Outcome of Dual Mobility Constructs for Adverse Local Tissue Reaction Associated Abductor Deficiency in Revision Total Hip Arthroplasty

Klemt, Christian; Smith, Evan J.; Oganesyan, Ruben; Limmahakhun, Sakkadech; Fitz, David W.; Kwon, Young‐Min

doi:10.1016/j.arth.2020.06.043

Cited by 29 publications

(20 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are superior to the midterm follow-up results of CALs mentioned before. Additionally, Klemt et al recently reported using DM in 42 revision THAs with abductor de ciency caused by adverse local tissue reaction, and the average 4-year follow-up demonstrated that there was no dislocation, and the implant survival rate at the 3-year follow-up was 87% [5]. Overall, the current studies show that DM seems to have a promising application in dealing with hip instability.…”

Section: Discussionmentioning

confidence: 51%

“…In addition, large-diameter heads can lead to increased volumetric wear [3]. A previous study showed that DM acetabular components achieved satisfactory short-to mid-term results in the revision of THA with abductor de ciency [5]. However, long-term follow-up results of DM acetabular components used for revision THA with abductor de ciency are lacking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Constrained Acetabular Liners are a Viable Option in Second-Stage Re-Implantation for Chronic Infected Total Hip Arthroplasty with Abductor or Greater Trochanter Deficiency and Large Acetabular Bone Defects

Xiao

Ling

Zhou

et al. 2022

Preprint

View full text Add to dashboard Cite

Background Abductor mechanism deficiency is a clear indication for using constrained acetabular liners (CALs), and large acetabular bone defects are considered a relative contraindication to CALs. We report the results of using CALs in special cases in which abductor or greater trochanter deficiency was accompanied by large acetabular bone defects at second-stage re-implantation for chronic infected total hip arthroplasty (THA). Methods Between January 2010 and January 2018, 19 patients who used CALs at second-stage re-implantation and had abductor or greater trochanter deficiency and large acetabular bone defects were included in this study. We followed up with the clinical and radiological results of these patients. Complications and infection-related information were also recorded. Results Eight patients, 4 patients, and 7 patients had Paprosky type ⅡB, type ⅡC, and type ⅢA acetabular bone defects at second-stage re-implantation, respectively. The indication for using CALs was abductor deficiency in 14 patients and greater trochanter deficiency in the other 5 patients. The mean follow-up was 74.4 months (range 50–96). The mean Harris Hip Score (HHS) was 76.3 points (range 62–86) at the last follow-up. Three patients presented acetabular radiolucent lines with no progress: zone 3, zone 3 and zone 2 and 3, respectively. One patient suffered transient sciatic nerve palsy. There was no dislocation, failure of the CALs, reoperation, or recurrence of infection. Conclusion Our results suggested that for screened patients, CALs are a viable option in second-stage re-implantation for chronic infected THA with abductor or greater trochanter deficiency and large bone defects.

show abstract

Section: Discussionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Constrained Acetabular Liners are a Viable Option in Second-Stage Re-Implantation for Chronic Infected Total Hip Arthroplasty with Abductor or Greater Trochanter Deficiency and Large Acetabular Bone Defects

Xiao

Ling

Zhou

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A study by Klemt et al using DM in revision THA with associated abductor deficiency demonstrated significantly lower dislocation rates at 4 years follow-up with 0% dislocations compared with 15.5% and 4.1% in conventional liners and constrained liners, respectively. 47 Chalmers et al found that LDH implants were a viable salvage option for high-risk cases with recurrent dislocation despite using constrained liners at a median follow up of 37 months. 48 A study by Eckar et al followed 216 patients for a median period of 69 months to assess the revision rate and dislocation rate of DM cups used in complex revision THA.…”

Section: Discussionmentioning

confidence: 99%

Monobloc press-fit cups with large-diameter bearings are safe in revision total hip arthroplasty

et al. 2022

View full text Add to dashboard Cite

BACKGROUND Instability is a major cause of failure of revision total hip arthroplasty (THA) which can be avoided with the use of monobloc press-fit cups with large diameter heads (LDH). OBJECTIVE This consecutive case series analyses whether LDH monobloc components are a safe and clinically beneficial option for revision THA. METHODS This consecutive case series includes 47 revision THA with LDH monobloc acetabular cup. Acetabular bone defects were Paprosky type I (42), type IIA (2) and type IIC (3). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Forgotten Joint Score (FJS) and the Patient’s Joint Perception (PJP) scores were analysed and a radiographic evaluation for signs of implant dysfunction was performed. RESULTS After a mean follow-up of 4.5 years, there were 5 (10.6%) acetabular cup re-revisions: 2 loss of primary fixation and 3 instabilities. Implant survivorship at 4-years was 89.4% (95% CI: 89.3 to 89.5). Recurrent hip dislocation was reported in 1 patient (2.1%) and remains under conservative treatment. The mean WOMAC and FJS were 19.5 (16.8; 0.0 to 58.3) and 57.3 (28.9; 6.3 to 100.0), respectively. Regarding the PJP, 3 (8.8%) patients perceived their hip as natural, 8 (23.5%) as an artificial joint with no restriction, 14 (41.2%) with minor restriction and 9 (26.5%) with major restriction. CONCLUSION In cases of revision THA with limited bone loss, press-fit primary fixation with LDH monobloc acetabular components are valuable options that offer excellent mid-term out-comes with low re-revision and joint instability rates.

show abstract

“…The most frequently occurring complication was dislocation (15%), despite the use of a large diameter femoral head, followed by PJI (7%). The risk factors associated with early complications of revision surgery for ALTR due to MACC in patients with MoP THA include prerevision MRI findings of a solid lesion with abductor deficiency and intraoperative tissue damage [51]. Dislocation and re-revision procedures were strongly associated with the magnitude of necrotic tissue identified intraoperatively, highlighting the importance of a systematic approach in evaluating symptomatic MoP THA patients in order for early recognition and to optimize patient outcomes [52].…”

Section: Revision Surgerymentioning

confidence: 99%

Metal Articulations as a Source of Total Hip Arthroplasty Pain

Kwon

Klemt

2022

The Journal of Arthroplasty

Self Cite

View full text Add to dashboard Cite

Outcome of Dual Mobility Constructs for Adverse Local Tissue Reaction Associated Abductor Deficiency in Revision Total Hip Arthroplasty

Cited by 29 publications

References 40 publications

Constrained Acetabular Liners are a Viable Option in Second-Stage Re-Implantation for Chronic Infected Total Hip Arthroplasty with Abductor or Greater Trochanter Deficiency and Large Acetabular Bone Defects

Constrained Acetabular Liners are a Viable Option in Second-Stage Re-Implantation for Chronic Infected Total Hip Arthroplasty with Abductor or Greater Trochanter Deficiency and Large Acetabular Bone Defects

Monobloc press-fit cups with large-diameter bearings are safe in revision total hip arthroplasty

Metal Articulations as a Source of Total Hip Arthroplasty Pain

Contact Info

Product

Resources

About