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Pagano S, Plate JF, Kappenschneider T, Reinhard J, Scharf M, Maderbacher G. Polyethylene liner dissociation in total hip arthroplasty: a retrospective case-control study on a single implant design. J Orthop Traumatol 2024; 25:38. [PMID: 39143399 PMCID: PMC11324622 DOI: 10.1186/s10195-024-00785-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Modular acetabular components for total hip arthroplasty (THA) provide intraoperative flexibility; however, polyethylene liner dissociation may occur. This study aimed to examine the incidence and causes of liner dissociation associated with a specific acetabular component design at a single centre. MATERIALS AND METHODS A retrospective analysis of 7027 patients who underwent primary THA was performed to identify isolated liner dislocations. Patient demographics, clinical presentations, surgical and implant details, and both radiographic and computed tomography (CT) findings were analysed. Patients with liner dislocation were matched to a control group via 2:1 propensity score matching, and a logistic regression analysis was employed to identify associated risk factors. RESULTS A total of 32 patients (0.45%) experienced liner dislocation at a mean 71.47 ± 60.10 months post surgery. Significant factors contributing to dislocations included the use of a conventional compared with a highly crosslinked polyethylene component (p = 0.049) and screw fixation (p = 0.028). Radiographic and CT analysis highlighted the importance of proper component orientation, revealing that patients experiencing dislocations demonstrated significantly lower acetabular cup anteversion angles (p = 0.001) compared with the control group. Impingement and malposition, identified in 41% and 47% of the cases, respectively, further underscored the multifactorial nature of dislocation risks. CONCLUSIONS While the overall rate of polyethylene liner dislocation was low, the findings of this study highlight the importance of appropriate cup placement to decrease the risk of dissociation. It further substantiates the influence of impingement and malposition in liner displacement, with increased mechanical stress exerted on the locking mechanism under adverse conditions and the potential risk increase due to screw placement.
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Affiliation(s)
- S Pagano
- Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany.
| | - J F Plate
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - T Kappenschneider
- Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany
| | - J Reinhard
- Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany
| | - M Scharf
- Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany
| | - G Maderbacher
- Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany
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Wakabayashi H, Hasegawa M, Naito Y, Tone S, Sudo A. Minimum 10-Year Results of Modular Metal-On-Metal Total Hip Arthroplasty. J Clin Med 2022; 11:jcm11216505. [PMID: 36362734 PMCID: PMC9657710 DOI: 10.3390/jcm11216505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
Background: this study aimed to assess the long-term outcomes of (a minimum of 10-years) total hip arthroplasty with a metal-on-metal acetabular prosthesis. Methods: Eighty-nine primary total hip arthroplasties (82 patients) were performed using a Pinnacle modular metal-on-metal acetabular prosthesis. Clinical hip function outcomes were evaluated using the Japanese Orthopaedic Association hip score preoperatively and at the final follow-up. Radiological analysis was performed at the final follow-up and magnetic resonance imaging in all hips postoperatively. Results: Out of 82 patients, 17 were excluded who were followed up for <10 years. Of the remaining 65 patients (70 hips), 19 (20 hips) developed pseudotumors during 2−10 years postoperatively. After 10 and 13 years, the survival rates of revision endpoint were 93.6% and 90.4%, respectively. Clinical hip function outcomes had improved significantly at the final follow-up. In the radiological analysis, the mean cup angle of inclination and mean ratio of femoral offset on the operated hip to the contralateral hip was highest in patients with revision surgery for adverse reactions to metal debris. Conclusions: This study showed a 29.0% prevalence of pseudotumors. Some cases required revisions even after 10 years following surgery. Regular clinical surveillance is recommended for the early detection of adverse reactions to metal debris.
