Adapter Sleeves Are Not Needed to Reduce the Risk of Fracture of a New Ceramic Head Implanted on a Well-Fixed Stem.

Abstract

The purpose of this study was to assess (1) the prevalence of the fracture of ceramic heads implanted on used trunnions of well-fixed stems without using a titanium adapter sleeve; (2) the prevalence of trunnionosis secondary to fretting and/or corrosion at the trunnion of the well-fixed stem; and (3) clinical and radiographic results and the survival rate of the revised acetabular components. Eighty-eight patients (100 hips) underwent isolated revision of the acetabular components for polyethylene wear and osteolysis of the acetabulum. The study group consisted of 70 men and 18 women with a mean age of 52.8 years (range, 31-54 years) when the primary total hip arthroplasty was performed. Evidence of fretting and corrosion of the trunnion of all prostheses was examined macroscopically using a magnifying lens. Degree of fretting and corrosion of the trunnion was assessed using a 4-point scoring technique. A new 36-mm alumina delta ceramic head was implanted on the trunnion of a well-fixed stem without using a titanium adapter sleeve in all hips. The mean follow-up after revision of the acetabular component was 12.8 years (range, 10-14 years). Among the 100 new ceramic heads implanted on a well-fixed stem, no fracture of the ceramic head occurred at a mean follow-up of 12.8 years. The median fretting and corrosion scores for the trunnions were 1.5±1.1 and 1.3±0.9 points, respectively. The mean Harris hip score at the final follow-up was 89±15 points (range, 63-100 points). Survivorship of the revised acetabular components at 14 years was 95% (95% confidence interval, 87.6%-98.6%). [Orthopedics. 2018; 41(3):158-163.].

• Authors: Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
• Journal: Orthopedics (Orthopedics) Vol. 41 Issue 3 Pg. 158-163 (May 01 2018) ISSN: 1938-2367 [Electronic] United States
• PMID: 29738600 (Publication Type: Journal Article)
• Copyright: Copyright 2018, SLACK Incorporated.

Chemical References

• Polyethylene
• Aluminum Oxide

Topics

• Acetabulum (surgery)
• Adult
• Aged
• Aged, 80 and over
• Aluminum Oxide (adverse effects)
• Arthroplasty, Replacement, Hip (instrumentation, methods)
• Corrosion
• Female
• Follow-Up Studies
• Hip Joint (physiopathology)
• Hip Prosthesis (adverse effects)
• Humans
• Male
• Middle Aged
• Polyethylene (adverse effects)
• Prosthesis Design
• Prosthesis Failure (adverse effects)
• Reoperation
• Time Factors
• Treatment Outcome