Document Detail

Constrained liner in neurologic or cognitively impaired patients undergoing primary THA.
MedLine Citation:
PMID:  20376709     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: THA performed in patients with cognitive deficits or neuromuscular diseases has been associated with a high postoperative dislocation rate. The constrained liner reportedly provides stability in patients with recurrent dislocation. However, achieving stability could be offset by early loosening when used in patients with neurologic diseases.
QUESTIONS/PURPOSES: We therefore asked whether constrained liners had a higher risk of loosening when used in primary THA for patients with neurologic diseases.
METHODS: We retrospectively reviewed a 144 patients (164 hips) with neuromuscular disease who had a constrained polyethylene insert from 1999 to 2004 and compared them to another 120 patients (132 hips) with neuromuscular disease operated on immediately before this period (from 1994 to 1998) who had a conventional polyethylene insert.
RESULTS: Thirty-three (25%) of the 132 hips without a constrained liner were known to have had at least one dislocation and 21 had revision for recurrent dislocation. Ten other hips had revision for loosening of the cup. The survival rate was 82% at 5 years and 77% at 10 years with revision due to recurrent dislocation or loosening of the cup as the endpoint. With a constrained liner, at minimum 5-year followup (mean, 7 years; range, 5-10 years), the incidence of complications, particularly dislocation, was decreased (three dislocations among 164 hips; 2%), with one revision for recurrent dislocation and one revision for loosening.
CONCLUSIONS: This constrained acetabular component provides durable protection against dislocation without substantial increased loosening at midterm followup.
Philippe Hernigou; Paolo Filippini; Charles-Henri Flouzat-Lachaniette; Sobrinho Uirassu Batista; Alexandre Poignard
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-06     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3255-62     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, University Paris XII, Hôpital Henri Mondor, 94010, Creteil, France.
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MeSH Terms
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects,  instrumentation*
Chi-Square Distribution
Cognition Disorders / complications*
Dislocations / epidemiology,  etiology,  surgery
Hip Joint / physiopathology,  radiography,  surgery*
Hip Prosthesis*
Joint Instability / epidemiology,  etiology,  surgery
Kaplan-Meier Estimate
Middle Aged
Neuromuscular Diseases / complications*
Proportional Hazards Models
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Young Adult
Reg. No./Substance:

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