Journal article
Long-Term Outcomes of Constrained Liners Cemented into Retained, Well-Fixed Acetabular Components
Journal of bone and joint surgery. American volume, Vol.101(7), pp.620-627
04/03/2019
DOI: 10.2106/JBJS.18.00607
PMID: 30946196
Abstract
Cementation of a constrained liner is a viable option for treating instability after total hip arthroplasty (THA) when the acetabular component is well fixed and well aligned. However, concerns regarding long-term mechanical failure and recurrent instability remain. The aim of this study was to evaluate the long-term survivorship, complications, and clinical and radiographic outcomes of constrained polyethylene liners cemented into well-fixed acetabular components at the time of revision THA.
We identified 125 cases in which a constrained liner of 1 design was cemented into a retained, osseointegrated acetabular component during revision THA between 1998 and 2006. The mean patient age at revision was 70 years. Mean follow-up was 7 years. Survivorship data, risk of instability, and clinical and radiographic outcomes were analyzed.
Survivorship free from revision for instability was 86% at 5 years and 81% at 10 years. Survivorship free from aseptic acetabular component revision was 78% at 5 years and 65% at 10 years, with the most common failure mechanism being dissociation of the constrained liner from the acetabular component. Survivorship free from revision for any reason was 76% at 5 years and 60% at 10 years. The most common complications were instability and periprosthetic joint infection, with cumulative incidences at 7 years of 18% and 11%, respectively. Harris hip scores did not significantly improve. Cup position did not affect implant survivorship or risk of dislocation.
Cementing a constrained liner into a retained acetabular shell at the time of revision THA has durable long-term results, with 8 in 10 patients free from instability at 10 years. Aseptic acetabular survivorship was worse (65%) at 10 years, primarily due to dissociation of the constrained liner from the acetabular component.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Details
- Title: Subtitle
- Long-Term Outcomes of Constrained Liners Cemented into Retained, Well-Fixed Acetabular Components
- Creators
- Timothy S Brown - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaMeagan E Tibbo - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaDiren Arsoy - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaDavid G Lewallen - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaArlen D Hanssen - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaRobert T Trousdale - Department of Orthopedic Surgery, Mayo Clinic, Rochester, MinnesotaMatthew P Abdel - Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
- Resource Type
- Journal article
- Publication Details
- Journal of bone and joint surgery. American volume, Vol.101(7), pp.620-627
- DOI
- 10.2106/JBJS.18.00607
- PMID
- 30946196
- NLM abbreviation
- J Bone Joint Surg Am
- ISSN
- 0021-9355
- eISSN
- 1535-1386
- Publisher
- Journal of Bone and Joint Surgery Incorporated; United States
- Language
- English
- Date published
- 04/03/2019
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040348002771
Metrics
15 Record Views