SynthesisJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2023
Efficacy and safety of modular versus monoblock stems in revision total hip arthroplasty: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Bacteriophages in Hip and Knee Periprosthetic Joint Infections: A Promising Tool in the Era of Antibiotic Resistance.Medical sciences (Basel, Switzerland) · 2025Pooled it
- Do Meta-Analyses of Total Hip Arthroplasty Produce Reliable Results? A Systematic Review and Meta-Epidemiological Study of Statistical Methods.Orthopaedic surgery · 2025Pooled it
- A Review of the Variations in Design Features in Diaphyseal Engaging Tapered Fluted Titanium Femoral Stems in Revision Total Hip Arthroplasty.Hip & pelvis · 2026Review
- Five-year results of a monolithic tapered, fluted titanium femoral component in complex primary and revision total hip arthroplasty.Bone & joint open · 2026Article
- Towards an Automated Computational Workflow to Assess Primary Stability in Total Hip Arthroplasty.Bioengineering (Basel, Switzerland) · 2025Article
- Re-revision risk of modular and monobloc revision stems after revision hip arthroplasty.Bone & joint open · 2025Article
- 'Hybrid' spacers in two-stage total hip arthroplasty revision: surgical technique, clinical and radiographic outcomes.Archives of orthopaedic and trauma surgery · 2025Article
- Total hip arthroplasty preoperative planning for childhood hip disorders' sequelae: Focus on developmental dysplasia of the hip.World journal of orthopedics · 2024Article
- Femoral stem extraction devices.Archives of orthopaedic and trauma surgery · 2024Article
- Mid-term results of a cementless hip stem in femoral revision: how much diaphyseal press-fit do we need?Archives of orthopaedic and trauma surgery · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoth modular and monoblock tapered fluted titanium (TFT) stems are increasingly being used for revision total hip arthroplasty (rTHA). However, the differences between the two designs in clinical outcomes and complications are not yet clear. Here, we intend to compare the efficacy and safety of modular versus monoblock TFT stems in rTHA.
methodsPubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies comparing modular and monoblock implants in rTHA. Data on the survivorship of stems, postoperative hip function, and complications were extracted following inclusion criteria. Inverse variance and Mantel-Haenszel methods in Review Manager (version 5.3 from Cochrane Collaboration) were used to evaluate differences between the two groups.
resultsTen studies with a total of 2188 hips (1430 modular and 758 monoblock stems) were finally included. The main reason for the revision was aseptic loosening. Paprosky type III was the most common type in both groups. Both stems showed similar re-revision rates (modular vs monoblock: 10.3% vs 9.5%, P = 0.80) and Harris Hip Scores (WMD = 0.43, P = 0.46) for hip function. The intraoperative fracture rate was 11.6% and 5.0% (P = 0.0004) for modular and monoblock stems, respectively. The rate of subsidence > 10 mm was significantly higher in the monoblock group (4.5% vs 1.0%, P = 0.003). The application of extended trochanteric osteotomy was more popular in monoblock stems (22.7% vs 17.5%, P = 0.003). The incidence of postoperative complications such as periprosthetic femoral fracture and dislocation was similar between both stems.
conclusionsNo significant difference was found between modular and monoblock tapered stems as regards postoperative hip function, re-revision rates, and complications. Severe subsidence was more frequent in monoblock stems while modular ones were at higher risk of intraoperative fracture. LEVEL OF EVIDENCE: Level III, systematic review of randomized control and non-randomized studies.
trial registrationWe registered our study in the international prospective register of systematic reviews (PROSPERO) (CRD42020213642).
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