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Polyethylene liner dissociation in a DePuy pinnacle cup with a manufacturer analysis of the failed component
David Keohane1, Gerard A Sheridan2, James Harty2
1Orthopaedics, Cork University Hospital Group, Cork, Munster, Ireland doctorkeohane@gmail.com.
Insights
A patient experienced hip pain due to a failed polyethylene liner in her total hip arthroplasty (THA). Revision surgery was necessary, but the root cause of liner dissociation remains unidentified.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- Total hip arthroplasty (THA) is a common procedure for hip arthritis.
- Polyethylene liners are crucial components in THA, designed for durability and low friction.
- Failures in THA components can lead to revision surgery and patient morbidity.
Abstract:
A 74-year-old patient presented to the emergency department with acute atraumatic hip pain 9 years after her primary left total hip arthroplasty (THA). Plain radiographic imaging demonstrated lateralisation of the femoral head within the acetabular shell-indicating an issue with the polyethylene liner. The patient required revision of the acetabular component and the femoral head, as well as a new polyethylene liner. A detailed analysis of the components removed was performed by DePuy Synthes Engineering. Between 2009 and 2020, 8 publications have documented 52 cases of liner dissociation with the Pinnacle acetabular component and Marathon polyethylene liner. Various theories have been proposed in the literature as all of these components appear to fail in the same way, with shearing of the locking tabs in the polyethylene liner. In spite of a manufacturer analysis of the components, no root cause was identified as to why the polyethylene liner failed.
