Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-10-2015 | Original Article • HIP - ARTHROPLASTY

Are titanium-on-titanium TiAl₆V₄ modular necks safe in total hip arthroplasty for non-overweight patients? Results of a prospective series at a minimum follow-up of 7 years

Authors: Matthieu Ollivier, Sébastien Parratte, Alexandre Galland, Alexandre Lunebourg, Jean-Noel Argenson

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2015

Abstract

Using extramedullar modularity in total hip arthroplasty has been proposed as an option to optimize the restoration of hip biomechanics. To avoid the problems that were observed with cobalt-chrome modular neck, titanium modular necks have been developed. The goals of our study were to evaluate the safety of titanium-on-titanium TiAl₆V₄ modular neck system. Hundred patients with a mean age of 69.6 ± 10.6 (42–86 years) and mean BMI of 25.07 ± 4.86 (17–38 kg/m²) suffering from primary or secondary arthritis of the hip were prospectively included. At a minimum of 7 years, no fracture of the modular neck was observed. No patient required a revision. No sign of loosening was found in the radiological analysis. Our study shows that titanium-on-titanium TiAl₆V₄ modular neck system can safely be used with good midterm clinical and radiological results for non-overweight patients. These results should be confirmed at longer follow-up.

Toni A, Sudanese A, Ciaroni D, Dallari D, Greggi T, Giunti A (1990) Anatomical ceramic arthroplasty (AN.C.A.): preliminary experience with a new cementless prosthesis. Chir Org Mov 75(1):81–97

Srinivasan A, Jung E, Levine BR (2012) Modularity of the femoral component in total hip arthroplasty. J Am Acad Orthop Surg 20:214–222CrossRefPubMed

Chmell MJ, Rispler D, Poss R (1995) The impact of modularity in total hip arthroplasty. Clin Orthop Relat Res 77:84

Jones RE (2004) Modular revision stems in total hip arthroplasty. Clin Orthop Relat Res 142:7

Steppacher SD, Ecker TM, Timmerman I et al (2008) Managing length and stability: the role of the modular neck. Orthopedics 31:900CrossRefPubMed

Sakai T, Sugano N, Ohzono K, Nishii T, Haraguchi K, Yoshikawa H (2002) Femoral anteversion, femoral offset, and abductor lever arm after total hip arthroplasty using a modular femoral neck system. J Orthop Sci 7(1):62–67CrossRefPubMed

Barrack RL, Burke DW, Cook SD et al (1993) Complications related to modularity of total hip components. J Bone Joint Surg Br 75:688PubMed

Krishnan H, Krishnan SP, Blunn G, Skinner JA, Hart AJ (2013) Modular neck femoral stems. Bone Joint J 95-B:1011–1021CrossRefPubMed

Collier JP, Mayor MB, Jensen RE, et al (1992) Mechanisms of failure of modular prostheses. Clin Orthop Relat Res 129

10.

Cuckler JM (2012) If hip implant retrievals could speak, what would they tell us? J Bone Joint Surg Br 94:11–13CrossRefPubMed

11.

Dangles CJ, Altstetter CJ (2010) Failure of the modular neck in a total hip arthroplasty. J Arthroplasty 25:1169.e5–1169.e7CrossRef

12.

Grupp TM, Weik T, Bloemer W et al (2010) Modular titanium alloy neck adapter failures in hip replacement—failure mode analysis and influence of implant material. BMC Musculoskelet Disord 11:3. doi: 10.1186/1471-2474-11-3 PubMedCentralCrossRefPubMed

13.

Pellegrini VD, Hughes SS, Evarts CM (1992) A collarless cobalt–chrome femoral component in uncemented total hip arthroplasty. Five- to eight-year follow-up. J Bone Joint Surg Br 74:814PubMed

14.

Kop AM, Keogh C, Swarts E (2012) Proximal component modularity in THA. At what cost? An implant retrieval study. Clin Orthop Relat Res 470(7):1885–1894PubMedCentralCrossRefPubMed

15.

Omlor GW, Kretzer JP, Reinders J, Streit MR, Bruckner T, Gotterbarm T, Aldinger PR, Merle C (2013) In vivo serum titanium ion levels following modular neck total hip arthroplasty, 10 year results in 67 patients. Acta Biomater 9(4):6278–6282CrossRefPubMed

16.

Huot Carlson JC, Van Citters DW, Currier JH, Bryant AM, Mayor MB, Collier JP (2012) Femoral stem fracture and in vivo corrosion of retrieved modular femoral hips. J Arthroplasty 27(7):1389–1396CrossRefPubMed

17.

Harris WH (1979) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755

18.

Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM (2003) Hip disability and Osteoarthritis Outcome Score (HOOS)—validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 30:4–10

19.

De Lee J, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20

20.

Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17PubMed

21.

Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 69:45PubMed

22.

Murray DW, Carr AJ, Bulstrode C (1993) Survival analysis of joint replacements. J Bone Joint Surg Br 75:697PubMed

23.

Toni A, Sudanese A, Paderni S, Guerra E, Bianchi G, Antonietti B, Giunti A (2001) Cementless hip arthroplasty with a modular neck. Chir Org Mov 86(2):73–85

24.

Garbuz DS, Tanzer M, Greidanus NV, Masri BA, Duncan CP (2010) The John Charnley award: metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 468(2):318–325PubMedCentralCrossRefPubMed

25.

Paulsen A, Pedersen AB, Overgaard S, Roos EM (2012) Feasibility of 4 patient-reported outcome measures in a registry setting. Acta Orthop 83(4):321–327PubMedCentralCrossRefPubMed

26.

Nourissat C, Essig J, Asencio G (2013) The cementless anatomic Benoist Girard (ABG) II total hip arthroplasty: a minimum 8-year follow-up study. J Arthroplasty 28(4):707–711CrossRefPubMed

27.

Fokter SK, Rudolf R, Moličnik A (2015) Titanium alloy femoral neck fracture-clinical and metallurgical analysis in 6 cases. Acta Orthop 4:1–6CrossRef

28.

Kretzer JP, Jakubowitz E, Krachler M, Thomsen M, Heisel C (2009) Metal release and corrosion effects of modular neck total hip arthroplasty. Int Orthop 33:1531–1536PubMedCentralCrossRefPubMed

Title: Are titanium-on-titanium TiAl6V4 modular necks safe in total hip arthroplasty for non-overweight patients? Results of a prospective series at a minimum follow-up of 7 years
Authors: Matthieu Ollivier
Sébastien Parratte
Alexandre Galland
Alexandre Lunebourg
Jean-Noel Argenson
Publication date: 01-10-2015
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-015-1665-7

At a glance: The STEP trials

Springer Medicine

Are titanium-on-titanium TiAl₆V₄ modular necks safe in total hip arthroplasty for non-overweight patients? Results of a prospective series at a minimum follow-up of 7 years

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2015

Flow cytometry as a diagnostic tool for identifying total hip arthroplasty loosening and differentiating between septic and aseptic cases

Salivary gland second cancer after bone sarcoma treatment

Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty

Functional outcomes and complications after surgical repair of triceps tendon rupture

Ankle arthrodesis from lateral transfibular approach: analysis of treatment results of 23 feet treated by the modified Mann’s technique

Validation study of the Forgotten Joint Score-12 as a universal patient-reported outcome measure