Standard vs. constrained liners had similar aseptic failure rates in revision THA
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Key takeaways:
- A standard liner for a custom triflange acetabular component had similar aseptic failure rates vs. a constrained liner.
- Dislocation rate was 7% in the standard liner group vs. 11% in the constrained liner group.
DALLAS — Results presented here showed standard liners and constrained liners had similar rates of aseptic failure and dislocation among patients undergoing revision total hip arthroplasty with a custom triflange acetabular component.
Gregory G. Polkowski, MD, MSCR, associate professor and chief of adult reconstruction, executive medical director of the orthopaedic patient care center and director of the adult reconstruction fellowship at Vanderbilt University Medical Center, and colleagues retrospectively reviewed patient demographics, surgical details and clinical outcomes among 81 patients who underwent revision THA with a custom triflange acetabular component with either a standard liner or a constrained liner.
“Indications for constrained liners were at surgeon discretion,” Polkowski said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “This is a major selection bias for our study, but usually it was done in the worse cases, complex abductor compromise, proximal femoral replacements [and] trochanteric issues.”
Polkowski said outcome measures included early aseptic failure of the acetabular component, all-cause failure, revisions and reoperations not related to the custom triflange acetabular component, and dislocation rates between the standard liner and constrained liner groups.
“We had two aseptic failures in the standard liner group, one at 2 years [and] one at 3.5 years, and only three patients in the constrained liner group, one of those was at 6 years,” Polkowski said. “There was no significant difference from the statistical analysis that we did on this group of patients, which is encouraging.”
Polkowski said infection was the main cause of all-cause failure, but infection rates were not different between the two groups, with three infections in the standard liner cohort and two infections in the constrained liner cohort. He added that the standard liner and constrained liner cohorts had no differences with respect to revisions and reoperations.
“From a dislocation standpoint, [it was] actually lower than I would expect,” Polkowski said. “Three patients, for 7% in the standard liner; four patients for 11% in the constrained liner group. Again, [there was] no difference.”
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Polkowski GG, et al. Paper 49. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 7-10, 2024; Dallas.
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