ADVANTAGES AND DISADVANTAGES OF USING MODULAR STEMS IN REVISION HIP ARTHROPLASTY

Abstract

The increasing number of revision hip surgeries highlights the challenge of selecting the optimal revision femoral component, particularly in cases of bone stock loss. Objective. To determine the advantages and disadvantages of modular revision stems compared to monoblock stems based on literature data and personal clinical observations. Methods. A literature review (37 sources) and a retrospective analysis of 175 revision surgeries performed between 2013 and 2025 were conducted. Patients were divided into two groups: 70 cases utilizing modular stems and 105 using monoblock stems. The study assessed the distribution of bone defects according to the Paprosky classification, complication rates, and functional outcomes using the Harris Hip Score (HHS) at 1-year follow-up. Results. Monoblock stems were predominantly used for Paprosky type I–II femoral defects (79 %), whereas modular stems were preferred for type III–IV defects (66.2 %). The overall complication rate was comparable: 8.8 % in the modular group and 8 % in the monoblock group (P = 0 .834). S ignificant s ubsidence ( > 10 m m) w as m ore f requently observed with monoblock stems. Functional outcomes according to HHS significantly improved in both groups after one year (80.2 ± 3.1 and 83.1 ± 3.3 points, respectively) with no statistically significant difference between them. Conclusions. The clinical outcomes of modular and monoblock stems are equivalent. The choice of implant should be based on the anatomical situation: monoblock stems are effective for moderate defects, while modular stems offer advantages in severe defects (Paprosky type III–IV) to ensure stable fixation and biomechanical restoration.