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Shell retention with a cemented acetabular liner.

John J Callaghan1, Steve S Liu, Nathan M Schularick

  • 1University of Iowa Health Center, 200 Hawkins Drive, Iowa City, IA 52242, USA.

Orthopedics
|September 16, 2009
PubMed
Summary
This summary is machine-generated.

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Cementing an acetabular liner into a well-fixed cementless shell is a viable option for worn liners or unstable total hip arthroplasty. Nonconstrained liners demonstrated a lower failure rate than constrained liners in this study.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering

Background:

  • Total hip arthroplasty (THA) revision surgery often involves addressing worn acetabular liners.
  • Cementless acetabular shells, once well-fixed, present a unique challenge for liner replacement.

Purpose of the Study:

  • To evaluate the indications, surgical technique, and outcomes of cementing a new acetabular liner into a pre-existing, well-fixed cementless acetabular shell.
  • To compare the failure rates of constrained versus nonconstrained liners when cemented into a cementless shell.

Main Methods:

  • A review of cases involving cementing acetabular liners into well-fixed cementless shells was conducted.
  • Specific preparation techniques for the acetabular shell (scoring if no screw holes) and liner (spiderweb and circular scoring) were detailed.
  • The study analyzed outcomes for 31 constrained and 30 nonconstrained liners.

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Main Results:

  • The overall failure rate for cemented constrained liners was 6%.
  • No failures were observed in the cemented nonconstrained liner group.
  • One dislocation occurred in the nonconstrained group, managed with bracing for 6 weeks.

Conclusions:

  • Cementing an acetabular liner into a well-fixed cementless shell is a feasible salvage procedure for worn liners or unstable THA constructs.
  • Nonconstrained liners appear to offer a lower failure rate compared to constrained liners in this specific application.
  • This technique requires adequate shell diameter to ensure a sufficient cement mantle (2 mm).