Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Thaller, A.
BioBall Universal Head Neck Adapters – Mix & Match in Total Hip Arthroplasty. A Retrospective Study
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Leitner Lukas
- Valentini Marisa
- Altmetrics:
- Abstract:
- Background. The safety of “mix & match” total hip arthroplasty (THA) using universal head-neck adapters (UHNA) remains unclear and is an important topic of discussion. The aim of this study is to analyze the complication and revision rates, potential influencing factors, and implant survival of UHNA in “mix & match” settings. Materials and Methods. A retrospective study was performed at the General Hospital Graz including 306 patients treated with THA (n = 288 (94.1%) of which were revisions) using UHNA (all BioBall®, Merete®, Berlin, Germany) between 2006 and 2022. Diagnoses, demographics, comorbidities, implant and UHNA specifications, and complications were recorded. Analyses of multifactorial outcome, revision rates, and implant survival were performed. Implant failure, defined as reoperation, was the primary outcome. Results. The median age at UHNA implantation was 74 years (IQR 62–81 years), 58.5% of patients were female, and the median calculated follow-up was 57 months (IQR 23–85 months). 19.9% (n = 61) of the included cases had at least one postoperative complication. The most common complications were postoperative recurrent dislocation (n = 27; 8.8%), periprosthetic infection (n = 13; 4.2%), periprosthetic fracture (n = 13; 4.2%), and aseptic component loosening (n = 10; 3.3%). 14.1% (n = 43) of patients had at least one re-revision surgery. One case of stem-neck fracture was recorded (0.3%), which was categorized as the only specific “mix & match” complication. Statistically significant risk factors included: postoperative recurrent dislocation and postoperative aseptic loosening were associated with dislocation as an indication for UHNA implantation (p < .001) and oversized neck lengths (≥ 2 XL; p = .004), respectively. Overall revision-free survival was 92% (95% CI 88.1– 95.9%) at 1 year and 82% (95% CI 76.1–87.9%) at 10 years. Better survival rates were seen in patients ≥ 60 years of age, with fewer comorbidities (< 2), and with normal neck lengths (S–XL). Conclusion. The results of this study underline the overall safety of the use of UHNA in THA through “mix & match” solutions. One mix & match specific complication was identified (0.3%, stem neck fracture). The highlighted risk factors for failure must be considered in patient education and decision making. Numerous variables must be considered to achieve favorable outcomes with UHNA in “mix & match” THA, including patient, implant, surgeon, and perioperative factors. However, further research and compatibility testing by prosthesis manufacturers is needed.