title: The long-term outcome of 755 consecutive constrained acetabular components in total hip arthroplasty examining the successes and failures.
abstract: Constrained acetabular components can treat or prevent instability after total hip arthroplasty (THA). We examine long-term results of 755 consecutive constrained THA in 720 patients (1986-1993; 62 primary, 59 conversion, 565 revision, 60 reimplantation, and 9 total femur). Eighty-three patients (88 THAs) were lost before 10-year follow-up, leaving 639 patients (667 THAs) available for study. Dislocation occurred in 117 hips (17.5%), in 37 (28.9%) of 128 constrained for recurrent dislocation, and 46 (28.2%) of 163 with dislocation history. Other reoperations were for aseptic loosening (51, 7.6% acetabular; 28, 4.2% stem; 16, 2.4% combined), infection (40, 6.0%), periprosthetic fracture (19, 2.8%), stem breakage (2, 0.3%), cup malposition (1, 0.1%), dissociated insert (1, 0.1%), dissociated femoral head (1, 0.1%), and impingement of 1 broken (0.1%) and 4 (0.6%) dissociated constraining rings. Although constrained acetabular components prevented recurrent dislocation in 71.1%, they should be used cautiously, with a 42.1% long-term failure rate observed in this series. Dislocation was common despite constraint with previous history as a significant risk.
authors.affiliation: Joint Implant Surgeons, Inc, Columbus, Ohio 43215, USA.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mallory
authors.forename: Joanne B
authors.initials: JB
authors.lastname: Adams
authors.forename: Jackie H
authors.initials: JH
authors.lastname: Russell
authors.forename: Kari L
authors.initials: KL
authors.lastname: Groseth
mesh_terms: D000077:Acetabulum; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome