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Acetabular loosening using an extended offset polyethylene liner.

Michael J Archibeck1, Tamara Cummins, Daniel W Junick

  • 1New Mexico Center for Joint Replacement Surgery, New Mexico Orthopaedics, Albuquerque, NM 87106, USA. archibeckmj@nmortho.net

Clinical Orthopaedics and Related Research
|September 11, 2008
PubMed
Summary

Extended offset acetabular liners in total hip arthroplasty (THA) may increase aseptic loosening. This study found higher failure rates in primary and revision THAs using these components, suggesting potential fixation issues.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Extended offset femoral components and acetabular liners are used in hip arthroplasty to restore preoperative offset.
  • Offset polyethylene liners have been utilized to achieve this restoration.

Purpose of the Study:

  • To evaluate the aseptic loosening rate of acetabular components with extended offset liners in primary and revision total hip arthroplasty (THA).

Main Methods:

  • Retrospective review of 1919 primary and 346 revision THAs.
  • Analysis of aseptic loosening rates comparing standard offset and 7-mm extended offset acetabular liners.
  • Follow-up ranged from 2 to 9 years.

Main Results:

  • Primary THA: Aseptic loosening rate was 4.2% with extended offset liners versus 0.12% with standard offset.

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  • Revision THA: Aseptic loosening rate was 7% with extended offset liners versus 1.7% with standard offset.
  • A significantly higher aseptic loosening rate was observed in both primary and revision THAs using extended offset acetabular liners.

    • Conclusions:

    • Extended offset acetabular liners, while restoring hip offset, are associated with a relatively high rate of aseptic loosening.
    • Torsional forces at the implant-bone interface may negatively impact fixation when using offset liners.
    • The findings suggest a potential compromise in the long-term fixation of acetabular components with offset liners.