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High failure rate found with use of modular-neck femoral stem in THA
Recently published results showed an 86% failure rate among patients who underwent total hip arthroplasty with a specific modular-neck femoral stem and indicated elevated serum cobalt ion levels as predictive of failure.
In a 3-year follow-up of patients who underwent total hip arthroplasty (THA) with the Rejuvenate modular-neck stem (Stryker Orthopaedics), researchers obtained preoperative and postoperative mean serum cobalt and chromium ion levels from 73 hips in 63 patients. Indications for revision surgery included elevated serum cobalt ion levels, pain or abnormal MRI.
Results showed an 86% clinical failure rate at a mean follow-up of approximately 4.2 years, with 78% of hips undergoing revision at a mean of approximately 3.2 years. Furthermore, 8% of hips were scheduled for revision at the time of follow-up. Compared with patients who did not undergo revision, researchers found patients who underwent revision tended to be younger, had greater serum metal ion levels and greater pain. The most important independent factor associated with revision surgery was an elevated serum cobalt ion level, according to results. Despite a sharp decrease in cobalt ion levels after revision, researchers noted persistent elevation with a more gradual decline in some patients. – by Casey Tingle
Disclosures: Bernstein reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.