Modular femoral neck failure after revision of a total hip arthroplasty: a finite element analysis

  • Jan Zajc
  • Jožef Predan
  • Nenad Gubeljak
  • Andrej Moličnik
  • Samo K. FokterEmail author
Up-to date Review and Case Report • HIP¨- ARTHROPLASTY


The authors report on a case of modular femoral neck fracture which appeared 21 months after revision of acetabular component. The revision surgery was performed 8 years after the primary total hip arthroplasty due to aseptic loosening of the acetabular component. During acetabular revision, the primary implanted short (S, − 3.5 mm) femoral head was also exchanged with extra-long (XL, + 7.0 mm) femoral head fitting the modular femoral neck with a longer lever arm. Numerical analysis has shown that this has resulted in a 19.9% increase in tensile stress at the neck–stem coupling during normal walking cycle. This could result in microcrack initiation and propagation and finally lead to modular neck failure of the otherwise well-fixed stem. Surgeons should avoid excessive loading of the exchangeable neck (dual-modular) femoral stem designs as the stem–neck couplings are subject to corrosion and are not as reliable as monoblock stems.


Total hip arthroplasty Dual-modular stem Modular femoral neck fracture Profemur Z Revision surgery Finite element modelling 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Jan Zajc
    • 1
  • Jožef Predan
    • 2
  • Nenad Gubeljak
    • 2
  • Andrej Moličnik
    • 3
  • Samo K. Fokter
    • 3
    Email author
  1. 1.Faculty of MedicineUniversity of MariborMariborSlovenia
  2. 2.Faculty of Mechanical EngineeringUniversity of MariborMariborSlovenia
  3. 3.Department for Orthopaedic SurgeryUniversity Medical Center MariborMariborSlovenia

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