Taper connection strength of revision heads with adapter sleeves compared to standard heads made of ceramics

Revision ceramic heads with titanium adapter sleeves are used in case of a femoral head revision in total hip arthroplasty to avoid ceramic fracture due to damaged tapers. Objective of the present study was to evaluate the taper connection strength of revision ceramic heads. Therefore, revision ceramic heads ( empty set 36 mm; adapter sleeve S) and standard ceramic heads ( empty set 36 mm; neck length S) were assembled with an axial load (2 kN) to titanium tapers with various damage modes (undamaged, truncated, and elevated). Subsequently, the heads were either pulled-off directly after assembly or after dynamic loading over 2.5 million cycles (sinusoidal 0.3 kN-3.0 kN). Pull-off forces of the revision heads (1.24 kN-1.66 kN) were up to 43.7% higher compared to standard heads (1.02 kN-1.48 kN) in dependency of the taper damage. After dynamic loading, the pull-off forces did not change in case of standard heads. The pull-off forces of the revision heads decreased in combination with the undamaged and truncated tapers but increased in combination with the elevated tapers. In conclusion, revision heads with adapter sleeves (size S) showed higher taper connection strength than standard heads both on undamaged and damaged tapers.