Background: Elderly patients with a displaced femoral neck fracture treated with hip arthroplasty may have better function than those treated with internal fixation. We hypothesized that hemiarthroplasty would be superior to screw fixation with regard to hip function, mobility, pain, quality of life, and the risk of a reoperation in elderly patients with a nondisplaced femoral neck fracture.
Modularity in the heads and stems of total hip prostheses has afforded orthopaedic surgeons the ability to intraoperatively adjust version, limb length, and offset in ways that can optimize hip biomechanics. Modular implants have achieved these important objectives in thousands of patients over the last couple of decades. However, the rewards of modularity come with risks—some of them serious. Reports of these risks seem to have become more prevalent in the recent orthopaedic literature.
In this “Watch,” we bring to the attention of the orthopaedic community several femoral neck fractures in patients with implants that had modular head-neck and neck-stem designs. While some of these designs are no longer available from manufacturers, thousands of such devices have already been implanted. This “Watch” encourages surgeons to be wary about one specific aspect of modular hip designs: long femoral necks.