Outcomes of Isolated Head and Liner Exchange Using Large Femoral Heads and Modern Liners in Revision Total Hip Arthroplasty

Sutter, E. Grant; Akram, Faisal; Miller, Allison; Paprosky, Wayne G.; Berger, Richard A.; Gerlinger, Tad L.

doi:10.1016/j.arth.2019.11.015

Cited by 10 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After induced the use of highly cross‐linked polyethylene liner, the revision‐free survivorship improved a lot. Sutter demonstrated a case series with 138 hips using larger head and modern liner in isolated head and liner exchange, which provides for better stability than previous reports 27 . In our series, all the cases underwent revision surgery for hip instability.…”

Section: Discussionmentioning

confidence: 60%

“…Sutter demonstrated a case series with 138 hips using larger head and modern liner in isolated head and liner exchange, which provides for better stability than previous reports. 27 In our series, all the cases underwent revision surgery for hip instability. Over the half of the cases (55%) using the larger femoral head than original femoral head.…”

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Cementation of the highly cross‐linked polyethylene liner into a well‐fixed acetabular shell to treat patients with recurrent dislocation after total hip arthroplasty

et al. 2020

View full text Add to dashboard Cite

Cementation of a highly cross-linked polyethylene liner into a well-fixed acetabular shell provided a good durability for liner wear. However, its efficacy in treating recurrent instability due to malposition cup is less reported. The aim of this study is to evaluate the outcome of this surgical technique to treat hip instability. From 2009 to 2019, we have identified 38 patients who had been surgically treated for recurrent instability, including cementation liner (N = 20) and revision cup (N = 18) procedures.Patients were followed for a mean of 45.66 months. We have recorded and analyzed all causes of implant failure including recurrent instability. Clinical outcomes were assessed including complication and Harris Hip Score (HHS) preoperatively and at the latest follow-up. Revision-free survivorship for any cause was 95.0% at 1 year, and 84.4% at 5 years in cementation liner group and 88.9% at 1 year and 5 years in revision cup group. Mean Harris hip score improved from 48.3 points preoperatively to 79.5 points at the last follow-up in cementation liner group and mean HHS improved from 43.3 points preoperatively to 77.2 points in revision cup group. There were two implant failures in each group, including one is due to persistent hip instability and the other is due to periprosthetic joint infection in the cementation liner group and two implant failure are due to persistent hip instability in the revision cup group. Functional scores and implant survival were similar in both groups. We demonstrated that orientation correction via the cementation of the polyethylene liner into well-fixed acetabular shell is a promising option to treat and prevent instability.

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 80%

Cementation of the highly cross‐linked polyethylene liner into a well‐fixed acetabular shell to treat patients with recurrent dislocation after total hip arthroplasty

et al. 2020

View full text Add to dashboard Cite

show abstract

“…One of the advantages of cementless acetabular fixation is the ability to exchange the liner in the case of infection (debridement, antibiotics, and implant retention (DAIR)) or dislocation, where a different liner can be successful in preventing further instability without the need to disrupt implant-bone fixation. [35][36][37] In our series, 46/93 revisions of hybrid THAs and 12/39 revisions of cementless THAs were simple bearing surface exchanges for these indications. Similarly, in one of the cementless THA revisions, a squeaking ceramic bearing was treated by head/liner exchange.…”

Section: Discussionmentioning

confidence: 83%

Should patient age thresholds dictate fixation strategy in total hip arthroplasty?

Bloch

White

Matar

et al. 2022

The Bone & Joint Journal

View full text Add to dashboard Cite

Aims Total hip arthroplasty (THA) is a very successful and cost-effective operation, yet debate continues about the optimum fixation philosophy in different age groups. The concept of the 'cementless paradox' and the UK 'Getting it Right First Time' initiative encourage increased use of cemented fixation due to purported lower revision rates, especially in elderly patients, and decreased cost. Methods In a high-volume, tertiary referral centre, we identified 10,112 THAs from a prospectively collected database, including 1,699 cemented THAs, 5,782 hybrid THAs, and 2,631 cementless THAs. The endpoint was revision for any reason. Secondary analysis included examination of implant survivorship in patients aged over 70 years, over 75 years, and over 80 years at primary THA. Results Cemented fixation had the lowest implant survival in all age groups, with a total ten-year survivorship of 97.0% (95% confidence interval (CI) 95.8 to 97.8) in the cemented group, 97.6% (95% CI 96.9 to 98.1) in the hybrid group, and 97.9% (95% CI 96.9 to 98.6) in the cementless group. This was not statistically significant (p = 0.092). There was no age group where cemented fixation outperformed hybrid or cementless fixation. Conclusion While all fixation techniques performed well at long-term follow-up, cemented fixation was associated with the lowest implant survival in all age groups, including in more elderly patients. We recommend that surgeons should carefully monitor their own outcomes and use fixation techniques that they are familiar with, and deliver the best outcomes in their own hands. Cite this article: Bone Joint J 2022;104-B(2):206–211.

show abstract

“…The use of bisphosphonates has not been helpful in the treatment of asymptomatic osteolysis. If wear is significant, a femoral head and acetabular liner can be exchanged, with an attempt at grafting the lesions; the long-term results with this technique are unclear as there is limited evidence that the bone graft incorporates to underlying bone [ 198 , 222 , 225 , 262 ]. Scant data exist to suggest that bone grafting provides any lasting bone incorporation when placed into lesions behind a well-fixed acetabular component [ 19 , 81 , 207 ].…”

Section: Panel 2: Implant Selection Management Of Osteolysis and The Management Of Massive Bone Lossmentioning

confidence: 99%

The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium

et al. 2021

View full text Add to dashboard Cite

Despite growing evidence supporting the evaluation, classification, and treatment of acetabular bone loss in revision hip replacement, advancements have not been systematically incorporated into a single document, and therefore, a comprehensive review of the treatment of severe acetabular bone loss is needed. The Stavros Niarchos Foundation Complex Joint Reconstruction Center at Hospital for Special Surgery held an Acetabular Bone Loss Symposium on June 21, 2019, to answer the following questions: What are the trends, emerging technologies, and areas of future research related to the evaluation and management of acetabular bone loss in revision hip replacement? What constitutes the optimal workup and management strategies for acetabular bone loss? The 36 international experts convened were divided into groups, each assigned to discuss 1 of 4 topics: (1) preoperative planning and postoperative assessment; (2) implant selection, management of osteolysis, and management of massive bone loss; (3) the treatment challenges of pelvic discontinuity, periprosthetic joint infection, instability, and poor bone biology; and (4) the principles of reconstruction and classification of acetabular bone loss. Each group came to consensus, when possible, based on an extensive literature review. This document provides an overview of these 4 areas, the consensus each group arrived at, and directions for future research.

show abstract

Outcomes of Isolated Head and Liner Exchange Using Large Femoral Heads and Modern Liners in Revision Total Hip Arthroplasty

Cited by 10 publications

References 14 publications

Cementation of the highly cross‐linked polyethylene liner into a well‐fixed acetabular shell to treat patients with recurrent dislocation after total hip arthroplasty

Cementation of the highly cross‐linked polyethylene liner into a well‐fixed acetabular shell to treat patients with recurrent dislocation after total hip arthroplasty

Should patient age thresholds dictate fixation strategy in total hip arthroplasty?

The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium

Contact Info

Product

Resources

About