Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 11/2016

01-11-2016 | Original Paper

The focally constrained liner is a reasonable option for revision of unstable total hip arthroplasty

Authors: Tatu J. Mäkinen, Simcha G. Fichman, Wael A. Rahman, Tomas Amenabar, Oleg Safir, Allan E. Gross, Paul R. T. Kuzyk

Published in: International Orthopaedics | Issue 11/2016

Login to get access

Abstract

Purpose

Revision surgery for a patient with previous recurrent dislocations or abductor muscle dysfunction has been considered to be a complication-prone procedure regardless of the type of constrained implant used. We investigated the survivorship of a focally constrained acetabular liner used for revision total hip arthroplasty in patients with abductor insufficiency or previous recurrent dislocations.

Methods

We retrospectively reviewed 98 patients in whom a focally constrained acetabular liner was used to treat abductor insufficiency or previous recurrent dislocations. The mean age was 69.4 years (37–92) and 64 of these were females. Previously, the patients had undergone a mean of two (1–5) revisions. The mean follow-up was 38 (12–66) months. Kaplan-Meier survival curves were calculated and Log-rank test was used to test the difference in survivorship between patients with abductor insufficiency and previous dislocations.

Results

Sixteen patients needed a further re-revision for any cause. Thus, the revision-free survivorship was 84.3 % at five years. Five patients suffered a dislocation with a mean of five months post-operatively and were managed with repeat revision. Five patients failed at the implant-host bone interface. Three of these failures occurred after cementing the constrained liner into a pre-existing shell.

