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Acetabular wall augmentation in selected patients with recurrent dislocation after THA.

Einar Andreas Sivertsen1, Pål Oliver Borgen1

  • 1Department of Orthopedic Surgery, Martina Hansen Hospital, Pb 823, Sandvika, Norway.

The Journal of Arthroplasty
|July 24, 2014
PubMed
Summary

Polymethyl methacrylate (PMMA) augmentation effectively treats recurrent posterior dislocation in total hip arthroplasty patients. This simple procedure offers high long-term success rates and patient satisfaction, making it a viable option for elderly individuals.

Keywords:
complicationselderly patientship arthroplastyrecurrent dislocationstability

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science

Background:

  • Recurrent posterior dislocation is a complication of cemented total hip arthroplasty (THA).
  • Revision surgery for THA complications can be complex and invasive.

Purpose of the Study:

  • To evaluate the efficacy of polymethyl methacrylate (PMMA) augmentation of the acetabular wall for recurrent posterior dislocation in cemented THA.
  • To assess the long-term outcomes, including dislocation recurrence, prosthesis survival, and patient satisfaction.

Main Methods:

  • Retrospective review of 42 patients who underwent PMMA augmentation for recurrent posterior dislocation.
  • Analysis of subsequent dislocation events, revision procedures, prosthesis survival rates, and patient-reported outcomes (satisfaction, pain, infection).

Main Results:

  • 38 out of 42 patients (90.5%) remained dislocation-free post-procedure.
  • 1, 5, and 10-year dislocation-free survival rates were 95%, 95%, and 64%, respectively.
  • 90% of patients reported satisfaction; complications included pain (4 patients) and infection (3 patients).

Conclusions:

  • PMMA augmentation is a simple, effective, and less invasive treatment for recurrent posterior dislocation in cemented THA.
  • The procedure demonstrates good short- and mid-term prosthesis survival and high patient satisfaction.
  • Consideration of PMMA augmentation is recommended for elderly patients experiencing recurrent posterior dislocation after THA.