Salvaging Unstable or Recurrent Dislocating Total Hip Arthroplasty with the Constrained Acetabular Component

• Published in: Journal of orthopaedic surgery (Hong Kong) 2002-12, Vol.10 (2), p.165-169
• Main Authors: Stanton, DA, Bruce, WJ, Goldberg, JA, Walsh, W
• Format: Article
• Language: English
• Subjects: Acetabulum; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Female; Hip Dislocation - diagnostic imaging; Hip Dislocation - etiology; Hip Dislocation - surgery; Hip Prosthesis - adverse effects; Humans; Joint Instability - diagnostic imaging; Joint Instability - etiology; Joint Instability - surgery; Male; Middle Aged; Prosthesis Design; Prosthesis Failure; Radiography; Recurrence; Reoperation; Retrospective Studies; Salvage Therapy - instrumentation; Salvage Therapy - methods
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949900201000210

Purpose. To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney. Methods. A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients. Results. From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14–121 months) and the mean age at the time of surgery was 73 years (range, 52–84 years). No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8), and intra-operative instability (n=5). There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell. Conclusion. We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.