Clinical Department of Orthopedic Surgery, University Medical Center Maribor, Maribor, Slovenia.
Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Expert Rev Med Devices. 2023 Jul-Dec;20(12):1051-1064. doi: 10.1080/17434440.2023.2264177. Epub 2023 Nov 24.
This review critically examines the efficacy of dual-modular stems in primary total hip arthroplasty. Given the variability and non-comparability of certain femoral stem designs and stem-neck couplings, with some even being withdrawn from the market, this review offers an in-depth analysis of predominant implant performances.
The paper explores a brief historical summary related to dual-modular stems, including the complications associated with their use, diagnostic tools for evaluation, analysis of both recalled and currently available models, as well as alternative therapeutic options. This information is pertinent for both clinical and research domains.
While dual-modular systems were initially touted to offer several advantages, the evidence substantiating these benefits has been ambiguous. Further, these systems introduce the risk of alternative complications. In specific cases involving patients with developmental hip dysplasia and certain proximal femoral deformities requiring complex reconstructions, dual-modular systems might be relevant. Nonetheless, the use of long interchangeable necks in patients with a body mass index above 30 kg/m is discouraged, and pairing a long varus-oriented neck with an extra-long femoral head should be avoided in all patients.
本综述批判性地评估了双模块柄在初次全髋关节置换术中的疗效。鉴于某些股骨柄设计和柄颈连接的可变性和不可比性，其中一些甚至已退出市场，本综述对主要植入物性能进行了深入分析。
本文探讨了与双模块柄相关的简要历史概述，包括其使用相关并发症、评估的诊断工具、对召回和当前可用模型的分析，以及替代治疗选择。这些信息与临床和研究领域都相关。
虽然双模块系统最初被吹捧为具有多项优势，但支持这些益处的证据一直存在争议。此外，这些系统还带来了其他并发症的风险。在涉及发育性髋关节发育不良的患者和需要复杂重建的特定股骨近端畸形的特定情况下，双模块系统可能相关。然而，不鼓励身体质量指数超过 30kg/m 的患者使用长可互换颈，并且应避免在所有患者中将长内翻定向颈与超长股骨头配对。
