title: [Partial exchange in total hip arthroplasty : What can we combine?]
abstract: BACKGROUND
  In case of hip revision arthroplasty, one component (cup/stem) is often well fixed and does not need to be exchanged. The newly implanted component needs to be compatible with the well-fixed implant. The combination of implants from different companies leads to "mix and match" or even mismatch between the implants.
  
  
  OBJECTIVE
  The objective of this work was to describe possible combinations including their specifications that need to be considered in partial exchange of hip prostheses. For this purpose the literature, surgical techniques of companies and judgements concerning this topic were analysed and our own results and experiences were included.
  
  
  CONCLUSIONS
  Partial revision arthroplasty can be challenging and needs to be planned in detail. In case of isolated cup or inlay revision with exchange of a modular head the cone of the stem needs to be identified. A ceramic head may be used in revision with a titanium sleeve even from a different company as long as they are compatible. Patients however need to give their informed consent for this mix and match procedure. This procedure is done frequently and good study results support this, however from a juristic point of view a definite recommendation cannot be given. If the inlay of a cup is replaced, the original inlay should be used. If this is not available anymore, it can be manufactured as a special product in many cases. If this is also not possible, an inlay can also be cemented into a well-fixed cup. Biomechanical and clinical studies support this off-label technique. In case of an isolated exchange of the stem with a ceramic inlay that is retained in a well-fixed cup, the revision stem and ceramic head need to be from the same company as the cup. In case of ceramic fracture, a ceramic head with a titanium sleeve should be combined with a PE or ceramic inlay, a metal head or inlay should never be used.
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland. Patrick.Weber@med.uni-muenchen.de.
authors.forename: P
authors.initials: P
authors.lastname: Weber
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Steinbrück
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: A C
authors.initials: AC
authors.lastname: Paulus
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Woiczinski
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Schmidutz
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Fottner
authors.affiliation: Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Jansson
mesh_terms: D065526:Acetabuloplasty / Q000295:instrumentation / Q000379:methods; D000077:Acetabulum / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006622:Hip Prosthesis; D006801:Humans; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012086:Reoperation / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Cementation of an inlay; Ceramic fracture; Cone adapter; Hip replacement arthroplasty; Mix and Match; Surgical revision