Usefulness of modular neck adapter in partial hip revision

Andrea Pautasso; Giuseppe Bardellini; Placido Stissi; Fabio D'Angelo

doi:10.21037/aoj-23-22

Usefulness of modular neck adapter in partial hip revision

Ann Jt. 2023 Sep 14:8:35. doi: 10.21037/aoj-23-22. eCollection 2023.

Authors

Andrea Pautasso¹, Giuseppe Bardellini², Placido Stissi¹, Fabio D'Angelo^{1

3}

Affiliations

¹ Orthopaedic and Traumatology Department, ASST Sette Laghi, Circolo Hospital and Macchi Foundation in Varese, University Center, Varese, Italy.
² Orthopaedic and Traumatology Department, University of Studies Insubria, Varese, Italy.
³ Department of Biotechnology and Life Sciences (DBSV), University of Studies Insubria, Varese, Italy.

Abstract

Background and objective: Modular neck adapters allow different length and offset changes to reach a stable total hip arthroplasty (THA) and permit a quick partial hip revision procedure without removing the existing components. The literature is poor on this matter and about the long-term related outcomes. This narrative review summarizes the most recent literature about these devices as an option of surgical treatment in partial total hip arthroplasty revision (THAr) focusing on indications, clinical and radiological outcomes, and related complications.

Methods: The narrative review of the current available literature was conducted in December 2022 through electronic database. The terms used were: "Head neck taper" OR "Merete BioBall" AND "revision Total Hip Arthroplasty (MeSH Terms)". The timeframe was limited between 01/01/2000 and 01/12/2022. The studies regarding the clinical use of the Merete BioBall^® system in hip revision surgery were included, while all the papers concerning modular stem prosthesis were excluded.

Key content and findings: The surgical procedure is safe, quick and allows the surgeon to correct a well-fixed stem version, length and offset, besides retensioning soft tissues. Clinical and radiological outcomes are good with low complications rates.

Conclusions: The modular neck adapter system seems to be a good surgical procedure for recurrent dislocation of THA, especially in case of a second THAr surgery. However, the main indication of adapter use remains the isolated acetabular cup revision. The related complications are rare: the worst is the re-dislocation due to an insufficient stem version and length correction. Re-dislocation rates reported in literature vary from 5.2% to 15%. Corrosion or fretting of the modular system are not reported in literature.

Keywords: Hip revision arthroplasty; Merete BioBall; head-neck adapter; total hip arthroplasty (THA).

Publication types

Review