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Crown TJL, Sheridan GA, Bengoa F, Fransen BL, Lawlor DK, Clarkson PW, Greidanus NV. Chronic Pseudoaneurysm and Anterior Dislocation After Total Hip Arthroplasty Complicated by Arterial Injury: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00039. [PMID: 36099455 DOI: 10.2106/jbjs.cc.22.00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 64-year-old man presented 18 months after total hip arthroplasty complicated by vascular injury with a history of leg pain, inability to mobilize, and progressive chronic leg edema. It is presumed that there was persistent subtle bleeding over time with pseudoaneurysm formation and prosthetic hip dislocation secondary to the mass effect. CONCLUSION Physicians should consider pseudoaneurysm as a possible diagnosis when confronted with a large intra-articular mass in the hip after a relatively short follow-up period, particularly in the context of a prior vascular injury at the time of the index procedure.
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Affiliation(s)
- Taylor J L Crown
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Gerard A Sheridan
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Francisco Bengoa
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Bas L Fransen
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - David K Lawlor
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Paul W Clarkson
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Nelson V Greidanus
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, University of British Columbia, Vancouver, BC, Canada
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Kenanidis E, Kakoulidis P, Leonidou A, Anagnostis P, Potoupnis M, Tsiridis E. Survival of monoblock RM vitamys compared with modular PINNACLE cups: mid-term outcomes of 200 hips performed by a single surgeon. Hip Int 2021; 31:465-471. [PMID: 31694404 DOI: 10.1177/1120700019885619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Monoblock cups have theoretical advantages over modular cups; however, their superiority in terms of survival has not been confirmed in comparative studies. METHODS We compared the mid-term survivorship of 107 RM Pressfit vitamys monoblock cups (Mathys Ltd., Bettlach, Switzerland) with 93 modular pressfit Pinnacle cups (DePuy Synthes, Warsaw, IN, USA). All cases were registered in the Arthroplasty Registry Thessaloniki and performed by a senior surgeon through the same approach between 2013 and 2014. The groups were comparable in sex distribution, preoperative diagnosis, follow-up, cup diameter, head diameter, type and use of screws, HOOS and HSS preop scores; the recipients of RM cup were significantly younger. RESULTS 3 sockets were revised. The 6-year survival for any reason was 99.1% for the RM and 97.8 % for the PINNACLE group. There was no difference in survival for aseptic loosening and any reason between groups (log-rank test p = 0.921 and p = 0.483, respectively). The age (95% CI, 0.79-1.1), sex (95% CI, 0.2-45.0), cup diameter (95% CI, 0.18-1.1), head diameter (95% CI, 0.004-6.2), preoperative diagnosis and use of screws (95% CI, 0.02-4.3), did not influence hazard ratio for revision between groups. HHS and HOOS were comparable at the last follow-up. CONCLUSIONS Our study demonstrated that both cup designs had similar revision rates at mid-term follow-up, regardless the fact that the RM vitamys was used in a cohort of younger patients; which according to the literature would have led to earlier failures. Further long-term data are needed to evaluate the superiority of RM vitamys in the clinical setting, especially in the young.
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Affiliation(s)
- Eustathios Kenanidis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Greece.,Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Panagiotis Kakoulidis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Greece.,Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Andreas Leonidou
- Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.,Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Panagiotis Anagnostis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Michael Potoupnis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Greece.,Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Eleftherios Tsiridis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Greece.,Centre of Orthopaedic and Regenerative Medicine (CORE), Centre for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
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Mahmood FF, Beck M, de Gast A, Rehbein P, French GJ, Becker R, Dominkus M, Helmy N, Hollmann L, Baines J. Survivorship and Patient-Reported Outcomes of an Uncemented Vitamin E-Infused Monoblock Acetabular Cup: A Multicenter Prospective Cohort Study. J Arthroplasty 2021; 36:1700-1706. [PMID: 33516632 DOI: 10.1016/j.arth.2020.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Addition of vitamin E to polyethylene is theorized to reduce the potential for oxidative wear in acetabular components. This paper presents a multicenter prospective cohort study that reports on outcomes from use of a Vitamin E-infused highly cross-linked polyethylene acetabular cup. METHODS Patients were recruited across nine medical institutions. Clinical outcome measures recorded were the Harris Hip Score, visual analogue score for pain and satisfaction. Evidence of implant loosening or osteolysis was collected radiologically. Cup survival and reasons for revision in relevant cases were also recorded. Data collection was undertaken preoperatively, at 6-12 weeks, 6 months, 1 year, 2 years, and 5 years. A total of 675 patients were recruited, with 450 cases available at final review. Data regarding cup survival was available to 8 years and 9 months postoperatively. RESULTS Improvements in both the Harris Hip Score and visual analogue score for pain and satisfaction were recorded at all time points, with these being maintained through the length of follow-up. In total, 89% of cups were implanted within the Lewinnek safe zone. A lucent line was identified in one case, with no evidence of acetabular osteolysis observed throughout the follow-up period. Cup survival was 98.9% at 8 years and 9 months. No revisions for aseptic loosening were observed. CONCLUSIONS The use of a vitamin E-infused polyethylene acetabular cup demonstrates reassuring patient-reported outcomes, radiological measures, and cup survival at medium to long-term follow-up.
