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Short-Term Results of Novel Constrained Total Hip Arthroplasty.

Pace T, Finley S, Snider R, Looper J, Tanner S - Orthop Rev (Pavia) (2015)

Bottom Line: One patient showed radiographic evidence of 1 mm polyethylene wear.Harris Hip Scores improved from a mean of 68.8 (range 58-87) preoperatively to 98.9 (range 65-100) at final clinical assessment.This constrained acetabular prosthesis had a dislocation rate of less than 2%, with 0% component failure rate at a minimum of 2 years of follow-up suggesting this prosthesis may be a viable alternative for patients at risk for instability or those known to have recurrent instability.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Greenville Health System , SC, USA ; University of South Carolina School of Medicine , West Columbia, SC, USA.

ABSTRACT
Constrained acetabular components have only been recommended as a salvage option for the persistently unstable total hip arthroplasty (THA), due to limited range of motion and less than satisfactory component failure rates. This is a retrospective review of 137 patients with 154 consecutive primary constrained THAs performed between November 2003 and August 2007. We reviewed serial radiographs, postoperative complications, groin/thigh pain, and compared preoperative and postoperative Harris Hip Scores. With a mean follow-up of 6 years, there was 1.9% dislocation rate, 0% component failure rate, and 2.6% infection rate. Seven patients reported continued groin pain, and three had continued thigh pain. One patient showed radiographic evidence of 1 mm polyethylene wear. Radiographic review showed no evidence of osteolysis or stem subsidence. Harris Hip Scores improved from a mean of 68.8 (range 58-87) preoperatively to 98.9 (range 65-100) at final clinical assessment. This constrained acetabular prosthesis had a dislocation rate of less than 2%, with 0% component failure rate at a minimum of 2 years of follow-up suggesting this prosthesis may be a viable alternative for patients at risk for instability or those known to have recurrent instability.

No MeSH data available.


Related in: MedlinePlus

Anteroposterior (A) and lateral (B) radiographs demonstrating good bony ingrowth at calcar without evidence of osteolysis or loosening at 6 years follow up.
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fig002: Anteroposterior (A) and lateral (B) radiographs demonstrating good bony ingrowth at calcar without evidence of osteolysis or loosening at 6 years follow up.

Mentions: The short-term results in the current study are very promising with four dislocations (2.6%). One required revision surgery due to recurrent dislocations. The other three dislocations (1.9%) were closed reduced without subsequent instability. This is of interest as there are no reported or confirmed cases of closed reduction as previously described using a different constrained implant design18 of this implant found during the course of this literature search. The hip remained stable after closed reduction, indicating that the constraining mechanism was not sufficiently damaged to require imminent revision as recommended by Harman and Robertson.21,22 Furthermore, of the 154 implants, there were no revisions secondary to component failure. There is no radiographic evidence of aseptic cup loosening or osteolysis during early follow-up (Figure 2). This is clinically significant as the literature suggests the majority of constrained cup failures occur within two to three years of implantation. The use of highly cross-linked UHMWPE is an improvement over conventional UHMWPE with polywear and osteolysis.23,24 The favorable wear characteristics of highly cross-linked UHMWPE with larger heads make prosthetic longevity a more biomechanically feasible expectation.24


Short-Term Results of Novel Constrained Total Hip Arthroplasty.

Pace T, Finley S, Snider R, Looper J, Tanner S - Orthop Rev (Pavia) (2015)

Anteroposterior (A) and lateral (B) radiographs demonstrating good bony ingrowth at calcar without evidence of osteolysis or loosening at 6 years follow up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508557&req=5

fig002: Anteroposterior (A) and lateral (B) radiographs demonstrating good bony ingrowth at calcar without evidence of osteolysis or loosening at 6 years follow up.
Mentions: The short-term results in the current study are very promising with four dislocations (2.6%). One required revision surgery due to recurrent dislocations. The other three dislocations (1.9%) were closed reduced without subsequent instability. This is of interest as there are no reported or confirmed cases of closed reduction as previously described using a different constrained implant design18 of this implant found during the course of this literature search. The hip remained stable after closed reduction, indicating that the constraining mechanism was not sufficiently damaged to require imminent revision as recommended by Harman and Robertson.21,22 Furthermore, of the 154 implants, there were no revisions secondary to component failure. There is no radiographic evidence of aseptic cup loosening or osteolysis during early follow-up (Figure 2). This is clinically significant as the literature suggests the majority of constrained cup failures occur within two to three years of implantation. The use of highly cross-linked UHMWPE is an improvement over conventional UHMWPE with polywear and osteolysis.23,24 The favorable wear characteristics of highly cross-linked UHMWPE with larger heads make prosthetic longevity a more biomechanically feasible expectation.24

Bottom Line: One patient showed radiographic evidence of 1 mm polyethylene wear.Harris Hip Scores improved from a mean of 68.8 (range 58-87) preoperatively to 98.9 (range 65-100) at final clinical assessment.This constrained acetabular prosthesis had a dislocation rate of less than 2%, with 0% component failure rate at a minimum of 2 years of follow-up suggesting this prosthesis may be a viable alternative for patients at risk for instability or those known to have recurrent instability.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Greenville Health System , SC, USA ; University of South Carolina School of Medicine , West Columbia, SC, USA.

ABSTRACT
Constrained acetabular components have only been recommended as a salvage option for the persistently unstable total hip arthroplasty (THA), due to limited range of motion and less than satisfactory component failure rates. This is a retrospective review of 137 patients with 154 consecutive primary constrained THAs performed between November 2003 and August 2007. We reviewed serial radiographs, postoperative complications, groin/thigh pain, and compared preoperative and postoperative Harris Hip Scores. With a mean follow-up of 6 years, there was 1.9% dislocation rate, 0% component failure rate, and 2.6% infection rate. Seven patients reported continued groin pain, and three had continued thigh pain. One patient showed radiographic evidence of 1 mm polyethylene wear. Radiographic review showed no evidence of osteolysis or stem subsidence. Harris Hip Scores improved from a mean of 68.8 (range 58-87) preoperatively to 98.9 (range 65-100) at final clinical assessment. This constrained acetabular prosthesis had a dislocation rate of less than 2%, with 0% component failure rate at a minimum of 2 years of follow-up suggesting this prosthesis may be a viable alternative for patients at risk for instability or those known to have recurrent instability.

No MeSH data available.


Related in: MedlinePlus