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Long-term risk of dislocation after THA decreased with the use of constrained liners

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COPENHAGEN – Constrained liners may decrease the cumulative long-term risk of dislocation following total hip arthroplasty in patients with femoral neck fractures, according to a study presented here.

Philippe Hernigou, MD, shared his findings at the 12th EFORT Congress 2011.

“For these patients … we see that total hip arthroplasty is the best, but to prevent dislocation we should probably use a device like a constrained liner,” Hernigou said.

Hernigou and colleagues studued 425 patients with femoral neck fractures who underwent primary total hip arthroplasty with a constrained acetabular liner between 2000 and 2005. Hernigou’s team compared the results from these patients with outcomes from 380 total hip arthroplasties performed without constrained liners between 1994 and 1999 at the same institution.

The investigators searched for radiographic evidence of implant failure in study participants with a minimum follow-up of 5 years. Follow-up included routine visits wherein patients were asked about dislocations.

Hernigou reported that patients without constrained liners demonstrated a cumulative first-time dislocation risk of 5% at 1 month and 12% at 1 year. The risk increased approximately 2% every 5 years to 21% by the 15-year mark for the patients who were living and had not undergone revision.

The investigators found that patients with constrained liners, however, demonstrated a cumulative first-time dislocation risk of 1% at 1 month and 2% at 1 year, without an increase in risk during the following 10-year period for those who were living and had not undergone revision.

The team also found that female patients and patients 80 years of age or older were more likely to experience dislocation. Cognitive impairments and neurologic disease were reported to be associated with higher dislocation risks.

Reference:

• Hernigou P, Poignard A, Flouzat L, et al. The cumulative long-term risk of dislocation after total hip arthroplasty is decreased with constrained liners in patients with femoral neck fractures. Paper #112. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.

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