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Affiliation(s)
- Fahd F Mahmood
- Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
| | - Martin Beck
- Luzerner Kantonsspital, Luzern, Switzerland; Orthopaedic Clinic Lucerne, Hirslanden Clinic St. Anna, Lucerne
| | - Arthur de Gast
- Diakonessenhuis Utrecht, Utrecht, the Netherlands; Clinical Orthopedic Research Center Midden-Nederland, Diakonessenhuis Zeist, Zeist, the Netherlands
| | - Philipp Rehbein
- Department of Orthopaedics, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | | | - Roland Becker
- Dept. of Orthopedics and Traumatology, Brandenburg Medical School, Brandenburg, Germany
| | - Martin Dominkus
- Orthopaedic Department, Orthopädisches Spital Speising, Wien, Austria; Sigmund Freud University, Campus Prater Freudplatz 1, Wien, Austria
| | - Naeder Helmy
- Department of Orthopaedics, Nurgerspital Solothurn, Solothurn, Switzerland
| | - Lutz Hollmann
- Streekziekenhuis Koningin Beatrix, Winterswijk, the Netherlands
| | - Joe Baines
- Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
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Bozza N, Guindani N, Pezzotta G, Alberto F, Castelli CC. 15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment. Hip Int 2020; 30:42-51. [PMID: 33267695 DOI: 10.1177/1120700020971662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION There is limited knowledge of the long-term results of metal-on-metal total hip arthroplasty (MoM THA), particularly concerning adverse local tissue reaction (ALTR), Co/Cr ions level and revision rate. Even if MoM bearing surfaces are no longer used, long-term data could help in defining the course and best management for these patients. The purpose of this study is to investigate the clinical outcomes, describe radiological findings including CT metal artefact reduction algorithm for orthopaedic implants (O-MAR) and MRI multi acquisition variable resonance image combination (MAVRIC) in 36-mm MoM THA. METHODS In this long-term prospective study, 46 consecutive patients with primary MoM THA (mono- or bilateral) were enrolled between 2004 and 2005. Pinnacle acetabular cup, Summit cementless stem with 36-mm metal head and Ultamet CoCr alloy liner (Depuy Inc.) were implanted, in the same centre by the same senior surgeon. Patients were reviewed at 5-, 10- and 15-years, including Co/Cr levels and standard radiographs at every follow-up, whilst the 15-year follow-up included hip sonography, MRI MAVRIC and CT O-MAR. RESULTS At 15 years, the overall survival rate of the implants (both stems and cups) was 83% (30/36). Revisions were performed in 9% (4/46) because of ALTR, 2% (1/46) septic loosening and 2% periprosthetic fracture. Both Cr and Co concentration increased over time, even though remaining at low level risk at 15 years: Co from 0.11 (+/- 0.18) to 4.29 (+/- 3.26) and Cr from 0.38 (+/- 0.32) to 1.37 (+/- 1.15). Functional scores in non-revised patients showed good to excellent results in more than 90%. Engh-score correlated with time from surgery (p = 0.017) and with sonographic, CT and RM findings (p < 0.05). Concordance has been found between CT and MRI findings (sign-rank test, p = 0.241; Intraclass Correlation Coefficients 0.987); however, no specific MRI or CT lesion patterns could be recognised among symptomatic and non-symptomatic patients. DISCUSSION The long-term rate of ALTR after 36-mm MoM THA was comparable with previous studies; a regular follow-up for those implants is mandatory. During follow-up Co-Cr levels increased over time and radiography was a suitable screening technique; the Engh score in particular, proved to be a reliable assessment tool. CT O-MAR and MRI with MAVRIC protocols may add valuable data in clinical practice, although MRI is significantly more efficient than CT in the identification of ALTR lesions, peri-articular effusion and in the evaluation of soft tissues.
