| Title: | Dual-modular versus single-modular stems for primary total hip arthroplasty : a long-term survival analysis |
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| Authors: | ID Fokter, Samo K. (Author)
ID Noč, Nejc (Author)
ID Levašič, Vesna (Author)
ID Hanc, Marko (Author)
ID Zajc, Jan (Author) |
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| Files: |  Fokter-2023-Dual-Modular_Versus_Single-Modular.pdf (1,09 MB)
MD5: EF6EA837B5125B8684A5FAB871A04079
 https://doi.org/10.3390/medicina59020290
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| Language: | English |
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| Work type: | Scientific work |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: | MF - Faculty of Medicine
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| Abstract: | Background and Objectives: Increased revision rate of dual-modular (DM) femoral stems in primary total hip arthroplasty (THA) because of modular-neck breakage and adverse local tissue reactions (ALTRs) to additional junction damage products is well established and some designs have been recalled from the market. However, some long-term studies of specific DM stems did not confirm the inferiority of these stems compared to standard single-modular (SM) stems, and a head-to-head comparison THA is missing. The objectives of this multicentre study were to determine the survivorship and complication rates of a common DM stem design compared to a similar SM stem. Materials and Methods: In a time frame from January 2012 to November 2015, a cohort of 807 patients (882 hips) consecutively underwent primary cementless THAs at two orthopaedic centres. 377 hips were treated with a Zweimüller-type DM stem THA system and 505 hips with a similar SM stem THA system, both including a modern press-fit acetabulum. Kaplan-Meier survivorship and complication rates were compared between both groups in a median follow-up of 9.0 years (maximum, 9.9 years). Results: The 9-year survivorship of the DM stem THA system (92.6%, 95% CI 89.9–95.3) was significantly lower than that of the SM stem THA system (97.0%, 95% CI 95.2–98.8). There were no differences in revision rates for septic loosening, dislocation, and periprosthetic fractures between the two groups. One ceramic inlay and one Ti-alloy modular neck breakage occurred in the DM stem THA system group, but the main reason for revision in this group was aseptic loosening of components. Conclusions: The survivorship of the DM stem THA system was lower than the similar SM stem THA system in a comparable clinical environment with long-term follow-up. Our results confirmed that no rationale for stem modularity exists in primary THAs. |
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| Keywords: | total hip arthroplasty, modular necks, exchangeable necks, survival rate, complications, revision rate, primary hip replacement, prosthesis, Ti-alloy |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Submitted for review: | 21.12.2022 |
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| Article acceptance date: | 31.01.2023 |
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| Publication date: | 02.02.2023 |
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| Publisher: | MDPI |
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| Year of publishing: | 2023 |
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| Number of pages: | Str. 1-10 |
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| Numbering: | Letn. 59, Št. 2, št. članka 290 |
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| PID: | 20.500.12556/DKUM-87410  |
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| UDC: | 617.3 |
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| ISSN on article: | 1648-9144 |
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| COBISS.SI-ID: | 141004291 |
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| DOI: | 10.3390/medicina59020290 |
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| Publication date in DKUM: | 18.03.2024 |
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| Views: | 560 |
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| Downloads: | 25 |
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| Metadata: |    |
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| Categories: | Misc.
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