Conclusions

The focally constrained liner provided a reasonable option for revision total hip arthroplasty in patients with hip instability. Failures were observed in patients with acetabular osteolysis but seemingly well-fixed component and unrecognized impingement.
Literature
1.
Wera GD, Ting NT, Moric M, Paprosky WG, Sporer SM, Della Valle CJ (2012) Classification and management of the unstable total hip arthroplasty. J Arthroplasty 27:710–715CrossRefPubMed
2.
Opperer M, Lee YY, Nally F, Blanes Perez A, Goudarz-Mehdikhani K, Gonzalez Della Valle A (2015) A critical analysis of radiographic factors in patients who develop dislocation after elective primary total hip arthroplasty. Int Orthop. In press
3.
Khan RJ, Fick D, Alakeson R, Li MG, Nivbrant B, Wood D (2007) The constrained acetabular component for hip instability. J Arthroplasty 22:377–382CrossRefPubMed
4.
Soong M, Rubash HE, Macaulay W (2004) Dislocation after total hip arthroplasty. J Am Acad Orthop Surg 12:314–321CrossRefPubMed
5.
Wetters NG, Murray TG, Moric M, Sporer SM, Paprosky WG, Della Valle CJ (2013) Risk factors for dislocation after revision total hip arthroplasty. Clin Orthop Relat Res 471:410–416CrossRefPubMed
6.
Shah SN, Kaye RJ, Kelly NH, Su EP, Padgett DE, Wright TM (2009) Retrieval analysis of failed constrained acetabular liners. J Arthroplasty 24(6 Suppl):54–57CrossRefPubMed
7.
Yun AG, Padgett D, Pellicci P, Dorr LD (2005) Constrained acetabular liners: mechanisms of failure. J Arthroplasty 20:536–541CrossRefPubMed
8.
Etienne G, Ragland PS, Mont MA (2005) Use of constrained acetabular liners in total hip arthroplasty. Orthopedics 28:463–469PubMed
9.
Anderson MJ, Murray WR, Skinner HB (1994) Constrained acetabular components. J Arthroplasty 9:17–23CrossRefPubMed
10.
Lombardi AV Jr, Mallory TH, Kraus TJ, Vaughn BK (1991) Preliminary report on the S-ROM constraining acetabular insert: a retrospective clinical experience. Orthopedics 14:297–303PubMed
11.
Munro JT, Vioreanu MH, Masri BA, Duncan CP (2013) Acetabular liner with focal constraint to prevent dislocation after THA. Clin Orthop Relat Res 471:3883–3890CrossRefPubMedPubMedCentral
12.
Goetz DD, Capello WN, Callaghan JJ, Brown TD, Johnston RC (1998) Salvage of total hip instability with a constrained acetabular component. Clin Orthop Relat Res 355:171–181CrossRef
13.
Shapiro GS, Weiland DE, Markel DC, Padgett DE, Sculco TP, Pellicci PM (2003) The use of a constrained acetabular component for recurrent dislocation. J Arthroplasty 18:250–258CrossRefPubMed
14.
Della Valle CJ, Chang D, Sporer S, Berger RA, Rosenberg AG, Paprosky WG (2005) High failure rate of a constrained acetabular liner in revision total hip arthroplasty. J Arthroplasty 20(7 Suppl 3):103–107CrossRefPubMed
15.
Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Russell JH, Groseth KL (2005) The long-term outcome of 755 consecutive constrained acetabular components in total hip arthroplasty examining the successes and failures. J Arthroplasty 20(7 Suppl 3):93–102CrossRefPubMed
16.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed
17.
DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976:20–32
18.
Guyen O, Lewallen DG, Cabanela ME (2008) Modes of failure of Osteonics constrained tripolar implants: a retrospective analysis of forty-three failed implants. J Bone Joint Surg Am 90:1553–1560CrossRefPubMed
19.
Pattyn C, De Haan R, Kloeck A, Van Maele G, De Smet K (2010) Complications encountered with the use of constrained acetabular prostheses in total hip arthroplasty. J Arthroplasty 25:287–294CrossRefPubMed
20.
Cooper HJ, Della Valle CJ (2014) Large diameter femoral heads: is bigger always better? Bone Joint J 96-B(11 Suppl A):23–26CrossRefPubMed
21.
Levine BR, Della Valle CJ, Deirmengian CA, Breien KM, Weeden SH, Sporer SM, Paprosky WG (2008) The use of a tripolar articulation in revision total hip arthroplasty: a minimum of 24 months’ follow-up. J Arthroplasty 23:1182–1188CrossRefPubMed
22.
Kosashvili Y, Drexler M, Backstein D, Safir O, Lakstein D, Safir A, Chakravertty R, Dwyer T, Gross A (2014) Dislocation after the first and multiple revision total hip arthroplasty: comparison between acetabulum-only, femur-only and both component revision hip arthroplasty. Can J Surg 57:E15–E18CrossRefPubMedPubMedCentral
23.
Plummer DR, Haughom BD, Della Valle CJ (2014) Dual mobility in total hip arthroplasty. Orthop Clin N Am 45:1–8CrossRef
24.
Lachiewicz PF, Watters TS (2012) The use of dual-mobility components in total hip arthroplasty. J Am Acad Orthop Surg 20:481–486CrossRefPubMed
25.
Prudhon JL, Steffann F, Ferreira A, Verdier R, Aslanian T, Caton J (2014) Cementless dual-mobility cup in total hip arthroplasty revision. Int Orthop 38:2463–2468CrossRefPubMed
26.
Wegrzyn J, Tebaa E, Jacquel A, Carret JP, Bejui-Hugues J, Pibarot V (2015) Can dual mobility cups prevent dislocation in all situations after revision total Hip arthroplasty? J Arthroplasty 30:631–640CrossRefPubMed
27.
Hailer NP, Weiss RJ, Stark A, Karrholm J (2012) Dual-mobility cups for revision due to instability are associated with a low rate of re-revisions due to dislocation: 228 patients from the Swedish Hip Arthroplasty Register. Acta Orthop 83:566–571CrossRefPubMedPubMedCentral
28.
Odak S, Ivory J (2013) Management of abductor mechanism deficiency following total hip replacement. Bone Joint J 95-B:343–347CrossRefPubMed
Metadata
Title
The focally constrained liner is a reasonable option for revision of unstable total hip arthroplasty
Authors
Tatu J. Mäkinen
Simcha G. Fichman
Wael A. Rahman
Tomas Amenabar
Oleg Safir
Allan E. Gross
Paul R. T. Kuzyk
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-3082-2

Other articles of this Issue 11/2016

International Orthopaedics 11/2016 Go to the issue

Original Paper

Treatment of displaced supracondylar humeral fractures in children by humero-ulnar external fixation

Original Paper

Local transplantation of bone marrow concentrated granulocytes precursors can cure without antibiotics infected nonunion of polytraumatic patients in absence of bone defect

Original Paper

Negative impact of waiting time for primary total knee arthroplasty on satisfaction and patient-reported outcome

Original Paper

Loss to follow-up in orthopaedic clinical trials: a systematic review

Original Paper

Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee

Original Paper

Leverage application on Gartland type IV supracondylar humeral fracture in children