Complications encountered with the use of constrained acetabular prostheses in total hip arthroplasty.
At our department, 46 constrained acetabular components in 38 patients were placed successively for a period of 4 years. Indications included recurrent dislocation, septic and aseptic loosening with extensive bone loss, tumor surgery with extensive bone resection, and instability due to neurologic impairment. Because 2 cup failures and 10 dislocations were observed with the constrained devices at 4 to 7 years of follow-up, the authors started to use large-diameter metal-on-metal bearings for similar indications. A series of 36 such bearings in 38 patients revealed only one cup failure and one dislocation at 2 to 4 years of follow-up. Although the 2 series are different and therefore difficult to compare, the authors recommend judicious use of constrained devices because of the high failure rate (26%) and consideration of alternative options such as the use of large-diameter metal-on-metal bearings.
Pattyn
Christophe
C
Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Gent, Belgium.
De Haan
Roel
R
Kloeck
Alex
A
Van Maele
Georges
G
De Smet
Koen
K
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D001859:Bone Neoplasms / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult
D008670:Metals