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Affiliation(s)
- Nicola Bozza
- Surgical Department, Orthopaedics and Traumatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Nicola Guindani
- Surgical Department, Orthopaedics and Traumatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giuseppe Pezzotta
- Surgical Department, Orthopaedics and Traumatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Ferrari Alberto
- Fondazione per la Ricerca Ospedale di Bergamo (FROM), Bergamo, Italy
| | - Claudio C Castelli
- Surgical Department, Orthopaedics and Traumatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Gwynne-Jones DP, Memon A. Acetabular Liner Dissociation: A Comparative Study of Two Contemporary Uncemented Acetabular Components. Arthroplast Today 2020; 6:354-359. [PMID: 32566716 PMCID: PMC7298534 DOI: 10.1016/j.artd.2020.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/13/2020] [Accepted: 04/18/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There are a number of reports of polyethylene liner dissociation of third-generation modular acetabular components. This study compares our experience with 2 contemporary systems to determine whether this is an implant- or class-specific problem. METHODS This is a single-center retrospective study of 961 primary total hip arthroplasties using 2 third-generation modular cementless acetabular shells: Pinnacle (535) and R3 (426) with a polyethylene liner. Details of all revisions were obtained from local databases and the New Zealand Joint Registry. Kaplan-Meier survival curves were calculated for all-cause revision, acetabular reoperation (including liner exchange), and liner dissociation. RESULTS There were 17 revisions in group 1 (Pinnacle; DePuy Synthes): 17 for recurrent dislocation, 6 for liner dissociations (1.12%), 3 for femoral loosening, and one for deep infection. In group 2 (R3; Smith and Nephew), there were 4 revision procedures: one for infection, 2 for dislocation, and one femoral revision for periprosthetic fracture. There were significantly higher proportions revised in group 1 for all-cause revision, acetabular reoperation, and dissociation (P = .024 to 0.038). The 7-year survival for all-cause revision was 96.1% for Pinnacle and 99.0% for R3 (P = .022), and that in the acetabular reoperation group was 96.9% for Pinnacle and 99.3% for R3 (P = .035). CONCLUSIONS There was a higher revision rate for the Pinnacle acetabular component than for the R3 at 7 years. This was mainly due to polyethylene liner dissociation that can occur early or late. It appears to be a problem specific to the Pinnacle cup design rather than a feature of similar third-generation acetabular components.
