Turan Cihan DÜLGEROĞLU

Constrained liner use of developing dislocation after total hip arthroplasty: Short-term results

Aim: Today total hip arthroplasty is one of the surgical procedures with the most satisfying data. In spite of all these good outcomes, difficult and upsetting complications for patient and surgeon may be encountered after total hip arthroplasty. Constrained liner were developed to reduce the risk for primary total hip arthroplasty patients with cognitive function disorder before surgery and patients with re-dislocation risks. The aim of this retrospective study is to present the clinical outcomes of freedom constrained lıner systems in patients developing dislocation after total hip arthroplasty.Material and Methods: The aim of our study was to present clinical outcomes of fifteen consecutive surgical procedures with freedom anti-luxation revision system (Biomet, Warsaw, IN, USA) from March 2014 to December 2018. Patients were assessed with Harris hip score, Oxford score and Charnley score and early period complications and satisfaction outcomes were evaluated.Results: Only one of the fifteen patients developed complications of intraoperative femur shaft fracture. According to postoperative data of early period outcomes, postoperative Harris hip score and Oxford scores were observed to have significant amelioration. No deep or superficial wound site complications developed. Neurovascular injury complications were not observed in patients.Conclusion: In conclusion, patients with hip arthroplasty procedure with the constrained implant used in our study obtained satisfactory results.

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1. Learmonth ID, Young C, Rorabeck C. The operation of the century:total hip replacement. Lancet 2007;370:1508-19.
2. Wetters NG, Murray TG, Moric M, et al. Risk factors for dislocation after revision total hip arthroplasty. Clin Orthop Relat Res 2013;471:410-6.
3. Iorio R, Robb WJ, Healy WL, et al. Orthopaedic surgeon workforceand volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg 2008;90:1598-605.
4. Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg 2007;89:780-5.
5. Tsukada S, Wakui M. Lower dislocation rate following total hip arthroplasty via direct anterior approach than via posterior approach: five-year-average follow-up results. Open Orthop J 2015;9:157-62.
6. Berry DJ, von Knoch M, Schleck CD, et al. The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. J Bone Joint Surg Am 2004;86-A:9-14.
7. Cullen C, Johnson DS, Cook G. Re-admission rates within 28 days of total hip replacement. Ann R Coll Surg Eng 2006;88:475-8.
8. Patel PD, Potts A, Froimson MI. The dislocating hip arthroplasty: prevention and treatment. J Arthroplasty 2007;22:86-90.
9. Brooks PJ. Dislocation following total hip replacement: causes and cures. BoneJoint J 2013;95-B:67-69.
10. de Palma L, Procaccini R, Soccetti A, et al. Hospital cost of treating early dislocation following hip arthroplasty. Hip Int 2012;22:62-7.
11. Khatod M, Barber T, Paxton E, et al. An analysis of the risk ofhip dislocation with a contemporary total joint registry. Clin Orthop Relat Res 2006;447:19-23.
12. Meek RM, Allan DB, McPhillips G, et al. Epidemiology of dislocation after total hip arthroplasty. ClinOrthopRelat Res 2006;447:9-18.
13. Paterno SA, Lachiewicz PF, Kelley SS. The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J Bone Joint Surg Am 1997;79:1202-10.
14. Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty 2002;17:282-8.
15. Scifert CF, Noble PC, Brown TD, et al. Experimental and computational simulation of total hip arthroplasty dislocation. Orthop Clin North Am 2001;32:553-67.
16. Su EP, Pellicci PM. The role of constrained liners in total hip arthroplasty. Clin Orthop Relat Res 2004;420:122-9.
17. Murray DW, Fitzpatrick R, Rogers K, et al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br 2007;89:1010-4.
18. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An endresult study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737-55.
19. Charnley J. Numerical grading of clinical results. In: Charnley J,ed. Low friction arthroplasty of the hip - theory and practice. Berlin, Heidleberg, New York: Springer, Verlag;1979:20-4.
20. Callaghan JJ, Heithoff BE, Goetz DD, et al: Prevention of dislocation after hip arthroplasty: Lessons from long-term followup. Clin Orthop Relat Res 2001;393:157-62.
21. Carter AH, Sheehan EC, Mortazavi SM, et al: Revision for recurrent instability: What are the predictors of failure? J Arthroplasty 2011;26:46-52.
22. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982;64:1295-306.
23. Fackler CD, Poss R. Dislocation in total hip arthroplasties. Clin Orthop Relat Res 1980;169-78.
24. Cooke CC, Hozack W, Lavernia C, et al: Early failure mechanisms of constrained tripolar acetabular sockets used in revisiontotal hip arthroplasty. J Arthroplasty 2003;18:827-33.
25. Yun AG, Padgett D, Pellicci P, et al: Constrained acetabular liners: Mechanisms of failure. J Arthroplasty 2005;20:536-41.
26. Noble PC, Durrani SK, Usrey MM, et al. Constrained cups appear incapable of meeting the demands of revision THA. Clin Orthop Relat Res 2012;470:1907-16.
27. Khan RJ, Fick D, Alakeson R, et al. The constrained acetabular component for hip instability. J Arthroplasty 2007;22:377-82.
28. Shrader MW, Parvizi J, Lewallen DG. The use of a constrained acetabular component to treat instability after total hip arthroplasty. J Bone Joint Surg Am 2003;85-A:2179-83.
29. Callaghan JJ, O’Rourke MR, Goetz DD, et al. Use of a constrained tripolar acetabular liner to treat intraoperative instability and postoperative dislocation after total hip arthroplasty: a review of our experience. Clin Orthop Relat Res 2004;117-23.