Benazzo F, Cuzzocrea F, Stroppa S, Ravasi F, Dalla Pria P
Department of Orthopaedics and Traumatology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Hip Int. 2007;17 Suppl 5:S138-41.
The Modulus (Lima-Lto) system has been created on the association of a conical stem and a modular neck in order to address the so called "difficult hip". Modularity can maximize the options for a correct reconstruction in a total hip replacement of the coxofemoral anatomy as well as biomechanics. Modulus should be used in CDH, primary hip arthritis, the sequelae of osteotomies and in each case in which we face a congenital or acquired hip deformity. The Modulus stem has been commonly utilised in association with the Delta cup (Lima-Lto) with the chance to use big diameter heads (32-36 mm) and ceramic on ceramic coupling. Modulus has been used in association with Delta cup since November 2002. 51 patients affected by CDH have been treated. Clinical and radiographic results can be considered very good. The average evaluation based on Merle D'Aubigné schedule is equal to 17.5 with a significant increase in the results with respect to the preoperatory score (with an average score equal to 10). In the light of the above, Modulus should be considered a valuable system to optimize the results of total hip replacement also in those more complex situations with a modified femoral morphology, allowing the restoration of a normal biomechanics in terms of off-set and anteversion with benefit in terms of stability and length of the implant as well as in terms of satisfaction of the patient as far as limb length and ROM are concerned. The association of Modulus with big diameter heads gives a higher guarantee in terms of duration of the implant and restoration of the functionality in young patients with a serious deformity and increased functional demands.
模量（利马-Lto）系统是基于锥形柄和模块化颈的结合而创建的，旨在解决所谓的“复杂髋关节”问题。模块化可以在全髋关节置换中最大化针对髋股解剖结构以及生物力学进行正确重建的选择。模量系统应用于先天性髋关节脱位（CDH）、原发性髋关节炎、截骨术后遗症以及我们遇到先天性或后天性髋关节畸形的每种情况。模量柄通常与德尔塔髋臼杯（利马-Lto）联合使用，有机会使用大直径股骨头（32 - 36毫米）以及陶瓷对陶瓷的关节配对。自2002年11月起，模量系统就与德尔塔髋臼杯联合使用。已治疗51例先天性髋关节脱位患者。临床和影像学结果可认为非常良好。根据默尔·德奥布涅评分表的平均评分为17.5，与术前评分相比结果有显著提高（术前平均评分为10）。鉴于上述情况，在那些股骨形态改变的更复杂情况下，模量系统也应被视为优化全髋关节置换结果的有价值系统，它能够在偏移和前倾角方面恢复正常生物力学，在植入物的稳定性和长度方面以及在患者对肢体长度和活动范围的满意度方面都有益处。模量系统与大直径股骨头的联合使用，对于严重畸形且功能需求增加的年轻患者，在植入物的使用寿命和功能恢复方面提供了更高的保障。
