Early fracture of the modular neck of a MODULUS femoral stem

Katsufumi Uchiyama, MD, PhD; Takeaki Yamamoto, MD, PhD; Mitsutoshi Moriya, MD; Kensuke Fukushima, MD; Yojiro Minegishi, MD; Naonobu Takahira, MD, PhD; Masashi Takaso, MD, PhD

doi:10.1016/j.artd.2016.09.004

Arthroplasty Today (Jun 2017)

Early fracture of the modular neck of a MODULUS femoral stem

Katsufumi Uchiyama, MD, PhD,
Takeaki Yamamoto, MD, PhD,
Mitsutoshi Moriya, MD,
Kensuke Fukushima, MD,
Yojiro Minegishi, MD,
Naonobu Takahira, MD, PhD,
Masashi Takaso, MD, PhD

Affiliations

Katsufumi Uchiyama, MD, PhD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
Takeaki Yamamoto, MD, PhD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
Mitsutoshi Moriya, MD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
Kensuke Fukushima, MD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
Yojiro Minegishi, MD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
Naonobu Takahira, MD, PhD: School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
Masashi Takaso, MD, PhD: Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan

DOI: https://doi.org/10.1016/j.artd.2016.09.004
Journal volume & issue: Vol. 3, no. 2
pp. 93 – 98

Abstract

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We present the case of a 46-year-old woman who underwent revision surgery approximately 4 years after total hip arthroplasty because of a fracture of the modular neck of a MODULUS femoral stem. The fractured surfaces of the retrieved implant were inspected using optical and scanning electron microscopy. Three-dimensional finite element analysis was also performed to identify the stresses that might have caused the failure. We concluded that active, obese patients who are implanted with a high-offset, small-sized modular component could experience stress-induced fractures of the modular neck, with proper fixation and osseointegration of the distal stem, especially if residual bone or tissue is present on the inner surface of the neck that could contribute to micromovement and decreased proximal fixation.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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Abstract

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