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Affiliation(s)
- David P. Gwynne-Jones
- Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Orthopaedic Surgery, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand
| | - Adeel Memon
- Department of Orthopaedic Surgery, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand
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Chaudhry H, MacDonald SJ, Howard JL, McCalden RW, Naudie DD, Vasarhelyi EM. Clinical Outcomes and Midterm Survivorship of an Uncemented Primary Total Hip Arthroplasty System. J Arthroplasty 2020; 35:1662-1666. [PMID: 32088053 DOI: 10.1016/j.arth.2020.01.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/11/2020] [Accepted: 01/23/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The rise in total hip arthroplasty (THA) has led to a concomitant increase in revision THAs. Tracking implant performance therefore remains a significant element of scientific inquiry to garner and maintain public trust in this procedure. There are few available reports of outcomes of a single manufacturer's total hip system outside registry data. METHODS We performed a retrospective review of a prospectively generated database to evaluate outcomes of a single manufacturer's femoral stem and acetabular shell for THA. We report the functional outcomes, revision data, and survivorship for this total hip system. RESULTS A total of 1942 primary THAs were implanted into 1672 patients. There were of 57 revisions. There were no cases of acetabular failure at 10-year follow-up. All functional outcome scores demonstrated significant improvements following THA. Kaplan-Meier survival analysis for all-cause revisions demonstrated 2-year implant survival of 97.6% (95% confidence interval [CI], 96.9-98.3), 5-year implant survival of 97.3% (95% CI, 96.5-98.1), and 10-year implant survival of 97.0% (95% CI, 96.0-98.0). When infection was excluded, implant survivorship improved to 99.2% (95% CI, 98.8-99.6) at 2 years, 98.9% (95% CI, 98.5-99.4) at 5 years, and 98.7% (95% CI, 98.1-99.4) at 10 years. CONCLUSION This THA implant system comprising an uncemented press-fit acetabulum used alongside a triple-tapered femoral stem is an excellent option for THA. Implant survivorship at 2, 5, and 10 years is among the best reported for any total hip system in the world.
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Affiliation(s)
- Harman Chaudhry
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Steven J MacDonald
- Division of Orthopaedic Surgery, Western University, London, Ontario, Canada
| | - James L Howard
- Division of Orthopaedic Surgery, Western University, London, Ontario, Canada
| | - Richard W McCalden
- Division of Orthopaedic Surgery, Western University, London, Ontario, Canada
| | - Douglas D Naudie
- Division of Orthopaedic Surgery, Western University, London, Ontario, Canada
| | - Edward M Vasarhelyi
- Division of Orthopaedic Surgery, Western University, London, Ontario, Canada
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Memon AR, Gwynne-Jones D. Polyethylene liner dissociation with the Pinnacle acetabular component: should we be concerned? Arthroplast Today 2020; 6:5-8. [PMID: 32211467 PMCID: PMC7083726 DOI: 10.1016/j.artd.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/14/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022] Open
Abstract
Between 2007 and 2018, 535 total hip arthroplasties using the uncemented Pinnacle acetabular component (DePuy Synthes, Warsaw, IN) and polyethylene liner were implanted in our unit. Of these, 6 patients presented acutely with liner polyethylene dissociation, giving a rate of liner dissociation of 1.11%. All dissociations were atraumatic. Failure occurred at mean 37 months (range 4.5 to 130 months). Radiologically, all acetabular components were within safe zone of abduction and mean anteversion was 10 degrees (range 2-20). In one case, there was posterior impingement against the femoral neck due to femoral malalignment. All patients underwent head and liner exchange with no repeat failures. Despite excellent long-term results, the frequency of dissociated polyethylene liners is a cause of concern with the Pinnacle acetabular component.
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Affiliation(s)
- Adeel R. Memon
- Corresponding author. Dunedin Hospital, Great King street Dunedin, Otago, New Zealand. Tel.: +64 3 4740999.
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10
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Lesko J, Kindsfater K. Response to letter to the editor on "Survivorship of a modular acetabular cup system: medium- to long-term follow-up". Arthroplast Today 2018; 4:394-396. [PMID: 30186928 PMCID: PMC6123242 DOI: 10.1016/j.artd.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/23/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Jim Lesko
- DePuy Synthes, Inc., Warsaw, IN, USA
| | - Kirk Kindsfater
- Orthopaedic and Spine Center of the Rockies, Fort Collins, CO, USA
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11
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Steffen JE, Fassler EA, Reardon KJ, Egilman DS. Grave fraudulence in medical device research: a narrative review of the PIN seeding study for the Pinnacle hip system. Account Res 2017; 25:37-66. [DOI: 10.1080/08989621.2017.1405259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | - David S. Egilman
- Department of Family Medicine, Brown University, Attleboro, Massachusetts, USA
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