Late Onset Disassembly of a Modular Neck-stem Component after Cementless Hip Replacement without Dislocation: A Case Report and Review of Literatures

Modular femoral prostheses are characterized by a second neck-stem junction. This modularity provides many clinical benefits including hip offset restoration, intraoperative leg length and anteversion adjustment. Although, this extra junction in modular femoral prostheses can contribute to catastrophic consequences like fracture, cold welding, corrosion and fretting of the modularity. However, only few complications related to the modularity itself have been reported in the literature. We report a unique case of neck-stem component dissociation without dislocation of the R-120PC™ Modular Stem (DJO Surgical). Our 71-year-old obese female patient underwent cementless hip replacement 5 years ago. Following radiographic confirmation of neck-stem dissociation open reduction was performed and wiring fixation was applied to secure the neck to the stem. After reduction and fixation, hip joint was stable, and our patient returned to her daily routine 2.5 months postoperatively. The last follow up was at 12 months after surgery with excellent radiographic and clinical evaluation.