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

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    Authors
    Banks, Louisa N
    McElwain, John P
    Affiliation
    Adelaide and Meath Hospital, Incorporating the National Children's Hospital,, Tallaght, Dublin, Ireland. Louisabanks@hotmail.com
    Issue Date
    2012-02-01T10:50:28Z
    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
    
    Metadata
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    Citation
    Arch Orthop Trauma Surg. 2010 Apr;130(4):503-5. Epub 2009 Jul 24.
    Journal
    Archives of orthopaedic and trauma surgery
    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
    ISSN
    1434-3916 (Electronic)
    0936-8051 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00402-009-0941-6
    Scopus Count
    Collections
    Tallaght University Hospital

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