Michael D Hellman1, David J Kaufman2, Scott M Sporer3, Wayne G Paprosky3, Brett R Levine3, Craig J Della Valle3. 1. California Orthopedics & Spine, Larkspur, CA. Electronic address: mdhellman@gmail.com. 2. Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL. 3. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Abstract
BACKGROUND: The purpose of this study was to examine the outcomes of repeat revision after failure of a constrained liner. METHODS: We reviewed 1212 consecutive revisions and identified 74 (6%) revisions of a failed constrained liner in 46 patients with a mean age of 65 years. The most common reasons for revision of a constrained liner were recurrent instability (64.9%) and infection (25.7%). RESULTS: At a mean of 35 months, 42 of the 74 hips (57%) required repeat revision. Kaplan-Meier revision-free survival was 24% at 10 years. Thirty-two of the 74 revisions (43%) had a dislocation event after the index revision. Kaplan-Meier dislocation-free survival was 43% at 10 years. There was a higher failure rate among the 34 patients with abductor deficiency (hazard ratio 1.90, 95% confidence interval, 1.06-3.43; P = .032). CONCLUSION: Patients undergoing revision of a failed constrained liner have a high likelihood of recurrent dislocation and repeat revision surgery. LEVEL OF EVIDENCE: Level IV.
BACKGROUND: The purpose of this study was to examine the outcomes of repeat revision after failure of a constrained liner. METHODS: We reviewed 1212 consecutive revisions and identified 74 (6%) revisions of a failed constrained liner in 46 patients with a mean age of 65 years. The most common reasons for revision of a constrained liner were recurrent instability (64.9%) and infection (25.7%). RESULTS: At a mean of 35 months, 42 of the 74 hips (57%) required repeat revision. Kaplan-Meier revision-free survival was 24% at 10 years. Thirty-two of the 74 revisions (43%) had a dislocation event after the index revision. Kaplan-Meier dislocation-free survival was 43% at 10 years. There was a higher failure rate among the 34 patients with abductor deficiency (hazard ratio 1.90, 95% confidence interval, 1.06-3.43; P = .032). CONCLUSION:Patients undergoing revision of a failed constrained liner have a high likelihood of recurrent dislocation and repeat revision surgery. LEVEL OF EVIDENCE: Level IV.
Authors: Timothy S Brown; Richard J McLaughlin; Daniel J Berry; David G Lewallen; Robert T Trousdale; Rafael J Sierra Journal: Clin Orthop Relat Res Date: 2019-02 Impact factor: 4.176
Authors: Paul Ruckenstuhl; Georgi I Wassilew; Michael Müller; Christian Hipfl; Matthias Pumberger; Carsten Perka; Sebastian Hardt Journal: J Clin Med Date: 2020-06-11 Impact factor: 4.241