products failed despite intensive laboratory testing and the approval of regulatory competent authorities either in the US or in Europe. Failures despite fulfilling all

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Marko Nabergoj Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Patrick J. Denard Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA

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Philippe Collin Centre Hospitalier Privé Saint-Grégoire (Vivalto Santé), Saint-Grégoire, France

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Rihard Trebše Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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components, modular stem or polyethylene disassociations, or glenoid screw problems. 19 Meanwhile, they defined a ‘problem’ as an intraoperative or postoperative event that was not likely to affect the patient’s final outcome. They considered these to

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Keith Tucker Orthopaedic Data Evaluation Panel (ODEP), Norwich, UK

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Klaus-Peter Günther University Centre of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany

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Per Kjaersgaard-Andersen Department of Orthopaedics, Vejle Hospital, South Danish University, Vejle, Denmark

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Jörg Lützner University Centre of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany

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Jan Philippe Kretzer Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany

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Rob G.H.H. Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands

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Toni Lange Center for Evidence-based Healthcare, University Hospital Carl Gustav Carus and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany

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Luigi Zagra IRCCS Istituto Ortopedico Galeazzi, Hip Department, Milan, Italy

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, especially in modular hip revisions stems, that elevated mechanical load on the components can lead to fracture of the taper connection. Other causes of mechanical failure (i.e. high offset, short proximal component, lack of adequate medial bone supporting

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William G. Blakeney Department of Surgery, CIUSSS-de-L’Est-de-L’Ile-de-Montréal, Hôpital Maisonneuve Rosemont, Montréal, Québec, Canada
Department of Surgery, Albany Health Campus, Albany, Australia

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Jean-Alain Epinette Clinique Médico-chirurgicale, Bruay la Buissière, France

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Pascal-André Vendittoli Department of Surgery, Albany Health Campus, Albany, Australia
Department of Surgery, Université de Montréal, Montréal, Québec, Canada

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shell. The majority of movement occurs at the small articulation. 4 Movement of the large articulation only happens when the stem’s neck comes into contact with the polyethylene head. Wear can occur at three interfaces: the small and large bearing

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Giorgio Perino Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany

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Ivan De Martino Division of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

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Lingxin Zhang Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, Canada

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Zhidao Xia Centre for Nanohealth, Swansea University Medical School, Singleton Park, Swansea, UK

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Jiri Gallo Department of Orthopaedics, Faculty of Medicine and Dentistry, University Hospital, Palacky University Olomouc, Czech Republic

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Shonali Natu Department of Pathology, University Hospital of North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK

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David Langton Orthopaedic Department, Freeman Hospital, Newcastle upon Tyne, UK

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Monika Huber Pathologisch-bakteriologisches Institut, Otto Wagner Spital, Wien, Austria

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Anastasia Rakow Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany

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Janosch Schoon Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany

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Enrique Gomez-Barrena Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain

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Veit Krenn MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik-GmbH, Trier, Germany

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various head/neck junctions and CoCr dual modular neck (DMN), in two types coupled with a TMZF (Ti, Mo, Zr, Fe) stem. 20 , 23 – 29 This body of work for hip implants can also be applied to all other joint replacements with metallic junctions. The

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Maria Moralidou Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK

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Anna Di Laura Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK

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Johann Henckel Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK

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Harry Hothi Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK

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Alister J. Hart Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK

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(2°) and distances (1 mm), 60 has been used to plan THAs with stems featuring modular neck designs. However, these components have been proven to perform poorly in a number of material and design combinations. 61 , 62 Studies so far have

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Didier Hannouche Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Matthieu Zingg Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Hermes Miozzari Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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Remy Nizard Department of Orthopaedic Surgery, AP-HP, Hôpital Lariboisière, Paris University, Paris, France

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Anne Lübbeke Department of Orthopaedic Surgery and Traumatology, Geneva University Hospital, Switzerland

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, as it was initially glued or screwed on the stem. 21 Later, modularity of the acetabulum allowed secure fixation of the Al insert by conical sleeving in a metallic shell ( Fig. 1 ). Finally, in 1995, the introduction of hot isostatic pressing

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Theofilos Karachalios School of Health Sciences, Faculty of Medicine, University of Thessalia, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece

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George Komnos Orthopaedic Department, University General Hospital of Larissa, Greece

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Antonios Koutalos Orthopaedic Department, University General Hospital of Larissa, Greece

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months. Aseptic loosening rates for short-stemmed THA are double compared with conventional stems at ten years (2.7% compared with 1.3%). However, revision rates vary according to the type of implant. Femoral stems with modular necks show a double

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Nikolaos Patsiogiannis Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds, UK

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Nikolaos K. Kanakaris Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds, UK
NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK

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Peter V. Giannoudis Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds, UK
NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK

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tapered fluted modular titanium stem (TFMT) 41 , 77 , 78 +/- adjuvant fixation (cables, plates, struts) if advocated. Revision arthroplasty of the acetabular component might take please if required. Cemented stems can also be used, usually for the

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Christiaan P. van Lingen Isala Clinics, Department of Orthopaedic Surgery and Traumatology, Zwolle, The Netherlands

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Luigi M. Zagra IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Harmen B. Ettema Isala Clinics, Department of Orthopaedic Surgery and Traumatology, Zwolle, The Netherlands

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Cees C. Verheyen Isala Clinics, Department of Orthopaedic Surgery and Traumatology, Zwolle, The Netherlands

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THA initially concerned raised blood cobalt and chromium ions, 27 loosening of components, 28 soft-tissue reactions around the hip 29 and osteolysis. 30 Wear at the ball and socket interface as well as modularity at the head—neck

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