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Modular neck total hip arthroplasty - a perfect storm.

Ali Humadi1, Richard Jamieson1, Tat Chao1

  • 1Albury Base Hospital, University of New South Wales, Victoria - Australia.

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|February 13, 2016
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Summary

Femoral neck notching is a risk in modular neck total hip arthroplasty (THA). A specific combination of components (anteverted neck, extended offset, length code -8) significantly increased failure rates in THA patients.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science

Background:

  • Modular neck total hip arthroplasty (THA) offers customization but may present unique failure modes.
  • Femoral neck notching has been anecdotally reported in THA revisions.

Purpose of the Study:

  • To identify neck notching as a cause of failure in modular neck THA.
  • To determine specific modular component combinations associated with increased failure risk and elucidate the failure mechanism.

Main Methods:

  • Retrospective review of 301 total hip arthroplasties (THA) utilizing Kinectiv modular neck Technology.
  • Analysis of patient records, operative notes, and radiographs to identify neck notching requiring revision.
  • Statistical analysis to assess risk factors.

Main Results:

  • Seven failures (2.3%) were observed in 301 THA.
  • All failures (100%) involved a specific modular combination: anteverted neck, extended offset, and length code -8.
  • This specific combination demonstrated a significantly high failure rate (36.8%, p<0.001).

Conclusions:

  • Femoral neck notching is a significant cause of failure in modular neck THA.
  • The combination of an anteverted neck, extended offset, and length code -8 with the Kinectiv modular neck system is strongly associated with neck notching and subsequent failure.
  • Caution is advised when using this specific implant combination in THA procedures.