Registry study on failure incidence in 1,127 revised hip implants with stem trunnion re-use after 10 years of follow-up: limited influence of an adapter sleeve

Abstract

Background and purpose — Little is known about the role of retained trunnions in revision hip arthroplasties, i.e., when only the femoral head is substituted. Wear (fretting corrosion) and ceramic head fractures are 2 poorly understood concerns related to use, and the role of adapter sleeves has not been defined. In this registry study we assessed the influence of sleeve interposition on re-revision rates in revision hip arthroplasties with retained stems. Confounding factors (demographics, implant-related features) and failures were also analyzed.Patients and methods — We conducted a registry study on 1,127 revised implants (retained trunnion and head exchange). In 26% of implants an adapter sleeve was interposed; in 74% no adapter sleeve was implanted. Demographic and implant-related features were investigated including a descriptive analysis of failures.Results — The mean follow-up of revised implants with and without the use of an adapter sleeve was 3.3 and 5.1 years, respectively. The implant survival without an adapter sleeve was significantly higher, 98.4% (95% CI 96.9–99.8) vs. 95.2% (CI 93.2–96.6) with an adapter sleeve at 5 years. No re-revisions due to adverse local tissue reactions or ceramic head fractures were reported. In order to overcome the different distribution of head materials and head sizes in the two cohorts, only Delta balls were investigated.Interpretation — Adapter sleeve interposition had a minor influence on the revision rates. No adverse local tissue reactions or head fractures occurred.

Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study

“…Capture rate of the registry is 98% (missing data accounting for 2%). The accuracy is confirmed by crossover comparisons and missing data retrievals [ 10 ]. RIPO structure is similar to the main national arthroplasty registries [ 10 ].…”

“…The accuracy is confirmed by crossover comparisons and missing data retrievals [10]. RIPO structure is similar to the main national arthroplasty registries [10]. When an implant failed, the surgeon performing the revision surgery fills a specific RIPO form, specifying the reason for revision, the batch and the code of the newly implanted device, and the demographical data of the patients receiving the reimplantations.…”

“…The Register of the Orthopaedic Prosthetic Implants (Registro dell’Implantologia Protesica Ortopedica, RIPO) is an Italian regional (Emilia-Romagna, 4.5 million inhabitants) arthroplasty registry following hip, knee, and shoulder procedures since 2000 [ 10 ]. Paper data forms about demographic features, diagnoses, and types (batch and code) of the implants in primary and revision surgeries are regularly filled out by the surgeons and actively collected by the RIPO registry [ 10 ].…”

“…The Register of the Orthopaedic Prosthetic Implants (Registro dell’Implantologia Protesica Ortopedica, RIPO) is an Italian regional (Emilia-Romagna, 4.5 million inhabitants) arthroplasty registry following hip, knee, and shoulder procedures since 2000 [ 10 ]. Paper data forms about demographic features, diagnoses, and types (batch and code) of the implants in primary and revision surgeries are regularly filled out by the surgeons and actively collected by the RIPO registry [ 10 ]. To avoid possible loss to follow-up, analysis has been limited to Emilia-Romagna resident patients, because even if revision surgery would be performed outside the region, the cost of the procedure would be billed back to Emilia-Romagna and therefore trackable and accounted as a failure.…”

A Perspective on Biotribology in Arthroplasty: From In Vitro toward the Accurate In Silico Wear Prediction

“…In recent years, many efforts have been made to improve both biomaterials and the design of new prosthetic couplings. The fundamental tools for the evaluation of a prosthetic design are the multicentric outcome registries [5,6]. These registries offer important information regarding any complications or event related to a joint prosthesis.…”