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Constrained liner

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...
October 8, 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...
May 6, 2016: Journal of Arthroplasty
William G Hamilton
No abstract text is available yet for this article.
October 2016: Clinical Orthopaedics and related Research
J R Donaldson, F Tudor, J Gollish
AIMS: The aim of this study was to examine the results of revision total knee arthroplasty (TKA) undertaken for stiffness in the absence of sepsis or loosening. PATIENTS AND METHODS: We present the results of revision surgery for stiff TKA in 48 cases (35 (72.9%) women and 13 (27.1%) men). The mean age at revision surgery was 65.5 years (42 to 83). All surgeries were performed by a single surgeon. Stiffness was defined as an arc of flexion of < 70° or a flexion contracture of > 15°...
May 2016: Bone & Joint Journal
Roman C Stedman, Daniel Lim, Adeel Husain, Paul M Courtney, Charles L Nelson
PURPOSE: Dislocation is the most frequent complication following revision total hip arthroplasty (THA). Although several risk factors for dislocation in revision THA have been described, many cannot be modified at the time of surgery. Identifying modifiable risk factors for subsequent dislocation after revision THA provides opportunity for orthopedic surgeons to decrease instability. METHODS: A retrospective analysis of 203 consecutive revision THA procedures performed by a single surgeon with a minimum 2-year follow-up between May 2003 and June 2012 was performed...
May 16, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Philippe Hernigou, Matthieu Trousselier, François Roubineau, Charlie Bouthors, Charles Henri Flouzat Lachaniette
BACKGROUND: Obesity is associated with an increased risk of dislocation after total hip arthroplasty (THA). However, in patients with obesity, it is not known whether the risk is only in the early postoperative period or whether it persists several years after surgery, and whether having bariatric surgery before undergoing THA and/or receiving a specific device (such as a dual-mobility or constrained acetabular liner) is more effective in terms of decreasing the risk of dislocation. QUESTION/PURPOSES: (1) What is the cumulative risk of dislocation in patients with obesity after THA in the absence of a dual-mobility or constrained liner, and is this related to component positioning? (2) Does bariatric surgery before undergoing THA decrease dislocation risk in patients with obesity? (3) Are dual-mobility and constrained liners efficient in preventing dislocation in patients with obesity? METHODS: At our university-based practice, all surgeons adhered to the following treatment approaches: Before 2000 no dual-mobility implants or constrained liners were used for primary THAs...
October 2016: Clinical Orthopaedics and related Research
Darren R Plummer, Jonathan M Christy, Scott M Sporer, Wayne G Paprosky, Craig J Della Valle
BACKGROUND: The purpose of this study was to evaluate the performance of dual-mobility articulations in patients at high risk for dislocation after revision total hip arthroplasty. METHODS: We reviewed the results of 36 consecutive revision total hip arthroplasties performed on patients considered high risk for instability. Indications for inclusion included abductor insufficiency, recurrent instability, failure of constrained liner, or inadequate intraoperative stability when trialing...
September 2016: Journal of Arthroplasty
Peter K Sculco, Matthew S Austin, Carlos J Lavernia, Aaron G Rosenberg, Rafael J Sierra
Restoration of equal leg lengths and dynamic hip stability are essential elements of a successful total hip arthroplasty. A careful clinical examination, a preoperative plan, and appropriate intraoperative techniques are necessary to achieve these goals. Preoperative identification of patients at risk for residual leg length discrepancy allows surgeons to adjust the surgical approach and/or the type of implant and provide better preoperative patient education. The use of larger femoral heads, high-offset stem options, and enhanced soft-tissue repairs have improved impingement-free range of motion as well as dynamic hip stability and have contributed to an overall reduction in dislocation...
2016: Instructional Course Lectures
Arnaud Clavé, David Maurer, Ludovic Tristan, Frederic Dubrana, Christian Lefèvre, Hemant Pandit
BACKGROUND: Constrained liners are used as part of a salvage procedure to provide stability for patients at high risk for dislocation after a total hip arthroplasty. However, no recent studies exist highlighting their effectiveness and/or limitations. METHOD: This prospective review included 166 consecutive hip arthroplasties, either primary (27%) or revision (73%), with a unique design of a constrained liner: Lefèvre retentive cup. There were 113 females (69%), and the average age at index surgery was 75...
September 2016: Journal of Arthroplasty
Francisco Ferrero Manzanal, Antonio Murcia Asensio, Raquel Lax Pérez, José Eduardo Gil Gómez, Mariano Fernández Fairén
Constrained liners are a salvage procedure for treating or preventing recurrent dislocations. The Longevity® constrained liner (Zimmer) has a special design with cut-outs on its circumference for avoiding impingement in certain areas and a metallic constraining ring that has to be impacted. The ring impaction may be technical demanding. We recommend preassembly with the head component prior to seating into the acetabular cup, thus avoiding the soft tissue or cement interference and malposition due to bad angle of incidence of impaction force...
March 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Brian P Chalmers, Diren Arsoy, Rafael J Sierra, David G Lewallen, Robert T Trousdale
BACKGROUND: Addressing recurrent instability in patients with poor bone stock and inadequate abductor tensioning remains a challenge in revision total hip arthroplasty. One treatment method is implantation of a constrained liner. The purpose of this study was to determine clinical outcomes, redislocation rate, and revisions of a focally constrained liner in a high-risk patient cohort. METHODS: Fifty-eight hips between 2008 and 2011 underwent implantation of a focally constrained liner...
