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Z Orthop Unfall 2015; 153(03): 312-316
DOI: 10.1055/s-0035-1545965
Aus den Sektionen – AE Deutsche Gesellschaft für Endoprothetik
Georg Thieme Verlag KG Stuttgart · New York

Modulare Primärendoprothetik – Risiko gerechtfertigt?

Modular Neck in Primary Total Hip Replacement – A Justifiable Risk?
J. P. Kretzer
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg
,
V. Ewerbeck
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg
› Author Affiliations
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Publication History

Publication Date:
26 June 2015 (online)

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Zusammenfassung

Mehrteilig modulare Hüftimplantate sollen eine möglichst variable Versorgung bei der Rekonstruktion des Hüftgelenks ermöglichen. Demgegenüber steht die Häufung von Schadensfällen und Komplikationen, die im Zusammenhang mit der zusätzlichen modularen Schnittstelle gesehen werden. An dieser Schnittstelle können unterschiedliche Korrosionsprozesse ablaufen, die eine Versagenskaskade des Gesamtsystems initiieren können. Basierend auf Registerdaten und klinischen Studien erfolgt im Rahmen dieser Arbeit eine Bewertung des Risikos mehrteilig modularer Hüftimplantate für den klinischen Einsatz. Im Ergebnis zeigt sich, dass mehrteilig modulare Implantate nur sehr eingeschränkt für die generelle Primärversorgung geeignet zu sein scheinen.

Abstract

Modular necks are considered as a treatment option in primary total hip replacement aiming to allow a variable reconstruction of the hip joint. Concerns are related to increased failure and complication rates which may be associated with the additional modular interface. This interface is frequently affected by corrosion processes which may initiate premature failure of the entire implant. In this study the risk of modular necks as a clinical treatment option is evaluated. Based on register data and clinical studies modular necks should only be used with strict limitations for general treatment in primary total hip replacement.

