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The focally constrained liner is a reasonable option for revision of unstable total hip arthroplasty

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Abstract

Purpose

Revision surgery for a patient with previous recurrent dislocations or abductor muscle dysfunction has been considered to be a complication-prone procedure regardless of the type of constrained implant used. We investigated the survivorship of a focally constrained acetabular liner used for revision total hip arthroplasty in patients with abductor insufficiency or previous recurrent dislocations.

Methods

We retrospectively reviewed 98 patients in whom a focally constrained acetabular liner was used to treat abductor insufficiency or previous recurrent dislocations. The mean age was 69.4 years (37–92) and 64 of these were females. Previously, the patients had undergone a mean of two (1–5) revisions. The mean follow-up was 38 (12–66) months. Kaplan-Meier survival curves were calculated and Log-rank test was used to test the difference in survivorship between patients with abductor insufficiency and previous dislocations.

Results

Sixteen patients needed a further re-revision for any cause. Thus, the revision-free survivorship was 84.3 % at five years. Five patients suffered a dislocation with a mean of five months post-operatively and were managed with repeat revision. Five patients failed at the implant-host bone interface. Three of these failures occurred after cementing the constrained liner into a pre-existing shell.

Conclusions

The focally constrained liner provided a reasonable option for revision total hip arthroplasty in patients with hip instability. Failures were observed in patients with acetabular osteolysis but seemingly well-fixed component and unrecognized impingement.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada

    Tatu J. Mäkinen, Simcha G. Fichman, Wael A. Rahman, Tomas Amenabar, Oleg Safir, Allan E. Gross & Paul R. T. Kuzyk

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  1. Tatu J. Mäkinen
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  2. Simcha G. Fichman
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  3. Wael A. Rahman
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  4. Tomas Amenabar
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  5. Oleg Safir
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  6. Allan E. Gross
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  7. Paul R. T. Kuzyk
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Correspondence to Tatu J. Mäkinen.

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Mäkinen, T.J., Fichman, S.G., Rahman, W.A. et al. The focally constrained liner is a reasonable option for revision of unstable total hip arthroplasty. International Orthopaedics (SICOT) 40, 2239–2245 (2016). https://doi.org/10.1007/s00264-015-3082-2

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  • DOI: https://doi.org/10.1007/s00264-015-3082-2

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