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A constrained liner cemented into a secure cementless acetabular shell.

John J Callaghan1, Javad Parvizi, Clifford C Novak

  • 1Department of Orthopaedic Surgery, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA 52242, USA. john-callaghan@uiowa.edu

The Journal of Bone and Joint Surgery. American Volume
|October 7, 2004
PubMed
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Cementing constrained tripolar liners into existing cementless acetabular shells effectively treats total hip instability. This technique offers good short-term stability and durability for complex hip revision cases.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Reconstructive Surgery

Background:

  • Constrained acetabular components address recurrent instability after total hip arthroplasty (THA).
  • Cementing constrained liners into existing, stable cementless shells is a viable option for revision THA with instability.
  • This technique is particularly useful when a secure cementless acetabular shell is already in place.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of cementing a tripolar constrained liner into a well-fixed cementless acetabular shell.
  • To assess the effectiveness of this method in managing hip instability during revision surgery.
  • To determine the long-term success and potential complications of this specific constrained liner technique.

Main Methods:

Related Experiment Videos

  • A retrospective study involving 31 patients who underwent cementing of constrained liners into cementless acetabular shells between 1988 and 2000.
  • Patients were treated at three centers for either recurrent (16 hips) or intraoperative (15 hips) instability.
  • Evaluations included clinical assessment and radiographic analysis for shell loosening and osteolysis.

Main Results:

  • At an average follow-up of 3.9 years, 94% (29 of 31) of liners were securely fixed.
  • Two constrained liners failed: one due to cement separation, the other due to capturing mechanism fracture; both were successfully revised.
  • No acetabular components showed radiographic evidence of progressive loosening or osteolysis.

Conclusions:

  • Cementing a constrained tripolar liner into a secure, well-positioned cementless acetabular shell provides short-term stability and durability.
  • Meticulous attention to liner preparation, component sizing, and cementing technique is crucial for minimizing construct failure.
  • This method is a valuable option for managing challenging cases of total hip instability.