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The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation
T K Cobb1, B F Morrey, D M Ilstrup
1Mayo Clinic, Rochester, Minnesota 55905, USA.
The Journal of Bone and Joint Surgery. American Volume
|January 1, 1996
Summary
An elevated-rim acetabular liner in total hip arthroplasty significantly reduced dislocation rates within two years. Further study is needed to assess long-term effects on wear and loosening.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Postoperative stability is crucial for total hip prosthesis longevity.
- Elevated-rim acetabular components are theorized to enhance stability but lack definitive clinical evidence.
Purpose of the Study:
- To evaluate the clinical effectiveness of elevated-rim acetabular liners in reducing total hip arthroplasty dislocation.
- To compare dislocation rates between elevated-rim and standard acetabular liners.
Main Methods:
- Retrospective review of 5167 total hip arthroplasties (1985-1991).
- Comparison of 2469 elevated-rim liners versus 2698 standard liners.
- Kaplan-Meier survivorship analysis to estimate cumulative dislocation probability.
Main Results:
- The two-year dislocation probability was significantly lower for elevated-rim liners (2.19%) compared to standard liners (3.85%, p=0.001).
- Improved stability with elevated-rim liners was consistent across various surgical approaches, fixation methods, patient demographics, and arthroplasty types.
- A similar trend was observed at five years, though not statistically significant due to a smaller sample size.
Conclusions:
- Elevated-rim acetabular liners demonstrate improved short-term stability, significantly reducing dislocation risk in total hip arthroplasty.
- The findings are particularly relevant for high-risk hips prone to prosthetic dislocation.
- Long-term effects on wear and loosening associated with elevated-rim liners require further investigation.