{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T22:01:37Z","timestamp":1787176897042,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Medical Centre Maribor, Slovenia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Increased revision rate of dual-modular (DM) femoral stems in primary total hip arthroplasty (THA) because of modular-neck breakage and adverse local tissue reactions (ALTRs) to additional junction damage products is well established and some designs have been recalled from the market. However, some long-term studies of specific DM stems did not confirm the inferiority of these stems compared to standard single-modular (SM) stems, and a head-to-head comparison THA is missing. The objectives of this multicentre study were to determine the survivorship and complication rates of a common DM stem design compared to a similar SM stem. Materials and Methods: In a time frame from January 2012 to November 2015, a cohort of 807 patients (882 hips) consecutively underwent primary cementless THAs at two orthopaedic centres. 377 hips were treated with a Zweim\u00fcller-type DM stem THA system and 505 hips with a similar SM stem THA system, both including a modern press-fit acetabulum. Kaplan-Meier survivorship and complication rates were compared between both groups in a median follow-up of 9.0 years (maximum, 9.9 years). Results: The 9-year survivorship of the DM stem THA system (92.6%, 95% CI 89.9\u201395.3) was significantly lower than that of the SM stem THA system (97.0%, 95% CI 95.2\u201398.8). There were no differences in revision rates for septic loosening, dislocation, and periprosthetic fractures between the two groups. One ceramic inlay and one Ti-alloy modular neck breakage occurred in the DM stem THA system group, but the main reason for revision in this group was aseptic loosening of components. Conclusions: The survivorship of the DM stem THA system was lower than the similar SM stem THA system in a comparable clinical environment with long-term follow-up. Our results confirmed that no rationale for stem modularity exists in primary THAs.<\/jats:p>","DOI":"10.3390\/medicina59020290","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T02:05:28Z","timestamp":1675389928000},"page":"290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Dual-Modular Versus Single-Modular Stems for Primary Total Hip Arthroplasty: A Long-Term Survival Analysis"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1902-8447","authenticated-orcid":false,"given":"Samo K.","family":"Fokter","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University Medical Centre, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nejc","family":"No\u010d","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Leva\u0161i\u010d","sequence":"additional","affiliation":[{"name":"The National Arthroplasty Registry of Slovenia, Valdoltra Orthopaedic Hospital, 6280 Ankaran, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Hanc","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, General Hospital, 9000 Murska Sobota, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6240-3989","authenticated-orcid":false,"given":"Jan","family":"Zajc","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Medical Centre, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2106\/JBJS.I.00533","article-title":"Sex Differences in Hip Morphology: Is Stem Modularity Effective for Total Hip Replacement?","volume":"91","author":"Traina","year":"2009","journal-title":"J. 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