Hip & pelvis

  • 제30권3호
  • /
  • Pages.190-195
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  • 2018
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
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DOI QR코드

DOI QR Code

Late Onset Disassembly of a Modular Neck-stem Component after Cementless Hip Replacement without Dislocation: A Case Report and Review of Literatures

  • 투고 : 2018.03.20
  • 심사 : 2018.07.06
  • 발행 : 2018.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

Modular femoral prostheses are characterized by a second neck-stem junction. This modularity provides many clinical benefits including hip offset restoration, intraoperative leg length and anteversion adjustment. Although, this extra junction in modular femoral prostheses can contribute to catastrophic consequences like fracture, cold welding, corrosion and fretting of the modularity. However, only few complications related to the modularity itself have been reported in the literature. We report a unique case of neck-stem component dissociation without dislocation of the $R-120PC^{TM}$ Modular Stem (DJO Surgical). Our 71-year-old obese female patient underwent cementless hip replacement 5 years ago. Following radiographic confirmation of neck-stem dissociation open reduction was performed and wiring fixation was applied to secure the neck to the stem. After reduction and fixation, hip joint was stable, and our patient returned to her daily routine 2.5 months postoperatively. The last follow up was at 12 months after surgery with excellent radiographic and clinical evaluation.

키워드

참고문헌

  1. Kop AM, Keogh C, Swarts E. Proximal component modularity in THA--at what cost? An implant retrieval study. Clin Orthop Relat Res. 2012;470:1885-94. https://doi.org/10.1007/s11999-011-2155-9
  2. Ahmed P, Kumar D. Late disassembly of femoral head and neck of a modular primary total hip arthroplasty. J Orthop Case Rep. 2015;5:8-10.
  3. Barrack RL, Burke DW, Cook SD, Skinner HB, Harris WH. Complications related to modularity of total hip components. J Bone Joint Surg Br. 1993;75:688-92.
  4. Kouzelis A, Georgiou CS, Megas P. Dissociation of modular total hip arthroplasty at the neck-stem interface without dislocation. J Orthop Traumatol. 2012;13:221-4. https://doi.org/10.1007/s10195-011-0172-9
  5. Shiga T, Mori M, Hayashida T, Fujiwara Y, Ogura T. Disassembly of a modular femoral component after femoral head prosthetic replacement. J Arthroplasty. 2010;25:659.e17-9. https://doi.org/10.1016/j.arth.2009.03.001
  6. Star MJ, Colwell CW Jr, Donaldson WF 3rd, Walker RH. Dissociation of modular hip arthroplasty components after dislocation. A report of three cases at differing dissociation levels. Clin Orthop Relat Res. 1992;278:111-5.
  7. Grupp TM, Weik T, Bloemer W, Knaebel HP. Modular titanium alloy neck adapter failures in hip replacement--failure mode analysis and influence of implant material. BMC Musculoskelet Disord. 2010;11:3. https://doi.org/10.1186/1471-2474-11-3
  8. Bunn A, Colwell CW Jr, D'Lima DD. Bony impingement limits design-related increases in hip range of motion. Clin Orthop Relat Res. 2012;470:418-27. https://doi.org/10.1007/s11999-011-2096-3
  9. Pallini F, Cristofolini L, Traina F, Toni A. Modular hip stems: determination of disassembly force of a neck-stem coupling. Artif Organs. 2007;31:166-70. https://doi.org/10.1111/j.1525-1594.2007.00359.x
  10. Badarudeen S, Shu AC, Ong KL, Baykal D, Lau E, Malkani AL. Complications after revision total hip arthroplasty in the medicare population. J Arthroplasty. 2017;32:1954-58. https://doi.org/10.1016/j.arth.2017.01.037

피인용 문헌

  1. Outcomes of Vancouver B2-type and B3-type proximal femur periprosthetic fractures after revision surgery using cementless tapered modular stem: a retrospective case series of 39 fractures vol.35, pp.2, 2018, https://doi.org/10.36149/0390-5276-222