title: Midterm Survivorship of the Lefèvre Constrained Liner: A Consecutive Multisurgeon Series of 166 Cases.
abstract: Constrained liners are used as part of a salvage procedure to provide stability for patients at high risk for dislocation after a total hip arthroplasty. However, no recent studies exist highlighting their effectiveness and/or limitations.
  
  
  
  This prospective review included 166 consecutive hip arthroplasties, either primary (27%) or revision (73%), with a unique design of a constrained liner: Lefèvre retentive cup. There were 113 females (69%), and the average age at index surgery was 75.9 years (range, 35-94). The mean follow-up was 6.2 years (range, 0.3-11).
  
  
  
  Twenty patients had a reoperation; 10 for infection (4 acute and 6 chronic joint infection) and 10 for cup failure (5 fixation failure, 3 aseptic loosening, and 2 dislocation). Ten-year survivals for cup revision were 89% (CI, 83-94) and 92% (CI, 89-97) for all revision and revision for noninfectious reasons, respectively. When solely evaluating for dislocation, the survival at 10 years was 99% (CI, 97-100). Considering primary and revision cases, 10-year survivals cup revision for aseptic reasons were 92.4% (CI, 84-100) and 92.5% (CI, 87-98), respectively.
  
  
  
  The Lefèvre retentive cup demonstrated excellent 10-year's survivorship. With the rate of aseptic loosening around 2% and a dislocation rate around 1%, the cup is as effective as other available devices and is therefore a cost-effective tool to reduce the risk of dislocation in at-risk patients undergoing hip arthroplasty.
authors.affiliation: The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, United Kingdom; LaTIM, Unité INSERM, Hôpital Morvan, Brest, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Clavé
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: David
authors.initials: D
authors.lastname: Maurer
authors.affiliation: Université de Bretagne Occidentale, Faculté de Médecine, Brest, France; Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, Brest, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Tristan
authors.affiliation: Université de Bretagne Occidentale, Faculté de Médecine, Brest, France; Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, Brest, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Dubrana
authors.affiliation: LaTIM, Unité INSERM, Hôpital Morvan, Brest, France; Université de Bretagne Occidentale, Faculté de Médecine, Brest, France; Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, Brest, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Lefèvre
authors.affiliation: The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, United Kingdom; The Nuffield Orthopaedic Centre, Headington, Oxford, United Kingdom.
authors.forename: Hemant
authors.initials: H
authors.lastname: Pandit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D004204:Joint Dislocations; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Dual mobility cup; constrained liner; dislocation; hip arthroplasty; survivorship