Cementation of polyethylene liners into well-fixed metal shells at the time of revision total hip arthroplasty

Cementing polyethylene liners into well-fixed metal shells at revision total hip arthroplasty is an accepted technique. Previous studies have tested the initial strength of this construct, but none have tested the construct under physiologic and abnormal loading conditions. The current study examines liner-shell performance under these conditions. In addition, this study quantitates whether hand-modified regular liners or liners designed for cementation with integrated cement spacers, which provide an even cement mantle, perform better. Cyclic loads of up to 4000 N for 500,000 cycles followed by 2000 N for 200,000 cycles of edge loading were used. The liners with integrated spacers demonstrated higher lever-out moments and statistically significant increase in tear-out loads.