Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
J Arthroplasty. 2023 Aug;38(8):1578-1583. doi: 10.1016/j.arth.2023.01.055. Epub 2023 Feb 9.
Five- to 10-year outcomes of a modular head-neck adapter system with ceramic heads in revision hip arthroplasty on large populations are still lacking. A registry study about modular adapter system with Delta ceramic head in revisions was designed, aiming to assess (1) the survival rates of the device, (2) the reasons for re-revisions of the device, and (3) a comparison to factory assembled titanium sleeve and Delta head cohort in revision hips.
Using a regional arthroplasty registry, we investigated the modular adapter system with a ceramic head in revision hips. Demographics, implant features, and reasons for revision were recorded. Survival rates and reasons for re-revision were assessed. The modular adapter system with the ceramic ball was compared to a factory-assembled ceramic titanium-sleeved head in revisions, acting as a control group. There were 354 revisions included at a mean follow-up of 5 years (range, 0 to 13).
The 5- and 7-year survival rates were 87.9% and 86.9%, respectively. Dislocations (2.8%) and cup aseptic loosening (4.2%) were the 2 most frequent reasons for re-revision. No breakage of the adapter system or the ceramic head occurred. A femoral neck failed (0.3%). No implant features, offset (P = .088) or skirted (P = .870) tapers, impacted on failures. No differences between the 2 cohorts were found regarding survival rates (P = .696) and reasons for re-revision (dislocations, P = .983; cup aseptic loosening, P = .296).
The modular head neck adapter system with a ceramic head seems to be a valid option in revisions at 5 and 7 years, without additional risk of implant breakage in this registry.
在大规模人群中，对于使用陶瓷头的模块化头-颈适配器系统进行翻修髋关节置换术的 5-10 年结果仍缺乏报道。本研究旨在评估（1）该装置的生存率；（2）该装置翻修的原因；（3）使用陶瓷头的模块化适配器系统与翻修髋关节中工厂组装的钛套筒和 Delta 头队列的比较。
我们使用区域关节置换登记处调查了翻修髋关节中使用陶瓷头的模块化适配器系统。记录了人口统计学资料、植入物特征和翻修原因。评估了生存率和再次翻修的原因。使用陶瓷球的模块化适配器系统与工厂组装的陶瓷钛套筒头进行了比较，作为对照组。共纳入 354 例翻修病例，平均随访 5 年（范围，0-13 年）。
5 年和 7 年的生存率分别为 87.9%和 86.9%。再翻修的 2 个最常见原因是脱位（2.8%）和杯无菌性松动（4.2%）。未发生适配器系统或陶瓷头断裂。1 例股骨颈失败（0.3%）。植入物特征、偏心距（P=0.088）或裙边（P=0.870）锥形无差异影响失败。2 个队列在生存率（P=0.696）和再翻修原因（脱位，P=0.983；杯无菌性松动，P=0.296）方面无差异。
在 5 年和 7 年时，使用陶瓷头的模块化头-颈适配器系统似乎是一种有效的翻修选择，在该登记处未发现植入物断裂的额外风险。
