Trilogy-constrained acetabular component for recurrent dislocation.

Annette Vest Andersen,Anne Grete Kjersgaard,Søren Solgaard

doi:10.1155/2013/629201

Abstract

32 patients received a Trilogy- or Trilogy-Longevity-constrained acetabular liner for recurrent dislocations after total hip replacement. The constrained liner was inserted into a well-fixed Trilogy acetabular shell with snap fit. At 1.8-year followup (range 3–63 months), 4 patients had suffered further dislocation(s) (12%), and one patient had revision surgery for a loosened acetabular shell. Radiologic evaluation detected no definitively loose components, but one patient with progressing radiolucent lines around the femoral component and one patient with an acetabular cyst were found, as well as a patient with a loose locking ring (but otherwise no failure). The nineteen patients who were available for the present followup had a mean Harris Hip Score of 81. The constrained liner is an effective method of dealing with recurrent dislocations in well-fixed components.

Highlights

Radiologic evaluation detected no de nitively loose components, but one patient with progressing radiolucent lines around the femoral component and one patient with an acetabular cyst were found, as well as a patient with a loose locking ring. e nineteen patients who were available for the present followup had a mean Harris Hip Score of 81. e constrained liner is an effective method of dealing with recurrent dislocations in well- xed components
Dislocation remains one of the most common complications a er primary and especially revision hip arthroplasty. e rate of dislocation is in uenced by many different factors and ranges between 0.3 and 10% in primary arthroplasty [1,2,3,4,5] and between 4 and 28% a er revision arthroplasty [1,2,3,4]. e incidence varies greatly in different studies with a much higher risk for patients with neuromuscular disease or lack of compliance resulting from dementia or substance abuse [1, 2]
None of the methods mentioned above have been without complications. e use of different kinds/brands of constrained liners has been reported with mixed results

Summary

Introduction

Dislocation remains one of the most common complications a er primary and especially revision hip arthroplasty. e rate of dislocation is in uenced by many different factors and ranges between 0.3 and 10% in primary arthroplasty [1,2,3,4,5] and between 4 and 28% a er revision arthroplasty [1,2,3,4]. e incidence varies greatly in different studies with a much higher risk for patients with neuromuscular disease or lack of compliance resulting from dementia or substance abuse [1, 2]. Dislocation remains one of the most common complications a er primary and especially revision hip arthroplasty. E rate of dislocation is in uenced by many different factors and ranges between 0.3 and 10% in primary arthroplasty [1,2,3,4,5] and between 4 and 28% a er revision arthroplasty [1,2,3,4]. By repositioning malpositioned components, inserting jumbo or bipolar heads, or longer necks and last but not least by using a constrained liner [1,2,3]. E use of different kinds/brands of constrained liners has been reported with mixed results. We report on the use of the Trilogy constrained liner (Trilogy and Trilogy Longevity) in a consecutive series of patients operated on because of recurrent dislocations

Materials and Methods

Results

Discussion

Conclusion