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Adapter Sleeves Are Not Needed to Reduce the Risk of Fracture of a New Ceramic Head Implanted on a Well-Fixed Stem
- Adapter Sleeves Are Not Needed to Reduce the Risk of Fracture of a New Ceramic Head Implanted on a Well-Fixed Stem
- Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- ORTHOPEDICS vol. 41, no. 3, pp. 158 - 163
- SLACK INC
- SCIE; SCOPUS
- Document Type
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- 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%).
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