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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 12, 1636-1638.
doi: 10.1302/0301-620X.87B12.16349  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Revision of an acetabular liner has a high risk of dislocation

A. W. Blom, PhD, FRCS(Trauma & Orth), Locum Consultant1; L. Astle, MRCS, Specialist Registrar1; J. Loveridge, MRCS, Senior House Officer1; and I. D. Learmonth, FRCS,FCS(SA), Professor Head of Department1

1 Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.

Correspondence should be sent to Mr A. W. Blom; e-mail: blocat{at}msn.com

Polyethylene liners of modular acetabular components wear sometimes need to be replaced, despite the metal shell being well fixed. Replacing the liner is a relatively simple procedure, but very little is known of the outcome of revision. We prospectively followed up 1126 Harris-Galante I metal-backed, uncemented components for between nine and 19 years. We found 38 (3.4%) liners of 1126 acetabular components wore and required revision. These revisions were then followed up for a mean of 4.8 years. The rate of dislocation was 28.9%. Nine of the dislocations occurred once and two were recurrent.

The overall secondary revision rate was three of 38 total hip replacements (7.9%) at a mean follow-up of 4.8 years. This gives a 92.1% survivorship (35 of 38) at under five years. In isolated revision of a liner, we had a complication rate of 23% (three of 13). In revision of a liner combined with revision of the femoral stem, there was a complication rate of 48% (12 of 25). We discuss possible reasons for the high dislocation rates.

Leaving the well-fixed acetabular shell in situ leads to an increased risk of instability. However, this needs to be balanced against the otherwise low complication rate for revision of the liner. Patients should be consented accordingly.




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M. R. Utting, M. Raghuvanshi, R. Amirfeyz, A. W. Blom, I. D. Learmonth, and G. C. Bannister
The Harris-Galante porous-coated, hemispherical, polyethylene-lined acetabular component in patients under 50 years of age: A 12- TO 16-YEAR REVIEW
J Bone Joint Surg Br, November 1, 2008; 90-B(11): 1422 - 1427.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General