Cementless modular neck stems: are they a safe option in primary total hip arthroplasty?

  • José M. Pelayo-de-Tomás
  • José L. Rodrigo-Pérez
  • Carlos D. Novoa-Parra
  • Alejandro Lizaur-Utrilla
  • María Morales-Suárez-Varela
  • José Antonio Blas-Dobón
Original Article • HIP - ARTHROPLASTY



The objective was to assess aseptic complications and functional outcome using a primary total hip arthroplasty with modular neck.


Prospective cohort of 317 consecutive patients. The mean age was 61.1 (range, 41–84) years. The H-Max-M model (Lima, Italy) system was used in all patients. The functional assessment was made by the Harris Hip Score, Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Radiological outcomes were also assessed, and adverse events and complications were noted.


The mean follow-up was 6.1 (range, 2–8) years. Functional outcome significantly improved in most patients. There were 3 deep infections (0.9%) and 17 aseptic complications (5.3%) including 1 intraoperative acetabular fracture, 3 later periprosthetic femoral fractures, 1 broken ceramic insert, 1 acetabular loosening, 3 femoral loosening and 1 broken titanium modular neck in a obese patient. No pseudotumors or elevated serum levels of metal ions were found among the patients with radiolucent lines or aseptic loosening.


The findings in the present study showed that the H-MAX-M stem provided satisfactory functional outcome in most patients with a low rate of complications attributable to the modular neck design. We consider that using this novel modular neck-stem coupling design can be an alternative to the conventional monoblock stems in patients without overweight.


Total hip arthroplasty Modular neck H-MAX M hip system Functional outcome Pseudotumor Serum metal ion level 


Compliance with ethical standards

Conflict of interest

The authors declare 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 2017

Authors and Affiliations

  • José M. Pelayo-de-Tomás
    • 1
  • José L. Rodrigo-Pérez
    • 1
  • Carlos D. Novoa-Parra
    • 1
  • Alejandro Lizaur-Utrilla
    • 2
  • María Morales-Suárez-Varela
    • 3
    • 4
  • José Antonio Blas-Dobón
    • 1
  1. 1.Department of Orthopaedic SurgeryDoctor Peset University HospitalValenciaSpain
  2. 2.Faculty of MedicineMiguel Hernandez UniversityElcheSpain
  3. 3.Unit of Public Health and Environmental Care, Department of Preventive MedicineUniversity of ValenciaValenciaSpain
  4. 4.CIBER of Epidemiology and Public Health (CIBERESP)MadridSpain

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