title: Salvaging unstable or recurrent dislocating total hip arthroplasty with the constrained acetabular component.
abstract: OBJECTIVE
  To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney.
  
  
  METHODS
  A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients.
  
  
  RESULTS
  From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14-121 months) and the mean age at the time of surgery was 73 years (range, 52-84 years). No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8), and intra-operative instability (n=5). There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell.
  
  
  CONCLUSIONS
  We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.
authors.affiliation: Department of Orthopaedics, Concord Hospital, Sydney, New South Wales, Australia.
authors.forename: D A
authors.initials: DA
authors.lastname: Stanton
authors.forename: W J
authors.initials: WJ
authors.lastname: Bruce
authors.forename: J A
authors.initials: JA
authors.lastname: Goldberg
authors.forename: W
authors.initials: W
authors.lastname: Walsh
mesh_terms: D000077:Acetabulum; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000295:instrumentation / Q000379:methods*