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The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
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Constrained Liner Revision Is Less Effective With Each Subsequent Constrained Liner Revision at Preventing
Nicholas M Hernandez1, Rafael J Sierra1, Robert T Trousdale1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
The Journal of Arthroplasty
|February 19, 2019
Summary
Revision to a second or third constrained liner after total hip arthroplasty has a high mechanical failure rate. Surgeons should carefully consider re-revision with constrained liners due to poor survivorship outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Materials Science
Background:
- Constrained liners are utilized for recurrent total hip arthroplasty dislocations.
- Limited data exists on the long-term outcomes of revision constrained liners.
- This study investigates the mechanical failure rates of sequential constrained liner revisions.
Purpose of the Study:
- To evaluate the revision rate for mechanical failure of first, second, and third constrained liners.
- To determine the survivorship of constrained liners after revision surgery.
- To identify risk factors associated with mechanical failure in revision constrained liners.
Main Methods:
- Retrospective review of 554 first, 40 second, and 13 third constrained liner revisions from 1989-2016.
- Analysis of mechanical failures requiring revision surgery.
- Minimum 2-year follow-up with a mean of 5.5 years.
Main Results:
- Four-year survivorship free of mechanical failure was 90% for first, 52% for second, and 28% for third constrained liners.
- Second (OR 8) and third (OR 10) constrained liners showed significantly higher odds of mechanical failure.
- Using a different constrained liner did not reduce the risk of failure.
Conclusions:
- Revision to a second or third constrained liner is associated with a high incidence of mechanical failure.
- Caution is advised when considering further constrained liner revisions for unstable total hip arthroplasty.
- Alternative strategies may be necessary for managing instability after constrained liner failure.
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