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Updated: Oct 16, 2025

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Modular neck stems in total hip arthroplasty: current concepts.

Giuseppe Solarino1, Giovanni Vicenti1, Massimiliano Carrozzo1

  • 1Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.

EFORT Open Reviews
|October 20, 2021
PubMed
Summary

Modular neck implants offer solutions for hip deformities, but early designs had issues. Latest generations show improved safety, guiding surgeons on optimal use for complex hip reconstructions.

Keywords:
complicationsfunctional outcomemodular neck stemtotal hip arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Reconstructive surgery

Background:

  • Modular neck (MN) implants aim to restore hip anatomy, particularly in cases of developmental dysplasia.
  • Early MN implant designs faced challenges including neck fractures and adverse local tissue reactions, limiting their clinical applications.
  • Advancements in MN prostheses aim to address these limitations and improve patient outcomes.

Purpose of the Study:

  • To review the current evidence on modular neck total hip arthroplasty (THA).
  • To evaluate the efficacy and safety of latest-generation MN implants.
  • To provide guidance on patient selection and surgical considerations for MN THA.

Main Methods:

  • Literature review of studies on modular neck total hip arthroplasty.
  • Analysis of clinical outcomes, complications, and failure modes associated with MN implants.
  • Evaluation of implant design features and material considerations.

Main Results:

  • Latest generation MN prostheses appear to have mitigated issues like neck fractures and adverse local tissue reactions.
  • Specific contraindications for long MN THA include body mass index > 30 and certain combinations of high offset femoral necks with long/extra-long heads.
  • Titanium alloy connections are recommended over chromium-cobalt (Cr-Co) necks.

Conclusions:

  • Modular neck THA may be considered for a select group of patients requiring complex hip reconstruction.
  • Surgeons should exercise caution with long MN THA in specific patient profiles and avoid Cr-Co necks.
  • Continued research and careful patient selection are crucial for optimizing outcomes with MN implants.