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Favorable results seen with constrained tripolar liners for recurrent dislocated hips
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LAS VEGAS — Favorable 10-year results were seen after constrained tripolar liners were used at a single institution for recurrent dislocation hip arthroplasty with dysfunctional hip stabilizers, according to a research presented at the American Academy of Orthopedic Surgeons Annual Meeting.
“When we looked up the results, we were encouraged with this robust and durable solution in these challenging cases, especially when we are looking at dislocation,” Donald S. Garbuz, MD, said during his presentation.
Garbuz and colleagues identified 111 patients with 113 revision tripolar constrained liners from 1998 to 2008. There were 89 revisions due to recurrent dislocations, 11 revisions due to pseudotumor with dysfunctional abductors and 13 revisions due to periprosthetic infection (PJI) with loss of soft tissue stabilizers. Investigators noted revision hip arthroplasty was performed in all patients before the constrained liner was used, with 13 liners used after a first revision; 13 liners used after a second revision, 38 liners used after a third revision and 45 liners were used after more than three revisions. Demographics, implant data, dislocation and the incidence of other complications were collected. Dislocation and failure for any reason were assessed with Meier curves. Dislocations of the constrained liner were seen in eight patients. One patient had simultaneous PJI at the time of open reduction, and one patient had a stem fracture 3 months before the liner dislocation.
Results showed survival free of dislocation at 10 years was 95.6% and was 90.6% at 20 years. Survival to any additional surgery was 89.4% at 10 years and was 82.5% at 20 years.
Deep infection was seen in some patients. Of these, there were four patients who needed excision arthroplasty and one patient was treated with debridement, exchange of mobile components and IV antibiotics.
Dissociated rings needed change of the liner, ring and head in two patients. There were periprosthetic femoral fractures in two patients who were treated with revision stems and constrained liner exchange. The mean WOMAC function score was 66.2 and the pain score was 75.9 out of a possible score of 100. – by Monica Jaramillo
Reference:
El-Husseiny M, et al. Abstract 186. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 12-16, 2019; Las Vegas.
Disclosure: Weekes reports no relevant financial disclosures.