Conventional single articulation constrained liners in revision hip arthroplasty: risk factors for failure and their combinations.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
Rashid M Tikhilov, Nikolai N Efimov, Igor I Shubnyakov, Maksim Y Goncharov, Dmitrii V Stafeev, Vitalii V Karelkin
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引用次数: 0

Abstract

Background: Constrained liners (CLs) have been used in revision total hip arthroplasty (rTHA) with varying results. Relatively few studies have identified specific risk factors for failure. This study aimed to assess implant survivorship and complication rates, identify risk factors for constraint-related complications, and assess the effect of multiple factors present in a single case.

Methods: We conducted a retrospective analysis of 101 rTHAs for various aseptic indications and as second-stage procedures for periprosthetic joint infection (PJI) utilising 2 models of conventional single-articulation CLs. We excluded 8 cases in which the liners were removed early due to PJI and assessed the risk factors for constraint-related complications in the remaining 93 cases. The mean follow-up duration for complication-free cases was 6.5 years (range 4.7-10.5 years).

Results: The incidences of dislocation of a prosthetic head and loosening of the acetabular component were 19.8% and 5.0%, respectively. We also observed 8 cases where the locking ring of the liner was dislodged without dislocation (1 case required re-revision). The presence of factors related to impingement (cup retention, smaller internal diameter CLs, signs of probable impingement from the femoral side) was associated with higher rates of constraint-related complications. The presence of factors related to soft-tissue stabilisers did not increase the rate of complications. The simultaneous presence of multiple impingement-related risk factors resulted in worse outcomes.

Conclusions: CLs may be less effective for treating or preventing instability related to impingement. CLs should be used with caution or avoided when multiple impingement-related risk factors are present.

翻修髋关节置换术中的传统单关节约束衬垫:失败的风险因素及其组合。
背景:翻修全髋关节置换术(rTHA)中已使用过约束衬垫(CL),但效果不一。确定失败具体风险因素的研究相对较少。本研究旨在评估植入物的存活率和并发症发生率,确定与约束相关并发症的风险因素,并评估单个病例中存在的多种因素的影响:我们对 101 例用于各种无菌适应症的 rTHAs 和作为假体周围关节感染(PJI)二期手术的两种型号的传统单关节 CL 进行了回顾性分析。我们排除了 8 例因 PJI 而提前移除衬垫的病例,并评估了其余 93 例病例中与约束相关并发症的风险因素。无并发症病例的平均随访时间为 6.5 年(范围为 4.7-10.5 年):结果:假体头脱位和髋臼组件松动的发生率分别为19.8%和5.0%。我们还观察到8例衬垫锁定环脱落但未脱位的病例(其中1例需要再次手术)。存在与撞击相关的因素(髋臼杯滞留、内径较小的CL、股骨侧可能存在撞击的迹象)与较高的约束相关并发症发生率有关。与软组织稳定器相关的因素并不会增加并发症的发生率。同时存在多种与撞击相关的风险因素会导致更差的结果:CL在治疗或预防与撞击相关的不稳定性方面的效果可能较差。当存在多种撞击相关风险因素时,应谨慎使用或避免使用CL。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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