Document Detail

Cementing acetabular liners into secure cementless shells for polyethylene wear provides durable mid-term fixation.
MedLine Citation:
PMID:  22585349     Owner:  NLM     Status:  MEDLINE    
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 nonoperatively. 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.
John J Callaghan; David W Hennessy; Steve S Liu; Kirsten E Goetz; Anneliese D Heiner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-11     Completed Date:  2013-01-03     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3142-7     Citation Subset:  AIM; IM    
University of Iowa, 200 Hawkins Drive, 01029 JPP, UIHC, Iowa City, IA 52242, USA.
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MeSH Terms
Acetabulum / surgery*
Aged, 80 and over
Arthroplasty, Replacement, Hip / methods*
Biocompatible Materials
Bone Cements
Hip Prosthesis*
Middle Aged
Osteolysis / prevention & control
Prosthesis Failure*
Reg. No./Substance:
0/Biocompatible Materials; 0/Bone Cements; 9002-88-4/Polyethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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