Radiological outcomes and biomechanical performance of modular versus monoblock stems in femoral revision arthroplasty: a retrospective study and finite element analysis

This retrospective study and finite element analysis (FEA) compared modular (n=66) and monoblock (n=63) tapered titanium stems in revision total hip arthroplasty. Both groups demonstrated significant clinical improvement and comparable complication rates at ≥2 years follow-up. However, modular stems achieved superior restoration of femoral offset and limb length, with significantly reduced subsidence. Furthermore, FEA revealed that modular stems transfer more stress to the femoral cortex, potentially promoting favorable bone remodeling despite increased junctional micromotion. While both designs are effective, modular stems offer distinct advantages in anatomical reconstruction and stability, supporting personalized implant selection.