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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2010

01-12-2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

Constrained Liner in Neurologic or Cognitively Impaired Patients Undergoing Primary THA

Authors: Philippe Hernigou, MD, Paolo Filippini, MD, Charles-Henri Flouzat-Lachaniette, MD, Sobrinho Uirassu Batista, MD, Alexandre Poignard, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2010

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Abstract

Background

THA performed in patients with cognitive deficits or neuromuscular diseases has been associated with a high postoperative dislocation rate. The constrained liner reportedly provides stability in patients with recurrent dislocation. However, achieving stability could be offset by early loosening when used in patients with neurologic diseases.

Questions/purposes

We therefore asked whether constrained liners had a higher risk of loosening when used in primary THA for patients with neurologic diseases.

Methods

We retrospectively reviewed a 144 patients (164 hips) with neuromuscular disease who had a constrained polyethylene insert from 1999 to 2004 and compared them to another 120 patients (132 hips) with neuromuscular disease operated on immediately before this period (from 1994 to 1998) who had a conventional polyethylene insert.

Results

Thirty-three (25%) of the 132 hips without a constrained liner were known to have had at least one dislocation and 21 had revision for recurrent dislocation. Ten other hips had revision for loosening of the cup. The survival rate was 82% at 5 years and 77% at 10 years with revision due to recurrent dislocation or loosening of the cup as the endpoint. With a constrained liner, at minimum 5-year followup (mean, 7 years; range, 5–10 years), the incidence of complications, particularly dislocation, was decreased (three dislocations among 164 hips; 2%), with one revision for recurrent dislocation and one revision for loosening.

Conclusions

This constrained acetabular component provides durable protection against dislocation without substantial increased loosening at midterm followup.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Constrained Liner in Neurologic or Cognitively Impaired Patients Undergoing Primary THA
Authors
Philippe Hernigou, MD
Paolo Filippini, MD
Charles-Henri Flouzat-Lachaniette, MD
Sobrinho Uirassu Batista, MD
Alexandre Poignard, MD
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1340-6

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