Constrained Acetabular Liners Implanted Simultaneously at the Time of Acetabular Revision Using Contemporary...

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Revision Arthroplasty

Background:

• Early acetabular component loosening can limit the use of constrained acetabular liners (CALs) during revision total hip arthroplasty (THA).
• Previous studies supported CAL use with porous tantalum shells and cemented liners.
• The efficacy of CALs with modern modular acetabular components remains uncertain.

Purpose of the Study:

• To evaluate the outcomes of using constrained acetabular liners (CALs) with contemporary revision acetabular components.
• To assess the rate of aseptic loosening and rerevision in such cases.

Main Methods:

• Retrospective review of 38 revision THAs using CALs with contemporary components and supplemental screw fixation.
• Data collected from 2000 to 2021, with a mean follow-up of 4 years.
• Analysis of survivorship, rerevision rates, and radiographic evidence of loosening.

Main Results:

• 5-year survivorship free from acetabular rerevision for aseptic loosening was 97%.
• Overall 5-year survivorship free from any acetabular rerevision was 94%.
• Only one acetabular component required rerevision for aseptic loosening; no radiographic loosening was observed in unrevised components.

Conclusions:

• Selective use of CALs with contemporary acetabular components and robust screw fixation demonstrates a low rate of aseptic loosening.
• This strategy is viable for acetabular revision when stable component insertion and fixation are achieved.
• CALs can be safely employed in revision THA to mitigate early loosening concerns.