Goyal Nitin, Hozack William J
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital & The Rothman Institute, Philadelphia, PA, USA.
Surg Technol Int. 2010 Oct;20:309-13.
Modular total hip arthroplasty (THA) components have evolved significantly as the success of uncemented femoral fixation has been proven. Current trends in the United States include widespread use of cementless components (acetabular and femoral), usually with monoblock femoral stems with modular heads. Femoral offset has been proven to play a vital role in hip abductor strength, hip range of motion, and hip stability. Also critical to hip stability is the orientation of the acetabular and femoral components. Thus, offset and component positioning are fundamental to success in THA. Modularity of the femoral neck has been proposed to aid in further customizing the THA component fit. Neck-modular stems enable the adjustment of leg length, femoral anteversion, and femoral offset independently of stem size. Modularity of the neck allows the surgeon to precisely match the anatomic characteristics of each patient to yield improved range of motion, stability, abductor strength, and leg length equality. Disadvantages are related to cost and the addition of another interface. Neck-modular femoral stems are not a new concept; however, as tough component manufacturing has advanced, these stems have been reintroduced to the armamentarium of the hip surgeon.
模块化全髋关节置换术（THA）组件随着非骨水泥型股骨固定的成功而有了显著发展。美国目前的趋势包括广泛使用非骨水泥组件（髋臼和股骨），通常采用带模块化股骨头的整体式股骨干。已证实股骨偏心距在髋关节外展肌力量、髋关节活动范围和髋关节稳定性中起着至关重要的作用。髋臼和股骨组件的方向对髋关节稳定性也至关重要。因此，偏心距和组件定位是全髋关节置换术成功的基础。有人提出股骨颈模块化有助于进一步定制全髋关节置换术组件的适配。颈模块化股骨干能够独立于骨干尺寸来调整腿长、股骨前倾角和股骨偏心距。颈部模块化允许外科医生精确匹配每个患者的解剖特征，以改善活动范围、稳定性、外展肌力量和腿长相等性。缺点与成本和增加另一个界面有关。颈模块化股骨干并非新概念；然而，随着组件制造技术的进步，这些股骨干已重新引入髋关节外科医生的器械库。
