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Polyethylene liner dissociation with the Pinnacle acetabular component: should we be concerned?
Adeel R Memon1, David Gwynne-Jones1
1Department of Trauma and Orthopaedics, Dunedin Hospital Dunedin, Dunedin, New Zealand.
Arthroplasty Today
|March 27, 2020
Summary
A concerning rate of polyethylene liner dissociation occurred in Pinnacle acetabular components after total hip arthroplasty. While revision surgery was successful, this failure mode warrants attention for hip implant safety.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- Total hip arthroplasty (THA) is a common procedure for hip joint restoration.
- The uncemented Pinnacle acetabular component with a polyethylene liner is widely used.
- Assessing long-term implant durability and failure modes is crucial for patient outcomes.
Observation:
- A total of 535 uncemented Pinnacle acetabular components were implanted between 2007 and 2018.
- Six patients (1.11%) experienced acute, atraumatic liner polyethylene dissociation.
- Failures occurred at a mean of 37 months post-implantation, with a wide range.
Findings:
- Radiological assessment showed acetabular components were within the safe zone for abduction and anteversion.
- One case involved posterior impingement due to femoral malalignment, potentially contributing to failure.
- All patients underwent successful head and liner exchange, with no subsequent failures.
Implications:
- The incidence of polyethylene liner dissociation with the Pinnacle acetabular component is a significant concern.
- Despite successful revision, the frequency of this failure mode necessitates further investigation into implant design or surgical technique.
- Continued monitoring and analysis of THA component performance are essential for improving patient safety and implant longevity.
