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Acetabular liner fixation by cement.

William A Jiranek1

  • 1Department of Orthopaedic Surgery, Medical College of Virginia/Virginia Commonwealth University, PO Box 980-694, Richmond, VA 23298, USA. wjiranek@hsc.vcu.edu

Clinical Orthopaedics and Related Research
|December 4, 2003
PubMed
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Fixing a new polyethylene (PE) liner with bone cement in well-fixed cementless acetabular shells offers a viable revision total hip arthroplasty (THA) option. This technique demonstrates high survival rates and reduces surgical morbidity.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Revision Arthroplasty

Background:

  • Revision total hip arthroplasty (THA) often necessitates polyethylene (PE) liner exchange within well-fixed cementless acetabular shells.
  • Challenges include liner unavailability, damaged locking mechanisms, or shell malposition, leading to significant morbidity during shell revision.
  • This scenario prompts investigation into alternative methods for liner fixation.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of fixing a new PE liner using bone cement within an existing cementless acetabular shell.
  • To identify techniques that enhance outcomes and determine optimal patient selection for this procedure.

Main Methods:

  • Biomechanical testing assessed the initial fixation strength of cemented PE liners compared to conventional locking mechanisms.

Related Experiment Videos

  • Clinical case reviews analyzed long-term survival rates and identified critical factors for success.

    • Main Results:

    • Biomechanical tests indicated that cemented PE liners achieve fixation strengths exceeding conventional methods.
    • Clinical follow-up data up to 6 years show approximately 90% survival rates for cemented liners.
    • Successful outcomes are linked to meticulous patient selection, precise liner sizing, substrate preparation, and cement technique.

    Conclusions:

    • Cementing a new PE liner into a well-fixed cementless acetabular shell is a promising revision THA strategy.
    • This approach offers potential benefits including reduced surgical morbidity, faster recovery, antibiotic incorporation, and expanded liner choices.
    • Careful patient selection and surgical technique are paramount for achieving favorable long-term results.