J Korean Orthop Assoc.  2016 Aug;51(4):281-286. 10.4055/jkoa.2016.51.4.281.

Revision Total Hip Arthroplasty with Constrained Liner in Patients with Abductor Insufficiency

• Lee KJ
• Min BW
• Bae KC
• Son ES
• Lee SW
• Lee SJ
• Lim KH

• KMID: 2348633
• DOI: http://doi.org/10.4055/jkoa.2016.51.4.281

Abstract

PURPOSE
The purpose of this study was to evaluate clinical and radiographic results of revision total hip arthroplasty with constrained liner in patients with abductor insufficiency.
MATERIALS AND METHODS
In this study, 30 patients treated with constrained liner during revision total hip arthroplasty due to abductor insufficiency were evaluated after minimum 2-year follow-up. There were 14 men and 16 women and the mean follow-up period was 4.6 years. Re-dislocation and aseptic loosening of the implant were defined as a failure of the constrained liner. Harris hip score and ambulatory function were evaluated as a clinical parameter and osteolysis, aseptic loosening of the implant and other complications were evaluated as a radiologic parameter.
RESULTS
During the follow-up period, there were 4 cases (13.3%) of constrained liner failure including two cases of re-dislocation and two cases of acetabular cup aseptic loosening. The average Harris hip score was improved from 38.3 points preoperatively to 73.4 points at last follow up. At the final follow-up, there were 20 cases (66.7%) of improvement in ambulatory function. There was 1 case of infection and 1 case of periprosthetic fracture.
CONCLUSION
Use of a constrained liner during revision total hip arthroplasty showed satisfactory results for prevention of re-dislocation in patients with abductor insufficiency. However longer term studies on loosening of implants are needed.

Keyword

abductor insufficiency; revision total hip arthroplasty; constrained liner

MeSH Terms

Acetabulum
Arthroplasty, Replacement, Hip*
Female
Follow-Up Studies
Hip
Humans
Male
Osteolysis
Periprosthetic Fractures

Figure

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  Figure 1 (A) Radiograph of a 68-year-old male shows dislocation of the right hip. He underwent two operations on the same hip and 10 times of dislocation after previous surgery. (B) During revision surgery a constrained liner was used due to abductor insufficiency (white arrow). (C) Radiograph obtained postoperative 3 years shows re-dislocation of the right hip.

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  Figure 2 (A) Postoperative radiograph of a 59-year-old male shows usage of a constrained liner during revision surgery. (B) Radiograph obtained postoperative 10 years shows a well maintained constrained liner without re-dislocation or aseptic loosening of the acetabular component.

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  Figure 3 (A) Postoperative radiograph of an 83-year-old female shows usage of a constrained liner during revision surgery. (B) Radiograph obtained postoperative 4 years shows dissociation of the locking ring without re-dislocation (white arrow).

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