Public Release: 

JBJS 'Watch' cites head-neck troubles with modular hip implants

Call for further research to better understand and prevent potentially catastrophic complications

Journal of Bone and Joint Surgery

Needham, MA.-JBJS Case Connector, an online case report journal published by The Journal of Bone and Joint Surgery, has issued a "Watch" regarding relatively rare but potentially catastrophic complications from failure of modular head-neck prostheses commonly used in hip-replacement surgery.

The arthroplasty community currently feels that the advantages gained from modularity in hip implants outweigh the risks, but this Watch raises that risk-benefit question again. The decision to issue the Watch was prompted by a case report by Swann et al. in the August 26, 2015 JBJS Case Connector and a report by Arvinte et al. in the April 22, 2015 JBJS Case Connector. Those two reports described three patients who experienced a complete head-neck dissociation seven to fourteen years after hip replacements that used modular components. The Watch also includes relevant findings from elsewhere in the recent orthopaedic literature to help surgeons better understand and minimize the risks.

In the August 26, 2015 edition of JBJS Case Connector, Swann et al. described two patients who experienced sudden head-neck dissociation seven years after hip-replacement surgery. In the April 22, 2015 JBJS Case Connector, Arvinte et al. reported on a patient who presented with a similar problem fourteen years after receiving a modular hip replacement.

The head-neck failures described in this Watch represent a unique opportunity for orthopaedists and industry to work together to conduct multicenter retrieval studies to better understand, and prevent, these rare but serious outcomes.

"The publication of 'Watches' helps fulfill our mission to serve the orthopaedic community," commented Marc Swiontkowski, MD, Editor-in-Chief of JBJS and co-editor of JBJS Case Connector. "The 'Watch' designation may encourage the orthopaedic community to either demonstrate that these are isolated, unrelated cases or sharpen the focus further by rigorously evaluating the intervention and/or reporting related cases."

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About JBJS Case Connector

JBJS Case Connector is an online, cross-referenced journal containing thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs and to mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. For more information, visit caseconnector.jbjs.org.

About JBJS

JBJS, Inc., is a not-for-profit publisher specializing in orthopaedic information. It publishes The Journal of Bone & Joint Surgery, which has been the most valued source of information for orthopaedic surgeons and researchers for 125 years and is the gold standard in peer-reviewed scientific information in the field -- a core journal and essential reading for orthopaedic surgeons worldwide. Other publications include JBJS Case Connector and JBJS Essential Surgical Techniques, along with CME and professional development products. Twitter: @jbjs.

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