Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study.

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  • Additional Information
    • Affiliation:
      Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA
      Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
    • Abstract:
      Background: We have previously reported the early clinical results of a modular-neck stem identifying an early 2-year revision rate of 13% due to neck-stem corrosion. This report updates our findings to a midterm mean follow-up of 5 years.Methods: This is a consecutive retrospective review of 186 modular-neck hips in 175 patients with a mean follow-up period was 60.1 ± 22.9 months (range 24-100). We reviewed clinical findings, routine radiographs, detailed imaging (metal artifact reduction software-magnetic resonance imaging, ultrasound), and serum ion levels of cobalt and chromium. We performed a survival analysis with the endpoint defined as revision total hip arthroplasty due to neck-stem corrosion.Results: We revised 41 hips (22.0%) for neck-stem corrosion. Clinical symptoms (groin pain ± local swelling) were consistently present in those that came for revision. Mean serum cobalt ion levels increased as time passed in all patients. Detailed image findings showed that larger fluid collections and local soft tissue masses were seen predominately in symptomatic patients. However, 14% of patients who underwent revision did not have positive magnetic resonance imaging or ultrasound findings. The survival rate was 87% (95% confidence interval 81-92) at 3 years postoperatively and 72% (95% confidence interval 64-80) at 7 years postoperatively.Conclusion: The revision rate for this modular-neck stem due to neck-stem corrosion at mid-term follow-up almost doubled in comparison to previous short-term results. It seems reasonable to consider clinical follow-up alone as symptoms, rather than blood testing for ion levels, seem to be the defining characteristic of failure.
    • Journal Subset:
      Biomedical; USA
    • ISSN:
      0883-5403
    • MEDLINE Info:
      PMID: NLM32199762 NLM UID: 8703515
    • Publication Date:
      In Process
    • Publication Date:
      20200520
    • DOI:
      http://dx.doi.org/10.1016/j.arth.2020.02.059
    • Accession Number:
      143232045
  • Citations
    • ABNT:
      INOUE, D. et al. Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study. Journal of Arthroplasty, [s. l.], v. 35, n. 6, p. S268–S272, 2020. DOI 10.1016/j.arth.2020.02.059. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143232045. Acesso em: 9 ago. 2020.
    • AMA:
      Inoue D, Restrepo C, Nourie B, Restrepo S, Hozack WJ. Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study. Journal of Arthroplasty. 2020;35(6):S268-S272. doi:10.1016/j.arth.2020.02.059
    • APA:
      Inoue, D., Restrepo, C., Nourie, B., Restrepo, S., & Hozack, W. J. (2020). Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study. Journal of Arthroplasty, 35(6), S268–S272. https://doi.org/10.1016/j.arth.2020.02.059
    • Chicago/Turabian: Author-Date:
      Inoue, Daisuke, Camilo Restrepo, Blake Nourie, Santiago Restrepo, and William J. Hozack. 2020. “Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study.” Journal of Arthroplasty 35 (6): S268–72. doi:10.1016/j.arth.2020.02.059.
    • Harvard:
      Inoue, D. et al. (2020) ‘Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study’, Journal of Arthroplasty, 35(6), pp. S268–S272. doi: 10.1016/j.arth.2020.02.059.
    • Harvard: Australian:
      Inoue, D, Restrepo, C, Nourie, B, Restrepo, S & Hozack, WJ 2020, ‘Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study’, Journal of Arthroplasty, vol. 35, no. 6, pp. S268–S272, viewed 9 August 2020, .
    • MLA:
      Inoue, Daisuke, et al. “Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study.” Journal of Arthroplasty, vol. 35, no. 6, June 2020, pp. S268–S272. EBSCOhost, doi:10.1016/j.arth.2020.02.059.
    • Chicago/Turabian: Humanities:
      Inoue, Daisuke, Camilo Restrepo, Blake Nourie, Santiago Restrepo, and William J. Hozack. “Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study.” Journal of Arthroplasty 35, no. 6 (June 2020): S268–72. doi:10.1016/j.arth.2020.02.059.
    • Vancouver/ICMJE:
      Inoue D, Restrepo C, Nourie B, Restrepo S, Hozack WJ. Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study. Journal of Arthroplasty [Internet]. 2020 Jun [cited 2020 Aug 9];35(6):S268–72. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143232045