Utility of modular implants in primary total hip arthroplasty

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Medical device engineering

Background:

• Modularity is widely accepted in primary total hip arthroplasty (THA).
• Concerns exist regarding risks associated with modular junctions, particularly taper tribocorrosion.
• Recent issues highlight the need for enhanced safety evaluations.

Purpose of the Study:

• To address concerns surrounding modular junctions in THA.
• To advocate for rigorous preclinical evaluation of new modularity.
• To propose a balanced approach to the use of modularity in THA.

Main Methods:

• Review of current understanding and concerns regarding modular hip implants.
• Analysis of the implications of taper tribocorrosion.
• Discussion of strategies for optimizing and judiciously using modularity.

Main Results:

• Modular junctions in THA present inherent risks, exemplified by taper tribocorrosion.
• Existing preclinical testing may be insufficient for novel modular designs.
• Optimization and selective use of modularity are crucial.

Conclusions:

• Further rigorous preclinical testing is essential before widespread adoption of new modularity in THA.
• Surgeons should optimize necessary modular junctions and avoid gratuitous use.
• A judicious approach to adopting new modularity is recommended to mitigate risks.