Maximilian F Kasparek1,2, Lisa Renner3, Martin Faschingbauer4, Wenzel Waldstein2, Kilian Rueckl1, Friedrich Boettner5. 1. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. 2. Department of Orthopedics, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. 3. Orthopaedic Department, Center for Musculoskeletal Surgery, Charité, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. 4. Department of Orthopedic Surgery, University Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany. 5. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. boettnerf@hss.edu.
Abstract
PURPOSE: Revision of failed modular metal-on-metal total hip replacement (MoM-THA) can be technically difficult. A dual mobility liner can help to salvage a well-fixed acetabular component. The present paper reports the clinical and radiographic outcome of revision of failed Birmingham modular MoM-THA using a dual mobility liner. METHODS: The present study reports on ten patients (3 female and 7 male) with 11 revision THAs. Patients underwent revision an average of 51 months (range 40-73 months) after index procedure. Mean follow-up after the revision was 31 months (range 24-37 months) and all patients underwent an MRI with metal artifact reduction software (MARS) at least two years after revision to assess for local polyethylene wear and osteolysis. RESULTS: The Harris Hip score improved from 92.2 (range 63.0-100.0) to 100.0 (p = 0.072). One patient had a one-time dislocation within seven days of surgery. No patient required additional surgeries. Radiographs showed no signs of component loosening and osteolysis and MRI imaging revealed no evidence of polyethylene wear or osteolysis. CONCLUSION: A dual mobility liner in an existing Birmingham cup can provide excellent clinical and radiological short-term results without MRI evidence of increased polyethylene wear. Post-operative hip precautions should be enforced.
PURPOSE: Revision of failed modular metal-on-metal total hip replacement (MoM-THA) can be technically difficult. A dual mobility liner can help to salvage a well-fixed acetabular component. The present paper reports the clinical and radiographic outcome of revision of failed Birmingham modular MoM-THA using a dual mobility liner. METHODS: The present study reports on ten patients (3 female and 7 male) with 11 revision THAs. Patients underwent revision an average of 51 months (range 40-73 months) after index procedure. Mean follow-up after the revision was 31 months (range 24-37 months) and all patients underwent an MRI with metal artifact reduction software (MARS) at least two years after revision to assess for local polyethylene wear and osteolysis. RESULTS: The Harris Hip score improved from 92.2 (range 63.0-100.0) to 100.0 (p = 0.072). One patient had a one-time dislocation within seven days of surgery. No patient required additional surgeries. Radiographs showed no signs of component loosening and osteolysis and MRI imaging revealed no evidence of polyethylene wear or osteolysis. CONCLUSION: A dual mobility liner in an existing Birmingham cup can provide excellent clinical and radiological short-term results without MRI evidence of increased polyethylene wear. Post-operative hip precautions should be enforced.
Entities:
Keywords:
Birmingham; Dual mobility liner; Metal-on-metal; Osteolysis; Revision; Total hip arthroplasty
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