Case Reports   |    
Caveat Emptor: Adverse Inflammatory Soft-Tissue Reactions in Total Hip Arthroplasty with Modular Femoral Neck ImplantsA Report of Two Cases
Anay R. Patel, MD1; Ronak M. Patel, MD1; Danielle Thomas, BS2; Thomas W. Bauer, MD, PhD3; S. David Stulberg, MD4
1 676 North Saint Clair Street, Suite 1350, Chicago, IL 60611. E-mail address for A.R. Patel: anayRpatel@gmail.com
2 244 E. Pearson Street, Apartment 1509, Chicago, IL 60611
3 Cleveland Clinic Main Campus, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195
4 Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 924, Chicago, IL 60611-3057
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Investigation performed at Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Dec 26;2(4):e80 1–6. doi: 10.2106/JBJS.CC.L.00136
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Modular femoral neck (MFN) implants in total hip arthroplasty facilitate optimizing femoral offset and version while minimizing femoroacetabular impingement1, but component fracture and dissociation have been reported with titanium-alloy MFN implants2-6. Cobalt-chromium MFN components have improved strength compared with earlier designs, but the long-term consequences of wear and corrosion at the femoral neck-stem junction are unknown3,7. Inflammatory metal-hypersensitivity reactions have been most frequently reported in cobalt-chromium metal-on-metal articulations used in total hip arthroplasty and hip resurfacing arthroplasty8,9, but to our knowledge, these reactions have not been described in MFN implants with metal-on-polyethylene articulations. We present two patients with MFN implants who developed partially cystic peri-implant soft-tissue masses with histologic features suggestive of metal hypersensitivity requiring revision arthroplasty. Both patients were informed that data concerning their cases would be submitted for publication, and they provided consent.
Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Case Connector?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    California - UCLA/OH Department of Orthopaedic Surgery
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    Louisiana - Ochsner Health System