An unusual mode of failure of a tripolar constrained acetabular liner: a case report.

Hdl Handle:
http://hdl.handle.net/10147/207932
Title:
An unusual mode of failure of a tripolar constrained acetabular liner: a case report.
Authors:
Banks, Louisa N; McElwain, John P
Affiliation:
Adelaide and Meath Hospital, Incorporating the National Children's Hospital,, Tallaght, Dublin, Ireland. Louisabanks@hotmail.com
Citation:
Arch Orthop Trauma Surg. 2010 Apr;130(4):503-5. Epub 2009 Jul 24.
Journal:
Archives of orthopaedic and trauma surgery
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207932
DOI:
10.1007/s00402-009-0941-6
PubMed ID:
19629505
Abstract:
Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient's weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.
Language:
eng
MeSH:
*Acetabulum; Adult; Arthroplasty, Replacement, Hip/*adverse effects; Female; Hip Dislocation/etiology/radiography/*surgery; Hip Prosthesis/*adverse effects; Humans; Joint Instability/etiology/surgery; *Prosthesis Failure; Reoperation
ISSN:
1434-3916 (Electronic); 0936-8051 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBanks, Louisa Nen_GB
dc.contributor.authorMcElwain, John Pen_GB
dc.date.accessioned2012-02-01T10:50:28Z-
dc.date.available2012-02-01T10:50:28Z-
dc.date.issued2012-02-01T10:50:28Z-
dc.identifier.citationArch Orthop Trauma Surg. 2010 Apr;130(4):503-5. Epub 2009 Jul 24.en_GB
dc.identifier.issn1434-3916 (Electronic)en_GB
dc.identifier.issn0936-8051 (Linking)en_GB
dc.identifier.pmid19629505en_GB
dc.identifier.doi10.1007/s00402-009-0941-6en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207932-
dc.description.abstractDislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient's weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.en_GB
dc.language.isoengen_GB
dc.subject.mesh*Acetabulumen_GB
dc.subject.meshAdulten_GB
dc.subject.meshArthroplasty, Replacement, Hip/*adverse effectsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHip Dislocation/etiology/radiography/*surgeryen_GB
dc.subject.meshHip Prosthesis/*adverse effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshJoint Instability/etiology/surgeryen_GB
dc.subject.mesh*Prosthesis Failureen_GB
dc.subject.meshReoperationen_GB
dc.titleAn unusual mode of failure of a tripolar constrained acetabular liner: a case report.en_GB
dc.contributor.departmentAdelaide and Meath Hospital, Incorporating the National Children's Hospital,, Tallaght, Dublin, Ireland. Louisabanks@hotmail.comen_GB
dc.identifier.journalArchives of orthopaedic and trauma surgeryen_GB
dc.description.provinceLeinster-

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