Cementing Acetabular Liners Into Secure Cementless Shells for Polyethylene Wear Provides Durable Mid-term Fixation

被引:26
作者
Callaghan, John J. [1 ,2 ]
Hennessy, David W. [3 ]
Liu, Steve S. [1 ]
Goetz, Kirsten E. [1 ]
Heiner, Anneliese D. [1 ]
机构
[1] Univ Iowa, UIHC, Iowa City, IA 52242 USA
[2] VA Med Ctr, Iowa City, IA USA
[3] Univ Wisconsin, Madison, WI USA
关键词
HIP; ARTHROPLASTY; CEMENTATION;
D O I
10.1007/s11999-012-2380-x
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background In a previous experiment studying cementation of liners into cementless acetabular shells, placing grooves in the liner in a spider-web configuration created the greatest construct strength. Scoring shells without screw holes or other texturing helped prevent failure at the shell-cement interface. However, it was unclear whether these practices caused durable constructs in patients. Questions/purposes We therefore determined (1) rerevision rates; (2) functional scores (Harris hip scores, WOMAC, and SF-36); (3) acetabular loosening rates; and (4) acetabular osteolysis rates in patients in whom we cemented nonconstrained liners into well-fixed and well-positioned acetabular shells. Methods We prospectively followed 30 patients with 31 total hip arthroplasties in which a worn acetabular liner was revised by cementing a new liner into the existing shell that was stable and well positioned. Acetabular liners were prepared as determined by our previous study. Twenty-seven of the 30 patients (28 hips) were evaluated clinically. We recorded revisions and determined radiographic loosening and osteolysis. The minimum clinical followup was 2 years (mean, 5.3 years; range, 2-10 years). Twenty-six hips (87%) had minimum 2-year radiographic followup with an average length of 4.8 years. Results No hip required rerevision during the followup interval. Two hips (6%) dislocated once, both treated non-operatively. Harris hip scores, WOMAC, and SF-36 scores increased over preoperatively at last followup. All acetabular shells and liners were radiographically stable without evidence of loosening or progressive acetabular osteolysis. Conclusions Cementation of a liner into a well-fixed cementless shell after scoring in a spider-web configuration provided secure fixation with no failures of the construct at average 5.3 years followup. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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收藏
页码:3142 / 3147
页数:6
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