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Primary Total Hip Arthroplasty: Modular Stems
Total hip arthroplasty (THA) implants with modular femoral head and neck designs were introduced in the early 1980s. A modular design offers several advantages, including the ability to adjust limb length and offset after the femoral implant is in place, use of a variety of head and stem materials, decreased stem inventory, simplified exposure in patients who require isolated acetabular revision, and the ability to adjust the femoral head size and femoral neck length to address instability. The disadvantages of modular implants include fretting and corrosion wear, generation of third-body wear debris, mechanical failure of the junction, dissociation of the femoral head, and decreased range of motion associated with use of skirted femoral heads. Fretting and corrosion wear depend on several factors, including load, number of loading cycles, contact stress distribution, and surface finish.