{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:13:20Z","timestamp":1777677200348,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dual-taper modular stems have been linked to implant failure due to aseptic lymphocytic vasculitis-associated lesions (ALVAL), yet data on revision outcomes remain limited. This study assessed the survival rate of modular stems revised for ALVAL and compared outcomes with a non-revised control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of 233 total hip arthroplasties (THA) with ABGII dual-taper modular stems (2007\u20132011) was conducted, with follow-up until 2024. 39 THA (16.7%) underwent revision for ALVAL, confirmed by intraoperative histology. The control group included unrevised patients with \u2a7e1-year follow-up. Pre-revision assessments included Harris Hip Score (HHS), radiographs, MARS-MRI, and cobalt\/chromium ion levels. Revision was indicated for disabling pain, cobalt &gt;5\u2009\u00b5g\/L, or progressive effusion\/pseudotumours. Outcomes included HHS, complications, and Kaplan-Meier survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Revisions for ALVAL (39 THA, 16.7%) were primarily due to groin pain (64.1%), MRI effusion (79.5%), and elevated cobalt levels (46.2%). The median time to revision was 4\u2009years postoperatively, with a mean time to revision of 2.4\u2009years. Of 21 unipolar revisions 10 hips (27.1%) had a had a dislocation, bipolar revisions (18 hips) had none (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                    <jats:p>\n                      At 5, 10, and 15\u2009years, overall revision-free survival was 88.8%, 80.3%, and 75.2%, respectively, while survival free from revision specifically due to ALVAL, confirmed by histological findings, was 91.4%, 83.7%, and 83.1%. 3 hips were re-revised for periprosthetic fractures. After ALVAL revision the HHS improved from 77.6 to 87.7 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001) but remained lower than in the non-revised controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002). 25.6% of the revised patients had persistent pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ALVAL-related revisions led to improvement in the HHS but did not reach the levels of non-revied control. Revision with dual-mobility cups reduced the dislocation risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000251356413","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T06:55:25Z","timestamp":1753685725000},"page":"598-606","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual-taper modular stems: aseptic lymphocytic vasculitis-associated lesions (ALVAL): revision rates and outcome in a single hospital series"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0717-9600","authenticated-orcid":false,"given":"Pascal","family":"Kouyoumdjian","sequence":"first","affiliation":[{"name":"Nimes University Hospital, CHU Car\u00e9meau, Nimes, France"},{"name":"Laboratoire de M\u00e9canique et G\u00e9nie Civil - UMR 5508, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad","family":"Mansour","sequence":"additional","affiliation":[{"name":"Nimes University Hospital, CHU Car\u00e9meau, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois","family":"Bauzou","sequence":"additional","affiliation":[{"name":"Nimes University Hospital, CHU Car\u00e9meau, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Michaud","sequence":"additional","affiliation":[{"name":"Nimes University Hospital, CHU Car\u00e9meau, Nimes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remy","family":"Coulomb","sequence":"additional","affiliation":[{"name":"Nimes University Hospital, CHU Car\u00e9meau, Nimes, 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