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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) radiograph demonstrating slight notching in a total hip arthroplasty femoral component neck in a patient that reported clicking. B) Lowenstein lateral radiograph of the same patient, demonstrating neck-ring contact.
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fig003: Anteroposterior (A) radiograph demonstrating slight notching in a total hip arthroplasty femoral component neck in a patient that reported clicking. B) Lowenstein lateral radiograph of the same patient, demonstrating neck-ring contact.

Mentions: The increased ROM gained from the recessed areas of the constrained liner likely further decreases impingement, resulting in decreased interfacial stresses and lever-out phenomenon experienced by the implant.25 The ability to use larger heads also provides a favorable head to neck ratio and increases the jump distance to further decrease the likelihood of significant impingement or dislocation.26 The rate of positional hip clicking in this study was 10.4%. That could feasibly represent impingement of the neck on the constraining liner (Figure 3). This is quite similar to the 9.8% rate of dislocation using the same stem design with unconstrained cups.27,28 Patients in the current series with occasional positional clicking remain pain free without compromise in the function of their arthroplasties.


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) radiograph demonstrating slight notching in a total hip arthroplasty femoral component neck in a patient that reported clicking. B) Lowenstein lateral radiograph of the same patient, demonstrating neck-ring contact.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig003: Anteroposterior (A) radiograph demonstrating slight notching in a total hip arthroplasty femoral component neck in a patient that reported clicking. B) Lowenstein lateral radiograph of the same patient, demonstrating neck-ring contact.
Mentions: The increased ROM gained from the recessed areas of the constrained liner likely further decreases impingement, resulting in decreased interfacial stresses and lever-out phenomenon experienced by the implant.25 The ability to use larger heads also provides a favorable head to neck ratio and increases the jump distance to further decrease the likelihood of significant impingement or dislocation.26 The rate of positional hip clicking in this study was 10.4%. That could feasibly represent impingement of the neck on the constraining liner (Figure 3). This is quite similar to the 9.8% rate of dislocation using the same stem design with unconstrained cups.27,28 Patients in the current series with occasional positional clicking remain pain free without compromise in the function of their arthroplasties.

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