A Modular Head-Neck Adapter System and Ceramic Heads in Revision Hip Arthroplasty: A Registry Study on 354 Implants

Pardo, Francesco; Castagnini, Francesco; Bordini, Barbara; Cosentino, Monica; Lucchini, Stefano; Traina, Francesco

doi:10.1016/j.arth.2023.01.055

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Theoretically, using the longest adapters with offset configuration increases the possible mechanical failure of the system and may influence implant stability due to the skirted configuration. We did not observe a negative effect with longer necks and skirted configurations, similarly to Woelfle et al and Pardo et al [11,17].…”

Section: Discussionsupporting

confidence: 90%

“…Hoberg et al [10] showed promising results using the same system with a survival rate of 92.8% at 8.17 years (mixed head materials, ceramic and metal heads). Pardo et al [11], in a registry study analyzing 354 modular head adapters coupled with ceramic heads, showed a survival rate of 87.8% at 5 years and 85.7% at 10 years, close to our case series. Offset and skirted devices did not impact the survival rates.…”

Section: Discussionsupporting

confidence: 90%

“…This result confirmed that mechanical failures of the modular head adapter system are anecdotical. Pardo et al did not report any mechanical failure in a cohort of 354 modular adapters with ceramic head [11].…”

Section: Discussionmentioning

confidence: 93%

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Revision Hip Arthroplasty Using a Modular Head–Neck Adapter System and a Ceramic Head: 5-Year Clinical and Radiographic Outcomes

Caternicchia,

Fantoni,

Poletto

et al. 2023

JCM

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Introduction: A modular head–neck adapter system may help surgeons restore the proximal hip biomechanics in revision hip arthroplasty. However, the clinical and radiographic 5-year outcomes of the system are still scarcely reported. The aim of this study is the assessment of (1) complications and survival rates, (2) clinical and (3) radiological outcomes of the modular head–neck adapter system with a ceramic head in revision hip arthroplasty at 5 years. Methods: 32 revision hip arthroplasties using a modular head–neck adapter system and a ceramic head were retrospectively recorded. Preoperative demographic and implant features were collected. Clinical and radiographic outcomes, failures and reasons for re-revisions were recorded at the last follow-up. Results: A mean follow-up of 59.8 ± 26 months was achieved. The survival rate was 90.6% at 5 years. Post-operative complications occurred in nine cases (28.1%): two dislocations (6.2%), one aseptic cup loosening (3.1%) requiring re-revision, one (3.1%) persistent pelvic pseudotumor requiring embolization. No mechanical failures of the adapter or ceramic head occurred. The mean post-operative HHS score was 84.4 points. Thirteen cases (40.6%) showed optimal radiographic cup osseointegration, and 17 hips (53.1%) showed valid stem osseointegration. The mean post-operative femoral offset was 48.84 mm, larger than the contralateral side (p = 0.02). The post-operative lateralization of the hip joint was 38.09 mm, close to the contralateral side (p = 0.4). Conclusions: In revisions, the modular head–neck adapter system with ceramic head provided good clinical outcomes and acceptable radiographic reconstruction of hip biomechanics, with a survival rate of 87.9% at 5 years.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%