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

Kyung-Jae Lee; Byung-Woo Min; Ki-Cheor Bae; Eun-Seok Son; Si-Wuk Lee; Seok-Jung Lee; Kyung-Hwan Lim

doi:10.4055/jkoa.2016.51.4.281

Journal List > J Korean Orthop Assoc > v.51(4) > 1013454

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Lee, Min, Bae, Son, Lee, Lee, and Lim: Revision Total Hip Arthroplasty with Constrained Liner in Patients with Abductor Insufficiency

Original Article

Journal of the Korean Orthopaedic Association 2016; 51(4): 281-286.

Published online: 11 August 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.4.281

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

Kyung-Jae Lee, M.D., Byung-Woo Min, M.D., Ki-Cheor Bae, M.D., Eun-Seok Son, M.D., Si-Wuk Lee, M.D., Seok-Jung Lee, M.D., Kyung-Hwan Lim, M.D.

Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.

Correspondence to: Kyung-Jae Lee, M.D. Department of Orthopedic Surgery, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea. TEL: +82-53-250-8161, FAX: +82-53-250-7205, oslee@dsmc.or.kr

Received 31 December 2015 Revised 5 February 2016 Accepted 12 February 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: abductor insufficiency, revision total hip arthroplasty, constrained liner

Figures and Tables

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.

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.

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).

Table 1

Correlation between Risk Factors and Failure of Constrained Liner

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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