Polyethylene Liner Dissociation Is a Complication of the DePuy Pinnacle Cup: A Report of 23 Cases

Abstract

Background Polyethylene liner dissociation is a rare but catastrophic event in total hip arthroplasty (THA), and certain implant designs are known to be at greater risk. Although the DePuy Pinnacle (Warsaw, IN, USA) modular acetabular construct has an excellent record of fixation and wear, an unexpectedly high number of liner dissociations has been noted.

Letter to the Editor: Polyethylene Liner Dissociation is a Complication of the DePuy Pinnacle Cup: A Report of 23 Cases

“…However, neither the current study nor previously published cases can provide sufficient evidence on the effect of this mode of failure on implant survival rates. Moreover, frequency estimations made by Yun and colleagues [8] cup (Warsaw, IN, USA) presented a 10-year survival rate of 94% or higher, which is comparable with the most durable implants presented in those reports. In addition, the UK registry describes a low revision rate at 10-years when this implant was used with a polyethylene liner, regardless of the material of the prosthetic head [7].…”

“…These studies, as well as Yun and colleagues [8], confirm this complication as a mechanism of failure of the device. However, neither the current study nor previously published cases can provide sufficient evidence on the effect of this mode of failure on implant survival rates.…”

“…W e read the study by Yun and colleagues [8] with great interest. We would like to share some comments that could contribute to a better interpretation of this paper.…”

A novel method to measure rim deformation in UHMWPE acetabular liners

“…This can lead to edge loading of the acetabular rim. Relatively little is known about the prevalence and clinical consequences of edge loading of the femoral head on an UHMWPE acetabular rim but it could potentially lead to excessive wear, rim fracture and/or liner dissociation, which have been associated with other edge loading mechanisms such as impingement, and has been shown to increase stresses in the rim [11,22,34,35]. The method developed and evaluated in the present study could be used to help determine the prevalence, location, severity and mechanism of in vivo rim deformation.…”

Acetabular liner dissociation: A case report and review of the literature

“…This has been well researched and it appears that certain implant designs have shown a greater risk of polyethylene liner dissociation (PLD). Despite the excellent track record with regard to the functional outcome and longevity, Pinnacle (DePuy), Harris-Galante (Zimmer) and Trident (Stryker) have been associated with PLD [1][2][3][4][5].…”