Bioball universal modular neck adapter as a salvage for failed revision total hip arthroplasty

Vaishya, Raju; Sharma, Mrinal; Chaudhary, Rushil

doi:10.4103/0019-5413.118211

Cited by 10 publications

(8 citation statements)

References 10 publications

(12 reference statements)

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“…The use of head neck adaptors is an attractive option as it allows surgeons to preserve the in-situ femoral stem thus reducing the risks associated with revision of a well-fixed stem. 13 There is a paucity of clinical and functional outcome data with the use of these devices in the literature and this article aims to address this issue. The incidence of instability following re-revision arthroplasty is high in revision for ALVAL secondary to MoM bearings.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and dislocation rates after hip reconstruction using the Bioball system

et al. 2019

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Introduction: Instability accounts for 1/3 of revision total hip arthroplasty (rTHA) performed in the UK. Removal of well-fixed femoral stems in rTHA is challenging with a risk of blood loss and iatrogenic damage to the femur. The Bioball universal adaptor (BUA), a modular head neck extension adaptor, provides a mechanism for optimisation of femoral offset, leg length and femoral anteversion. This can avoid the need for femoral stem revision in selected cases. The aim of this study is to present the clinical results and rate of instability following revision with this BUA at a minimum of 2 years follow-up. Patients and methods: A review of our prospectively collected database was performed. All patients treated with the Bioball device were included. Clinical and radiologic review were performed pre- and post-surgery. Specific enquiry for instability was made. The Oxford Hip Score (OHS), EuroQol (EQ-5D) score and WOMAC scores were calculated pre-and post-operatively. Complications were recorded. Results: 32 rTHA procedures were performed using the Bioball device between 2013 and 2016. 4 patients did not wish to complete post-operative questionnaires. 2 patients (2/28, 7%) complained of recurrent dislocations following their rTHA procedure. 1 patient complained of instability but no dislocation. The median pre-operative EQ-5D was 0.195 (range −0.07–0.85), OHS was 20 (range 5–43) and WOMAC was 29.8 (range 15.5–52.3). The median EQ-5D was 0.85 (range 0.59–1), OHS was 39 (range 21–48) and WOMAC was 91.1 (range 44.5–99.2) at final follow-up. There were significant improvements in the EQ-5D ( p = 0.0009), OHS ( p = 0.0004) and WOMAC ( p = 0.0001). Conclusion: The BUA is associated with significant functional improvement and relatively low dislocation rates in revision THA. It is a viable option for use in the revision setting.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes and dislocation rates after hip reconstruction using the Bioball system

et al. 2019

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“…We have used ceramic BHA in 5 (9.1%) of our cases with ARMD as an indication for partial rTHA, confident that no effect can be expected due to the release of titanium ions, and without any clinical or radiological sign of recurrence of the disease. 15 Another theoretical risk is breakage and/or disassembly of the system; from a biomechanical point of view the most dangerous coupling, especially in the offset configuration, should be when the longest adapters are used; in fact, we do not report any such complications in the 9 cases (20%) when 5XL (+21 mm) and 4 XL (+17.5 mm). Our data are in line with those reported by Woelfle et al, 16 who did not see a single case in their series of 20 BHA in 18 patients followed up to 6.7 years; they claim that dissociation or breakage of the adapter or the neck within the adapter is not to be expected based on test results and has not yet been reported in literature.…”

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Retrospective multi-centre study on head adapters in partial revision hip arthroplasty

et al. 2020

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Background: Instability and dislocation after total hip arthroplasty (THA) is a common reason for revision surgery. THA head-neck adapters promise the reconstruction of optimal femoral offset and leg length in revision THA (rTHA) while retaining stable implants. The aim of this retrospective multi-centre study is to report on the results achieved with the use of head adapters in partial rTHA, to avoid the instability of the implant. Methods: 55 cases of partial rTHA performed between February 2015 and April 2017 in 3 different hospitals using the Bioball Head Adapter (BHA) (Bioball Merete, Medical GmbH, Berlin, Germany) were retrospectively recorded. All patients were evaluated from a radiological point of view at an average follow-up of 3.5 years. Failure was defined as re-revision surgery for any cause as well as a subjective feeling of instability of the joint. Results: One failure was registered in an extreme case and radiological findings show no suggestive signs of radiolucencies or loosening and therefore all implants have been considered stable. Conclusions: Despite some limitations of this retrospective study and according to the relevant literature, our data confirms that BHA is a safe system that allows the flexibility to restore femoral offset and version, to adjust leg length, to minimise instability, to avoid unnecessary removal of otherwise well-fixed components thus improving tribology and reducing the risk of taper junction issues without major complications in partial rTHA.

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“…Obvious mal-positioning would necessitate a revision. 43,44 Recurrent dislocation with the absence of component malposition, is due to abductor imbalance or impingement. Generally, one must be prepared to manage both of these problems, as the exact cause may only be evident at the time of revision.…”

Section: Dislocation/instabilitymentioning

confidence: 99%

Diagnosis of the failed total hip replacement

Aqil

Shah

2020

Journal of Clinical Orthopaedics and Trauma

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Bioball universal modular neck adapter as a salvage for failed revision total hip arthroplasty

Cited by 10 publications

References 10 publications

Clinical outcomes and dislocation rates after hip reconstruction using the Bioball system

Clinical outcomes and dislocation rates after hip reconstruction using the Bioball system

Retrospective multi-centre study on head adapters in partial revision hip arthroplasty

Diagnosis of the failed total hip replacement

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