Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis

Int Orthop. 2021 Apr;45(4):877-881. doi: 10.1007/s00264-020-04812-6. Epub 2020 Sep 16.

Abstract

Introduction: Revision of a well-fixed stem due to unexpected modular neck fracture is a catastrophe for the patient and a challenge for the surgeon. This study aimed to test the possibility of predicting interchangeable neck fracture from serum levels of the stem/neck alloy-consisting metals.

Materials and methods: Nineteen patients at high risk for interchangeable neck fracture were randomly selected out of a cohort of 680 bimodular stems made from Ti6Al4V alloy. Serum levels of titanium, aluminium and vanadium were determined. Nine age- and gender-matched patients were used as controls.

Results: Mean serum levels of Ti were 6.04 ± 2.52 μg/L, of Al 3.89 ± 1.68 μg/L and of V 0.07 ± 0.04 μg/L in the high-risk group, and 8.22 ± 4.74 μg/L, 4.99 ± 3.98 μg/L and 0.27 ± 0.44 μg/L in the low-risk group, respectively. No statistically significant differences were found between the groups.

Discussion: Interchangeable neck fracture of bimodular femoral stems cannot be predicted from serum trace element analysis.

Keywords: Bimodular femoral stem; Component breakage; Hip arthroplasty; Interchangeable neck.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Femur / surgery
  • Hip Prosthesis* / adverse effects
  • Humans
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Trace Elements*

Substances

  • Trace Elements