Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
J Arthroplasty. 2018 Mar;33(3):945-951. doi: 10.1016/j.arth.2017.10.047. Epub 2017 Nov 1.
Implant manufacturers proclaim that the tapers of modular total hip arthroplasty are not standardized and can vary from manufacturer to manufacturer. That is why the combination of various components from different manufacturers ("Mix and Match") is not permitted. In this study, different taper combinations were investigated experimentally to assess the effect of "Mix and Match" regarding the taper connection strength.
Torque-off tests using hip stems and metal femoral heads from 6 different implant manufacturers were performed. First the components were tested as intended and afterwards the stems were combined with metal heads from other manufacturers.
There was no significant difference in taper connection strength when stems from the manufacturers Link, Smith & Nephew, and Zimmer were combined with heads from other manufacturers. The Biomet stems showed a significantly reduced taper connection strength if femoral heads of Aesculap, DePuy, or Smith & Nephew were used. On the contrary, the DePuy stems in combination with the originally intended femoral heads showed a significantly lower taper connection strength compared to the use of heads from Link, Biomet, and Zimmer. The same was observed for the Aesculap stems in combination with Zimmer heads.
The results of this study suggest that mixing components from different manufacturers may affect the taper connection strength and could reduce the stability. As safety should be a high priority in patient treatment, any potential risks should be avoided. Therefore, mixing and matching of heads and femoral stems from different manufacturers cannot be recommended.
植入物制造商宣称，模块化全髋关节置换术的锥度没有标准化，并且可能因制造商而异。这就是为什么不允许不同制造商的各种组件（“混合搭配”）组合使用的原因。在这项研究中，我们通过实验研究了不同的锥度组合，以评估“混合搭配”对锥度连接强度的影响。
对来自 6 家不同植入物制造商的髋关节柄和金属股骨头进行了扭矩试验。首先，按照预期对组件进行测试，然后将柄与来自其他制造商的金属头组合使用。
当将 Link、Smith & Nephew 和 Zimmer 制造商的柄与其他制造商的头组合使用时，锥度连接强度没有显著差异。如果使用 Aesculap、Depuy 或 Smith & Nephew 的股骨头，Biomet 柄的锥度连接强度显著降低。相反，与使用 Link、Biomet 和 Zimmer 的头相比，Depuy 柄与最初预期的股骨头组合使用时，锥度连接强度显著降低。与 Zimmer 头组合使用时，Aesculap 柄也观察到了同样的情况。
这项研究的结果表明，混合使用不同制造商的组件可能会影响锥度连接强度，并降低稳定性。由于安全性应该是患者治疗的首要任务，因此应避免任何潜在的风险。因此，不建议混合和搭配来自不同制造商的头和股骨柄。
