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Published on: September 7, 2022
Failure of cement-in-shell acetabular liner exchange
Caroline M Blakey1, Leela C Biant, Thomas G Kavanagh
1Research and Education Department, South West London Elective Orthopaedic Centre, Epsom Hospital, Dorking Road, Epsom, KT18 7EG,UK. cblakey4121@hotmail.com
Summary
Cement-in-shell liner exchange in total hip arthroplasty can fail due to dissociation at the cement-liner interface. This complication occurred three years post-surgery without prior radiographic signs.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Arthroplasty Research
Background:
- Revision surgery for total hip arthroplasty (THA) with polyethylene wear often requires addressing the acetabular component.
- Cement-in-shell acetabular liner exchange offers an alternative to full acetabular shell revision when direct liner exchange is not feasible.
- This technique involves cementing a new liner into a stable, uncemented acetabular shell, aiming to reduce surgical morbidity.
Observation:
- A case of acetabular liner dissociation at the cement-liner interface is presented.
- This complication occurred three years after a cement-in-shell liner exchange procedure.
- Pre-operative radiographic evaluation did not reveal any signs indicative of impending failure.
Findings:
- The study highlights a rare complication of cement-in-shell acetabular liner exchange: dissociation at the cement-liner interface.
- The dissociation occurred despite a well-fixed uncemented acetabular shell.
- Diagnosis was challenging due to the absence of typical radiographic indicators.
Implications:
- This case underscores the potential for late failure in cement-in-shell liner exchange, even without radiographic warning.
- It suggests a need for heightened clinical suspicion and potentially advanced diagnostic modalities for early detection.
- Further research into the long-term stability and failure mechanisms of cement-in-shell interfaces is warranted for improving revision THA outcomes.
