Garabadi Mohanrao, Akhtar Meraj, Blow Jody, Pawar Rajesh, Rowsell Mark, Antapur Prasad
Trauma & Orthopaedics, United Kingdom.
J Orthop. 2023 Mar 22;38:68-72. doi: 10.1016/j.jor.2023.02.015. eCollection 2023 Apr.
Removal of a well-fixed uncemented femoral component in revision hip arthroplasty is challenging. A modular head-neck adapter provides an option to optimise the femoral offset and anteversion, avoiding the need for femoral stem revision.
To present the clinical results following revision arthroplasty with the Bioball head-neck adapter in the elderly American Society of Anaesthesiologists (ASA) Grade II, III & IV patients.
A retrospective review of our database was performed, and all patients classed as ASA grades II, III, & IV treated with the Bioball Universal Adapter (BUA) for 10 years were included. The indication for revision, stem retention, type of adapter, and head size were identified. Patients were contacted by a research nurse to assess the Forgotten Joint Score (FJS), the Oxford Hip Score (OHS), and any symptoms of instability at a minimum of one year post revision surgery.
Our study included 47 patients. 5 (10.6%) were ASA II, 19 (40.4%) were ASA III and 23 (49%) were ASA IV. The mean age was 74 years. The mean follow up was 52 months ± 28.4 SD. The median FJS was 86 ± 11.6 SD. The median OHS was 43 ± 6.2 SD. One patient (2.1%) developed recurrent dislocation following lumbar spinal fusion. None of the other patients experienced instability. The survival rate for the adapter was 98%.
The BUA gives good clinical outcomes with very low post revision instability. It is a valuable option for the elderly because it avoids the morbidity and risks associated with the removal of a well-fixed femoral stem.
Level IV.
在髋关节翻修术中取出固定良好的非骨水泥型股骨假体具有挑战性。模块化头颈转接器为优化股骨偏心距和前倾角提供了一种选择，避免了股骨柄翻修的必要性。
介绍使用生物球头-颈转接器对美国麻醉医师协会（ASA）II、III和IV级老年患者进行翻修关节置换术后的临床结果。
对我们的数据库进行回顾性分析，纳入所有使用生物球通用转接器（BUA）治疗10年的ASA II、III和IV级患者。确定翻修指征、柄保留情况、转接器类型和股骨头尺寸。研究护士联系患者，以评估翻修手术后至少一年的遗忘关节评分（FJS）、牛津髋关节评分（OHS）以及任何不稳定症状。
我们的研究包括47例患者。5例（10.6%）为ASA II级，19例（40.4%）为ASA III级，23例（49%）为ASA IV级。平均年龄为74岁。平均随访时间为52个月±28.4标准差。FJS中位数为86±11.6标准差。OHS中位数为43±6.2标准差。1例患者（2.1%）在腰椎融合术后出现复发性脱位。其他患者均未出现不稳定情况。转接器的生存率为98%。
BUA具有良好的临床效果，翻修后不稳定率极低。对于老年人来说，它是一个有价值的选择，因为它避免了与取出固定良好的股骨柄相关的发病率和风险。
IV级。
