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Constrained liner

Scott S Kelley
No abstract text is available yet for this article.
February 2018: Clinical Orthopaedics and related Research
Brian P Chalmers, Graham D Pallante, Michael J Taunton, Rafael J Sierra, Robert T Trousdale
BACKGROUND: Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobility (DM) construct, but there are few data on this approach. QUESTIONS/PURPOSES: (1) What were the Harris hip scores in a small group of patients whose constrained liners were converted to DM constructs to treat recurrent dislocation? (2) What were the redislocation, rerevision, and DM construct retention rates in these patients? METHODS: We conducted a retrospective analysis of a longitudinally maintained institutional database maintained by individuals other than the treating surgeons to identify patients undergoing conversion of constrained liners to DM constructs in revision THA from 2011 to 2014...
February 2018: Clinical Orthopaedics and related Research
Stephen A Jones
BACKGROUND: Dislocation remains one of the most common complications after total hip arthroplasty. Constrained acetabular liners were developed to address the problem of recurrent instability. They have been in clinical use since the mid 1980s and function by capturing the femoral head. METHOD: The aim of this review is to highlight the mechanism of action, development, and advances in constrained liner design, together with an emphasis on the modes of failure and the authors' opinion on the current indications for the use of these implants...
March 7, 2018: Journal of Arthroplasty
Brian P Chalmers, Cameron K Ledford, Michael J Taunton, Rafael J Sierra, David G Lewallen, Robert T Trousdale
BACKGROUND: Recurrent instability remains a challenge after revision total hip arthroplasty (THA). We report the outcomes of cementing a cementless dual mobility (DM) component into a stable acetabular shell for the treatment and/or prevention of instability in revision THA. METHODS: Eighteen patients (18 THAs) undergoing revision THA with a specific monoblock DM construct cemented into a new acetabular component or an existing well-fixed component from 2011 to 2014 were retrospectively reviewed...
December 6, 2017: Journal of Arthroplasty
Vineet Tyagi, Oluwaseun Akinbo
INTRODUCTION: The concept of a dual mobility (DM) cup has been in existence for more than 40 years and was initially popularized in Europe. Only recently has it started to garner attention in the United States. Its design, consisting of a small femoral head articulating within a larger polyethylene (PE) insert, which articulates with an outer shell, has found increasing use in patients that are at risk for post-operative dislocations. This case report describes a case of recurrent total hip arthroplasty (THA) dislocation managed with the implantation of a DM cup with an acute intraprosthetic dislocation of the DM construct...
March 2017: Journal of Orthopaedic Case Reports
Grant H Young, Matthew P Abdel, Richard L Amendola, Devon D Goetz, David G Lewallen, John J Callaghan
BACKGROUND: The authors and others have previously described the technique of cementing constrained liners into secure cementless acetabular shells and reported the short-term, average 3.9-year follow-up, using that technique. The purpose of the present study was to report the minimum 15-year follow-up of this same cohort. METHODS: Between 1988 and 2000, 31 consecutive constrained liners of one design were cemented into well-fixed, well-positioned cementless acetabular shells at 3 institutions...
November 2017: Journal of Arthroplasty
José M Mirás-Avalos, Diego S Intrigliolo
Water stress and increasing soil salt concentration represent the most common abiotic constrains that exert a negative impact on Mediterranean vineyards performance. However, several studies have proven that deficit irrigation strategies are able to improve grape composition. In contrast, irrigation with saline waters negatively affected yield and grape composition, although the magnitude of these effects depended on the cultivar, rootstock, phenological stage when water was applied, as well as on the salt concentration in the irrigation water...
2017: Frontiers in Plant Science
Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Mark W Pagnano, Matthew P Abdel
BACKGROUND: Conversion of hemiarthroplasty to total hip arthroplasty (THA) has a historically high, up to 20%, postoperative dislocation rate. As such, dual-mobility (DM) constructs are an attractive option to mitigate this complication. We analyzed survivorship free of revision, complications, and clinical outcomes of hemiarthroplasties conversion to THAs utilizing DM constructs compared with large femoral heads (≥36 mm). METHODS: Conversion of 16 hemiarthroplasties to THAs with a specific DM construct compared with 13 conversions utilizing large femoral heads (≥36 mm) from 2011 to 2014 were reviewed...
May 12, 2017: Journal of Arthroplasty
Wael A Rahman, Hussain A Kazi, Jeffery D Gollish
AIM: To investigate success of one stage exchange with retention of fixed acetabular cup. METHODS: Fifteen patients treated by single stage acetabular component exchange with retention of well-fixed femoral component in infected total hip arthroplasty (THA) were retrospectively reviewed. Inclusion criteria were patients with painful chronic infected total hip. The patient had radiologically well fixed femoral components, absence of major soft tissue or bone defect compromising, and infecting organism was not poly or virulent micro-organism...
