Andrew J Grazette1,2, Julian Foote1, Michael R Whitehouse1, Ashley W Blom1. 1. Musculoskeletal Research Unit, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol - UK. 2. Department of Trauma and Orthopaedic Surgery, University Hospitals Coventry and Warwickshire, University Hospital, Coventry - UK.
Abstract
PURPOSE: Dissociation of the polyethylene liner is a known failure mechanism of the Harris Galante I and II uncemented acetabular components. The outcomes of revision surgery for this indication and the influence of time to diagnosis are not well described. METHODS: We report a series of 29 cases revised due to this failure mechanism. The median time from primary to revision surgery was 13 years. RESULTS: At a median of 4 years follow-up, the mean OHS was 34 (range 6-48) but results were poorer (mean 29; range 6-45) when the diagnosis and revision was delayed compared to when it was not (mean 39; range 20-48). A large proportion of our patients (n = 14) presented with sudden onset of symptoms with or without trauma. Osteolysis was common in this series but the cup was well fixed in 20/29 cases. There was macroscopic damage to the shell in all cases. CONCLUSIONS: In our experience, prompt revision of liner dissociation optimises outcomes in this group of patients and radiology reporting alone is not sufficient to identify these cases.
PURPOSE: Dissociation of the polyethylene liner is a known failure mechanism of the Harris Galante I and II uncemented acetabular components. The outcomes of revision surgery for this indication and the influence of time to diagnosis are not well described. METHODS: We report a series of 29 cases revised due to this failure mechanism. The median time from primary to revision surgery was 13 years. RESULTS: At a median of 4 years follow-up, the mean OHS was 34 (range 6-48) but results were poorer (mean 29; range 6-45) when the diagnosis and revision was delayed compared to when it was not (mean 39; range 20-48). A large proportion of our patients (n = 14) presented with sudden onset of symptoms with or without trauma. Osteolysis was common in this series but the cup was well fixed in 20/29 cases. There was macroscopic damage to the shell in all cases. CONCLUSIONS: In our experience, prompt revision of liner dissociation optimises outcomes in this group of patients and radiology reporting alone is not sufficient to identify these cases.