BACKGROUND: In a previous experiment studying cementation of liners into cementless acetabular shells, placing grooves in the liner in a spider-web configuration created the greatest construct strength. Scoring shells without screw holes or other texturing helped prevent failure at the shell-cement interface. However, it was unclear whether these practices caused durable constructs in patients. QUESTIONS/PURPOSES: We therefore determined (1) rerevision rates; (2) functional scores (Harris hip scores, WOMAC, and SF-36); (3) acetabular loosening rates; and (4) acetabular osteolysis rates in patients in whom we cemented nonconstrained liners into well-fixed and well-positioned acetabular shells. METHODS: We prospectively followed 30 patients with 31 total hip arthroplasties in which a worn acetabular liner was revised by cementing a new liner into the existing shell that was stable and well positioned. Acetabular liners were prepared as determined by our previous study. Twenty-seven of the 30 patients (28 hips) were evaluated clinically. We recorded revisions and determined radiographic loosening and osteolysis. The minimum clinical followup was 2 years (mean, 5.3 years; range, 2-10 years). Twenty-six hips (87%) had minimum 2-year radiographic followup with an average length of 4.8 years. RESULTS: No hip required rerevision during the followup interval. Two hips (6%) dislocated once, both treated nonoperatively. Harris hip scores, WOMAC, and SF-36 scores increased over preoperatively at last followup. All acetabular shells and liners were radiographically stable without evidence of loosening or progressive acetabular osteolysis. CONCLUSIONS: Cementation of a liner into a well-fixed cementless shell after scoring in a spider-web configuration provided secure fixation with no failures of the construct at average 5.3 years followup. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND: In a previous experiment studying cementation of liners into cementless acetabular shells, placing grooves in the liner in a spider-web configuration created the greatest construct strength. Scoring shells without screw holes or other texturing helped prevent failure at the shell-cement interface. However, it was unclear whether these practices caused durable constructs in patients. QUESTIONS/PURPOSES: We therefore determined (1) rerevision rates; (2) functional scores (Harris hip scores, WOMAC, and SF-36); (3) acetabular loosening rates; and (4) acetabular osteolysis rates in patients in whom we cemented nonconstrained liners into well-fixed and well-positioned acetabular shells. METHODS: We prospectively followed 30 patients with 31 total hip arthroplasties in which a worn acetabular liner was revised by cementing a new liner into the existing shell that was stable and well positioned. Acetabular liners were prepared as determined by our previous study. Twenty-seven of the 30 patients (28 hips) were evaluated clinically. We recorded revisions and determined radiographic loosening and osteolysis. The minimum clinical followup was 2 years (mean, 5.3 years; range, 2-10 years). Twenty-six hips (87%) had minimum 2-year radiographic followup with an average length of 4.8 years. RESULTS: No hip required rerevision during the followup interval. Two hips (6%) dislocated once, both treated nonoperatively. Harris hip scores, WOMAC, and SF-36 scores increased over preoperatively at last followup. All acetabular shells and liners were radiographically stable without evidence of loosening or progressive acetabular osteolysis. CONCLUSIONS: Cementation of a liner into a well-fixed cementless shell after scoring in a spider-web configuration provided secure fixation with no failures of the construct at average 5.3 years followup. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors: Geoffrey F Haft; Anneliese D Heiner; Lawrence D Dorr; Thomas D Brown; John J Callaghan Journal: J Bone Joint Surg Am Date: 2003-06 Impact factor: 5.284
Authors: John J Callaghan; Javad Parvizi; Clifford C Novak; Barron Bremner; Wade Shrader; David G Lewallen; Richard C Johnston; Devon D Goetz Journal: J Bone Joint Surg Am Date: 2004-10 Impact factor: 5.284
Authors: Harpal S Khanuja; Ajay Aggarwal; Marc W Hungerford; David S Hungerford; Lynne C Jones; Michael A Mont Journal: J Orthop Surg (Hong Kong) Date: 2010-08 Impact factor: 1.118
Authors: Paul E Beaulé; Edward Ebramzadeh; Michel Le Duff; Rajiv Prasad; Harlan C Amstutz Journal: J Bone Joint Surg Am Date: 2004-05 Impact factor: 5.284
Authors: John L Gaffey; John J Callaghan; Douglas R Pedersen; Devon D Goetz; Patrick M Sullivan; Richard C Johnston Journal: J Bone Joint Surg Am Date: 2004-02 Impact factor: 5.284
Authors: K P Günther; K Tucker; P Kjaersgaard-Andersen; J Lützner; J P Kretzer; R Nelissen; T Lange; L Zagra Journal: Orthopadie (Heidelb) Date: 2022-06-27
Authors: Keith Tucker; Klaus-Peter Günther; Per Kjaersgaard-Andersen; Jörg Lützner; Jan Philippe Kretzer; Rob G H H Nelissen; Toni Lange; Luigi Zagra Journal: EFORT Open Rev Date: 2021-11-19