Purpose: Dissociation of the polyethylene liner is a known failure mechanism of the Harris Galante I and II uncemented acetabular components. The outcomes of revision surgery for this indication and the influence of time to diagnosis are not well described.
Methods: We report a series of 29 cases revised due to this failure mechanism. The median time from primary to revision surgery was 13 years.
Results: At a median of 4 years follow-up, the mean OHS was 34 (range 6-48) but results were poorer (mean 29; range 6-45) when the diagnosis and revision was delayed compared to when it was not (mean 39; range 20-48). A large proportion of our patients (n = 14) presented with sudden onset of symptoms with or without trauma. Osteolysis was common in this series but the cup was well fixed in 20/29 cases. There was macroscopic damage to the shell in all cases.
Conclusions: In our experience, prompt revision of liner dissociation optimises outcomes in this group of patients and radiology reporting alone is not sufficient to identify these cases.
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http://dx.doi.org/10.5301/hipint.5000316 | DOI Listing |
Arthroplast Today
December 2024
Orthopaedic Department, University of Ulm, Ulm, Germany.
Since the early 2000s, oxidized zirconium implants have emerged as a valuable option in total hip and knee arthroplasty due to their wear resistance and suitability for patients with metal hypersensitivity. The surface of these components is created through a heating and oxidation process of a zirconium alloy, resulting in a thin layer with favorable wear properties. However, there have been few reports of severe metallosis resulting from inadvertent wear of oxidized zirconium components through various mechanisms, including dissociation of the polyethylene liner and joint instability.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
October 2024
Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Background: The purpose of this study was to compare the outcomes of primary reverse total shoulder arthroplasty (rTSA) using constrained liners (in a 145° onlay implant, Equinoxe [Exactech]) with primary rTSA using standard liners with a minimum 1-year follow-up.
Methods: A total of 836 primary rTSA patients were analyzed in this study. Patients treated with constrained liners (n = 209) were cross-matched 1:3 for age, gender, glenosphere diameter, and follow-up duration and compared with 627 patients who underwent primary rTSA with standard liners.
J Arthroplasty
September 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: Ceramic-on-highly crosslinked polyethylene (HXLPE) has become the most common bearing surface utilized in primary total hip arthroplasty (THA). The purpose of this study was to determine the implant survivorship and clinical outcomes of THAs with ceramic-on-HXLPE in a large single-institutional series.
Methods: We identified 5,536 primary THAs performed from 2007 to 2017 using a ceramic-on-HXLPE bearing through our total joint registry.
J Orthop Traumatol
August 2024
Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany.
Background: Modular acetabular components for total hip arthroplasty (THA) provide intraoperative flexibility; however, polyethylene liner dissociation may occur. This study aimed to examine the incidence and causes of liner dissociation associated with a specific acetabular component design at a single centre.
Materials And Methods: A retrospective analysis of 7027 patients who underwent primary THA was performed to identify isolated liner dislocations.
Technol Health Care
September 2024
Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany.
Background: Uncemented acetabular components are widely used in modern total hip arthroplasty (THA). Modularity has numerous advantages including the ability to use supplementary screw fixation for the shell, and allow to switch from ceramic to polyethylene (PE) bearings and vice versa, and the use of lipped and face-changing liners.
Objective: Despite these advantages, a problem with modular PE liners is dissociation.
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