Long-term outcome after revision of hip arthroplasty with the BioBall® adapter system in multimorbid patients

Hans-Jürgen Kock; Christopher Cho; Klaus Buhl; Joachim Hillmeier; Franz X Huber

doi:10.1016/j.jot.2019.08.007

Long-term outcome after revision of hip arthroplasty with the BioBall® adapter system in multimorbid patients

J Orthop Translat. 2019 Sep 20:22:43-49. doi: 10.1016/j.jot.2019.08.007. eCollection 2020 May.

Authors

Hans-Jürgen Kock¹, Christopher Cho², Klaus Buhl³, Joachim Hillmeier⁴, Franz X Huber⁴

Affiliations

¹ MEDIAN Klinik am Burggraben, Alte Vlothoer Land Street, 47-49, Bad Salzuflen, 32105, Germany.
² Vivantes Klinikum Im Friedrichshain, Zentrum für Muskuloskelettale Medizin, Landsberger Allee 49, 10249, Berlin, Germany.
³ Klinik für Allgemein-, Viszeral- und Transplanationsschirurgie, Universität Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Germany.
⁴ Universität Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Germany.

Abstract

Introduction: Long-term study evidence about the BioBall® adapter system is limited, especially in highly morbid elderly patients. Thus, we analysed the long-term outcome of revision hip arthroplasty using this system in highly morbid elderly patients.

Materials and methods: We included 19 patients undergoing revision hip arthroplasty after primary or secondary total hip arthroplasty dislocations between July 2002 and August 2004 and followed up their long-term outcome until 2015.

Results: The patients achieved a median of 17 points in the Merle d'Aubigné hip score in 2004 and a median of 18 points in 2011, and the 4 surviving patients in 2015 achieved 18 points. For the four 12-year survivors, the Merle d'Aubigné score was virtually stable over the complete observation period. The Harris Hip Score showed comparable results. The patients had a median Barthel index of 90 in 2004 and 100 in 2011, and the 4 survivors in 2015 had Barthel indices of 65, 95, 100, and 100, respectively, in 2015.

Conclusions: In multimorbid patients, using the BioBall® adapter system for total hip arthroplasty, revision due to dislocation results in good long-term outcome without impairment of quality of life.

Translational potential: Our study provides long-term evidence in a vulnerable patient population. It shows how the therapeutic concept of revision hip replacement with an adapter device translates into long-term outcome and quality of life in these patients. Thus, it adds important information for evaluation of therapeutic options in this field.

Keywords: BioBall® adapter system; CHD, coronary heart disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; Revision arthroplasty; THA dislocation; THA instability; THA, total hip arthroplasty; Total hip replacement.