Arnaud Clavé1, David Maurer2, Ludovic Tristan3, Frederic Dubrana3, Christian Lefèvre4, Hemant Pandit5. 1. The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, United Kingdom; LaTIM, Unité INSERM, Hôpital Morvan, Brest, France. 2. Indiana University School of Medicine, Indianapolis, Indiana. 3. Université de Bretagne Occidentale, Faculté de Médecine, Brest, France; Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, Brest, France. 4. 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. 5. The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, United Kingdom; The Nuffield Orthopaedic Centre, Headington, Oxford, United Kingdom.
Abstract
BACKGROUND: 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. METHOD: 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). RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHOD: 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). RESULTS: 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. CONCLUSIONS: 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: Brian P Chalmers; Graham D Pallante; Michael J Taunton; Rafael J Sierra; Robert T Trousdale Journal: Clin Orthop Relat Res Date: 2018-02 Impact factor: 4.176
Authors: Loes W A H Van Beers; Bart C H Van Der Wal; Tess Glastra Van Loon; Dirk Jan F Moojen; Marieke F Van Wier; Amanda D Klaassen; Nienke W Willigenburg; Rudolf W Poolman Journal: Acta Orthop Date: 2020-08-04 Impact factor: 3.717