March 18, 2017: World Journal of Orthopedics
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
May 1, 2017: Orthopedics
A Viste, K I Perry, M J Taunton, A D Hanssen, M P Abdel
AIMS: Loss or absence of proximal femoral bone in revision total hip arthroplasty (THA) remains a significant challenge. While the main indication for the use of proximal femoral replacements (PFRs) is in the treatment of malignant disease, they have a valuable role in revision THA for loosening, fracture and infection in patients with bone loss. Our aim was to determine the clinical outcomes, implant survivorship, and complications of PFRs used in revision THA for indications other than malignancy...
March 2017: Bone & Joint Journal
Krista A Goulding, Adam Schwartz, Steven J Hattrup, R Lor Randall, Donald Lee, Damian M Rispoli, Daniel M Lerman, Christopher Beauchamp
BACKGROUND: Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. QUESTIONS/PURPOSES: (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? METHODS: A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant® Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna...
June 2017: Clinical Orthopaedics and related Research
Deren T Bagsby, L Daniel Wurtz
BACKGROUND: Patients with destructive acetabular lesions are at high risk for morbidity. Harrington described reinforcing acetabular diseased bone with methylmethacrylate, supplemented by metal fixation, to allow total hip reconstruction. However, all published studies using this technique report dislocations. We believe that initial use of constrained liners would help alleviate dislocation risk, without increasing component loosening or polyethylene wear. METHODS: Sixty-eight patients who underwent Harrington hip arthroplasties for metastatic cancer from August 2005 to March 2015 were identified...
April 2017: Journal of Arthroplasty
Luigi Zagra, Eleonora Caboni
Dual mobility cups are getting increasing interest for the prevention, but also in the treatment of THA instability. Nevertheless when a dislocation occurs the main issue remains the knowledge and the correction of the causes of dislocation, including reorientation of the components and soft tissues treatment. There are several options of alternative implants to DMCs including upsizing of the head, and constrained liners. The Authors present how to evaluate patients with THA instability, the advantages and the disadvantages of each procedure and their experience in the treatment of cases without DMCs during a five years' time period...
March 2017: International Orthopaedics
A J Harvey-Thompson, A B Sefkow, M S Wei, T Nagayama, E M Campbell, B E Blue, R F Heeter, J M Koning, K J Peterson, A Schmitt
We report experimental results and simulations showing efficient laser energy coupling into plasmas at conditions relevant to the magnetized liner inertial fusion (MagLIF) concept. In MagLIF, to limit convergence and increase the hydrodynamic stability of the implosion, the fuel must be efficiently preheated. To determine the efficiency and physics of preheating by a laser, an Ar plasma with n_{e}/n_{crit}∼0.04 is irradiated by a multi-ns, multi-kJ, 0.35-μm, phase-plate-smoothed laser at spot-averaged intensities ranging from 1...
November 2016: Physical Review. E
Mustafa Yassin, Avraham Garti, Muhammad Khatib, Moshe Weisbrot, Dror Robinson
OBJECTIVE: To evaluate the efficacy of the use of retentive cup primary total hip replacement (THR) in high-dislocation risk subcapital fracture patients. METHODS: During the years 2008 to 2012, 354 patients with displaced subcapital fracture were operated at our institute. The patients were selected to undergo primary constrained THR according to the following criteria: (1) a preinjury grade 4 or more on the Functional Independence Measure mobility item "5...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Kathryn Gill, Sarah L Whitehouse, Matthew J W Hubble, Matthew J Wilson
BACKGROUND: Dislocation following primary total hip arthroplasty (THA) is a complication with an incidence of 2%-5%. This study examines the clinical and radiological outcome of a constrained acetabular implant used in primary THA in high-risk patients to prevent dislocation. METHODS: 54 patients with 55 constrained implants for primary THA were reviewed clinically and radiologically. Oxford, Harris Hip and Charlson scores were recorded. RESULTS: 54 patients, with an average age of 83...
November 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
M Karvonen, H Karvonen, M Seppänen, A Liukas, M Koivisto, K T Mäkelä
BACKGROUND AND PURPOSE: Dislocation is one of the most common complications following total hip arthroplasty. The aim of our study was to assess failure rate of the Biomet Freedom constrained liner (Biomet, Warsaw, IN, USA) either in revision surgery for recurrent dislocation, or as a preventive method in high dislocation risk patients. PATIENTS AND METHODS: We assessed retrospectively 105 consecutive surgical procedures in 103 patients where a Freedom constrained liner or cup was used in Turku University Hospital over a 7-year period from 2007 to 2014...
July 25, 2016: Scandinavian Journal of Surgery: SJS
Wael A Rahman, Tomás Amenábar, Bandar M Hetaimish, Oleg A Safir, Paul R Kuzyk, Allan E Gross
BACKGROUND: This is a retrospective review of the functional outcomes and complications of revision total hip arthroplasty (THA) of failed metal-on-metal (MoM) hip arthroplasty. METHODS: A total of 20 revision THAs were performed in 19 patients. Of them, 2 cases were failed hip resurfacing, and 18 cases were failed (MoM) THA. The mean age at revision (THA) was 59.35 years (standard deviation [SD] 9.83). RESULTS: The mean follow-up was 45 months (SD 13...
November 2016: Journal of Arthroplasty
William G Hamilton
No abstract text is available yet for this article.
October 2016: Clinical Orthopaedics and related Research
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