Management of polyethylene wear associated with a well-fixed modular cementless shell during revision total hip arthroplasty.
We identified 128 revision total hip arthroplasties from 1993 to 2005 involving a well-fixed Harris-Galante Porous (HGP)-I or HGP-II acetabular component with minimum 2-year post-revision follow-up. Three treatment cohorts were identified. Of the hips that underwent modular liner exchange at revision, 14 hips (25%) required re-revision of the acetabular component, 8 for liner dislodgement, 3 for osteolysis and poly-wear, 2 for dislocation, and 1 for aseptic loosening. Of the hips that underwent revision of the well-fixed shell, 4 (15%) required subsequent re-revision of the acetabular component; 2 for dislocation and 2 for aseptic loosening. Six hips (27%) in the cemented liner group were re-revised; 4 for dislocation and 2 for loosening. Complete revision of a well-fixed HGP acetabular component is more reliable than liner exchange or liner cementation.
Talmo
Carl T
CT
New England Baptist Hospital, Boston, Massachusetts, USA.
Kwon
Young-Min
YM
Freiberg
Andrew A
AA
Rubash
Harry E
HE
Malchau
Henrik
H
D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000453:epidemiology / Q000601:surgery; D057068:Periprosthetic Fractures / Q000453:epidemiology / Q000601:surgery; D020959:Polyethylene / Q000009:adverse effects*; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
D020959:Polyethylene