Schlüsselwörter

Modularität - Korrosion - Implantatversagen

Key words

modularity - corrosion - implant failure
 

  • Literatur

  • 1 Toni A, Sudanese A, Paderni S et al. Cementless hip arthroplasty with a modular neck. Chir Organi Mov 2001; 86: 73-85
    PubMedGoogle Scholar
  • 2 Sakai T, Sugano N, Nishii T et al. Optimizing femoral anteversion and offset after total hip arthroplasty, using a modular femoral neck system: an experimental study. J Orthop Sci 2000; 5: 489-494
    CrossrefPubMedGoogle Scholar
  • 3 Mathiesen EB, Lindgren JU, Blomgren GG et al. Corrosion of modular hip prostheses. J Bone Joint Surg Br 1991; 73: 569-575
    PubMedGoogle Scholar
  • 4 Collier JP, Surprenant VA, Jensen RE et al. Corrosion between the components of modular femoral hip prostheses. J Bone Joint Surg Br 1992; 74: 511-517
    PubMedGoogle Scholar
  • 5 Gilbert JL, Buckley CA, Jacobs JJ. In vivo corrosion of modular hip prosthesis components in mixed and similar metal combinations. The effect of crevice, stress, motion, and alloy coupling. J Biomed Mater Res 1993; 27: 1533-1544
    CrossrefPubMedGoogle Scholar
  • 6 Cook SD, Barrack RL, Baffes GC et al. Wear and corrosion of modular interfaces in total hip replacements. Clin Orthop Relat Res 1994; 298: 80-88
    PubMedGoogle Scholar
  • 7 Collier JP, Mayor MB, Williams IR et al. The tradeoffs associated with modular hip prostheses. Clin Orthop Relat Res 1995; 311: 91-101
    PubMedGoogle Scholar
  • 8 Goldberg JR, Gilbert JL, Jacobs JJ et al. A multicenter retrieval study of the taper interfaces of modular hip prostheses. Clin Orthop Relat Res 2002; 401: 149-161
    CrossrefPubMedGoogle Scholar
  • 9 Sigmund T, Stock O. Künstliche Hüfte rostet im Patienten. Handelsblatt 2006; Im Internet: http://www.handelsblatt.com/unternehmen/industrie/produktionsfehler-kuenstliche-huefte-rostet-im-patienten/2713860.html Stand: 01.02.2015
    PubMedGoogle Scholar
  • 10 Hermle T, Zeller R, Grupp TM et al. Kurzschaftprothese Metha: Untersuchung der modularen Konusverbindung. Implant 2007; 1: 12-17
    PubMedGoogle Scholar
  • 11 Grupp TM, Weik T, Bloemer W et al. Modular titanium alloy neck adapter failures in hip replacement–failure mode analysis and influence of implant material. BMC Musculoskelet Disord 2010; 11: 3
    CrossrefPubMedGoogle Scholar
  • 12 Wodecki P, Sabbah D, Kermarrec G et al. New type of hip arthroplasty failure related to modular femoral components: breakage at the neck-stem junction. Orthop Traumatol Surg Res 2013; 99: 741-744
    CrossrefPubMedGoogle Scholar
  • 13 Sittig C, Textor M, Spencer ND et al. Surface characterization of implant materials c.p. Ti, Ti-6Al-7Nb and Ti-6Al-4 V with different pretreatments. J Mater Sci Mater Med 1999; 10: 35-46
    CrossrefPubMedGoogle Scholar
  • 14 Hanawa T, Asami K, Asaoka K. Repassivation of titanium and surface oxide film regenerated in simulated bioliquid. J Biomed Mater Res 1998; 40: 530-538
    CrossrefPubMedGoogle Scholar
  • 15 Virtanen S, Milosev I, Gomez-Barrena E et al. Special modes of corrosion under physiological and simulated physiological conditions. Acta Biomater 2008; 4: 468-476
    CrossrefPubMedGoogle Scholar
  • 16 Brown SA, Flemming CA, Kawalec JS et al. Fretting corrosion accelerates crevice corrosion of modular hip tapers. J Appl Biomater 1995; 6: 19-26
    CrossrefPubMedGoogle Scholar
  • 17 Viceconti M, Baleani M, Squarzoni S et al. Fretting wear in a modular neck hip prosthesis. J Biomed Mater Res 1997; 35: 207-216
    CrossrefPubMedGoogle Scholar
  • 18 Mckay P, Mitton DB. An electrochemical investigation of localized corrosion on titanium in chloride environments. Corrosion 1985; 41: 52-62
    CrossrefPubMedGoogle Scholar
  • 19 Kretzer JP, Jakubowitz E, Krachler M et al. Metal release and corrosion effects of modular neck total hip arthroplasty. Int Orthop 2009; 33: 1531-1536
    CrossrefPubMedGoogle Scholar
  • 20 Rehmer A, Bishop NE, Morlock MM. Influence of assembly procedure and material combination on the strength of the taper connection at the head-neck junction of modular hip endoprostheses. Clin Biomech (Bristol, Avon) 2012; 27: 77-83
    Google Scholar
  • 21 Lavernia CJ, Baerga L, Barrack RL et al. The effects of blood and fat on Morse taper disassembly forces. Am J Orthop (Belle Mead NJ) 2009; 38: 187-190
    PubMedGoogle Scholar
  • 22 Jauch SY, Huber G, Hoenig E et al. Influence of material coupling and assembly condition on the magnitude of micromotion at the stem-neck interface of a modular hip endoprosthesis. J Biomech 2011; 44: 1747-1751
    CrossrefPubMedGoogle Scholar
  • 23 Menciere ML, Amouyel T, Taviaux J et al. Fracture of the cobalt-chromium modular femoral neck component in total hip arthroplasty. Orthop Traumatol Surg Res 2014; 100: 565-568
    CrossrefPubMedGoogle Scholar
  • 24 Cooper HJ, Urban RM, Wixson RL et al. Adverse local tissue reaction arising from corrosion at the femoral neck-body junction in a dual-taper stem with a cobalt-chromium modular neck. J Bone Joint Surg Am 2013; 95: 865-872
    CrossrefPubMedGoogle Scholar
  • 25 Meftah M, Haleem AM, Burn MB et al. Early corrosion-related failure of the rejuvenate modular total hip replacement. J Bone Joint Surg Am 2014; 96: 481-487
    CrossrefPubMedGoogle Scholar
  • 26 Molloy DO, Munir S, Jack CM et al. Fretting and corrosion in modular-neck total hip arthroplasty femoral stems. J Bone Joint Surg Am 2014; 96: 488-493
    CrossrefPubMedGoogle Scholar
  • 27 Restrepo C, Ross D, Restrepo S et al. Adverse clinical outcomes in a primary modular neck/stem system. J Arthroplasty 2014; 29: 173-178
    CrossrefPubMedGoogle Scholar
  • 28 Atwood SA, Patten EW, Bozic KJ et al. Corrosion-induced fracture of a double-modular hip prosthesis: a case report. J Bone Joint Surg Am 2010; 92: 1522-1525
    PubMedGoogle Scholar
  • 29 Wilson DA, Dunbar MJ, Amirault JD et al. Early failure of a modular femoral neck total hip arthroplasty component: a case report. J Bone Joint Surg Am 2010; 92: 1514-1517
    PubMedGoogle Scholar
  • 30 Dangles CJ, Altstetter CJ. Failure of the modular neck in a total hip arthroplasty. J Arthroplasty 2010; 25: 1169 e1165–1167
    PubMedGoogle Scholar
  • 31 Wright G, Sporer S, Urban R et al. Fracture of a modular femoral neck after total hip arthroplasty: a case report. J Bone Joint Surg Am 2010; 92: 1518-1521
    PubMedGoogle Scholar
  • 32 Skendzel JG, Blaha JD, Urquhart AG. Total Hip Arthroplasty Modular Neck Failure. J Arthroplasty 2011; 26: 338
    PubMedGoogle Scholar
  • 33 Ellman MB, Levine BR. Fracture of the modular femoral neck component in total hip arthroplasty. J Arthroplasty 2013; 28: 196.e191-195
    PubMedGoogle Scholar
  • 34 Sotereanos NG, Sauber TJ, Tupis TT. Modular femoral neck fracture after primary total hip arthroplasty. J Arthroplasty 2013; 28: 196.e197-199
    PubMedGoogle Scholar
  • 35 Gerhardt DM, Bisseling P, de Visser E et al. Modular necks in primary hip arthroplasty without anatomical deformity: no clear benefit on restoration of hip geometry and dislocation rate. An exploratory study. J Arthroplasty 2014; 29: 1553-1558
    CrossrefPubMedGoogle Scholar
  • 36 Duwelius PJ, Burkhart B, Carnahan C et al. Modular versus nonmodular neck femoral implants in primary total hip arthroplasty: which is better?. Clin Orthop Relat Res 2014; 472: 1240-1245
    CrossrefPubMedGoogle Scholar
  • 37 Graves S, Davidson D, de Steiger R et al. Annual Report 2014. Australian Orthopaedic Association National Joint Replacement Registry Adelaide 2014.. Im Internet: https://aoanjrr.dmac.adelaide.edu.au/de/annual-reports-2014 Stand: 23.04.2015
    PubMedGoogle Scholar