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Custom and modular components in primary total hip replacement

J C McCarthy1, J V Bono, P J O'Donnell

  • 1New England Baptist Hospital, Boston, MA 02120, USA.

Clinical Orthopaedics and Related Research
|December 31, 1997
PubMed
Summary
This summary is machine-generated.

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Custom and modular hip implants offer surgical versatility but present significant drawbacks, including high costs and potential complications. Their use in primary hip arthroplasty should be carefully considered and reserved for complex cases.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering

Background:

  • Custom cementless implants aim to improve fit for diverse hip anatomies using CT scans.
  • Modular prostheses offer intraoperative adjustments for leg length, offset, and fixation, beneficial in complex hip conditions.

Purpose of the Study:

  • To evaluate the clinical efficacy and drawbacks of custom and modular hip implants compared to traditional options.
  • To provide guidance on judicious use of these advanced implant types in primary hip arthroplasty.

Main Methods:

  • Review of clinical studies and experience with custom and modular hip implant designs.
  • Analysis of advantages, including surgical versatility and inventory reduction.
  • Assessment of disadvantages such as corrosion, fretting, dissociation, fracture, and wear.

Related Experiment Videos

Main Results:

  • Custom implants are costly and have not demonstrated superior clinical success or longevity.
  • Modular implants offer intraoperative benefits but are associated with corrosion, fretting, dissociation, and fracture risks.
  • Thin acetabular polyethylene in modular designs contributes to higher wear rates and osteolysis.

Conclusions:

  • The use of custom or modular implants in primary hip arthroplasty requires careful consideration due to cost and potential complications.
  • Modularity beyond the head and neck junction should be reserved for cases where monolithic implants are insufficient.