September 2016: Journal of Arthroplasty
Hee-Nee Pang, Hamid Rahmatullah Bin Abd Razak, Paul Jamiecson, Matthew G Teeter, Douglas D R Naudie, Steven J MacDonald
BACKGROUND: Wear in posterior-stabilized (PS) polyethylene tibial inserts depends on component position, limb alignment, and ligament balancing. Valgus-varus constrained (VVC) inserts are likely to be affected similarly. We aimed to compare wear characteristics of VVC and PS inserts and identify associated factors. METHODS: This was a retrieval analysis (macroscopic and radiographic) of all 18 VVC liners collected from patients who underwent revision surgery from 1999 to 2011...
June 2016: Journal of Arthroplasty
Simcha G Fichman, Tatu J Mäkinen, Alex Vincent, Benjamin Lozano, Oleg Safir, Paul R T Kuzyk
PURPOSE: Conversion of hip hemiarthroplasty to total hip arthroplasty (CTHA) is a complication-prone procedure with high dislocation rates and early component loosening. The purpose of this study was to evaluate the complications of CTHA performed using contemporary implants. METHODS: Forty-six patients who had CTHA were retrospectively matched to a control group of 46 patients who had a first-time THA revision. The mean follow-up was 47 (range 6-149) and 23 (range 6-139) months for CTHA and control groups, respectively...
December 2015: International Orthopaedics
Simon J Harrison, Daniel J Leeder, Timothy G McWilliams, Robert W Metcalf, Sameh A Sidhom
INTRODUCTION: Constrained acetabular inserts are designed as revision solutions for unstable total hip arthroplasties to prevent dislocation and as a possible primary option for elderly patients at risk of recurrent dislocation. PURPOSE: Our aim was to establish clinical and radiological outcomes of an 'all-poly' constrained acetabular device and to highlight reasons for component failure. METHODS: We retrospectively reviewed our use of the Stryker® Trident 'all-poly' constrained acetabular insert between 2008 and 2013...
November 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Shannon Carpenter, Daphne Pinkas, Michael D Newton, Michael D Kurdziel, Kevin C Baker, J Michael Wiater
BACKGROUND: Although short-term outcomes of reverse total shoulder arthroplasty (rTSA) remain promising, the most commonly cited complication remains prosthetic instability. A retentive rTSA liner is commonly used to increase system constraint; however, no studies have evaluated the rate of polyethylene wear. Our hypothesis was that more constrained retentive liners would have higher wear rates than nonretentive liners. METHODS: Six nonretentive and six retentive rTSA non-cross-linked polyethylene liners were subjected to 4...
September 2015: Journal of Shoulder and Elbow Surgery
Suenghwan Jo, Jose H Jimenez Almonte, Rafael J Sierra
A retrospective analysis was conducted on 539 hips undergoing revision total hip arthroplasty done for instability to report the cumulative risk and factors associated with re-dislocation and re-revision. The cumulative risk of re-dislocation and re-revision for all cause was 34.5% and 45.9% at 15 years, respectively. Multiple variable analyses revealed history of 2 or more previous surgeries, use of head size less than 36 mm, and cup retention to be risk factors for re-dislocation and re-revision. The use of a constrained liner was protective against re-dislocation but was not associated with a lower re-revision rate...
July 2015: Journal of Arthroplasty
Long-Co L Nguyen, Mandeep S Lehil, Kevin J Bozic
The incidence of total knee arthroplasty (TKA) has increased alongside our knowledge of knee physiology, kinematics, and technology resulting in an evolution of TKA implants. This study examines the trends in TKA implant utilization. Data was extracted from The Orthopedic Research Network to evaluate trends in level of constraint, fixed vs. mobile bearing, fixation, and type of polyethylene in primary TKAs. In 2012, 88% used cemented femoral and tibial implants, and 96% involved patellar resurfacing. 38% of implants were cruciate retaining, 53% posterior stabilized or condylar stabilized, 3% constrained...
May 2015: Journal of Arthroplasty
Jia Li, Wei Zheng, Jinzhu Zhao, Denghui Liu, Weidong Xu
BACKGROUND: Patients with Parkinson's disease and poliomyelitis can have a femoral neck fracture; yet, the optimal methods of treatment for these hips remains controversial. Many constrained or semi-constrained prostheses, using constrained liners (CLs) with a locking mechanism to capture the femoral head, were used to treat femoral neck fractures in patients with neurological disorders. We retrospectively studied a group of patients with Parkinson's disease and poliomyelitis who sustained femoral neck fractures and were treated by total hip arthroplasty using an L-MoM prosthesis...
November 2014: Indian Journal of Orthopaedics
N L Vasukutty, R G Middleton, P Young, C Uzoigwe, B Barkham, S Yusoff, T H A Minhas
INTRODUCTION: Dislocation following total hip replacement continues to be a problem for which no completely satisfactory solution has been found. Several methods have been proposed to reduce the incidence of hip dislocations with varying degrees of success, including elevated rim liners, constrained liners and large diameter bearings. We present our experience with the double mobility acetabular component in patients at high risk of instability. METHODS: This was a retrospective review of 65 primary total hip arthroplasties in 55 patients (15 men, 40 women), performed between October 2005 and November 2009...
November 2014: Annals of the Royal College of Surgeons of England
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