Medium-Term Results of Cementation of a Highly Cross-Linked Polyethylene Liner Into a Well-Fixed Acetabular Shell in Revision Hip Arthroplasty

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster Cortical Window technique which can be used for removal of cemented or uncemented femoral stems. Methodology The study was conducted at a specialist centre in the North-West of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using Lancaster Cortical Window technique for removal of femoral implant during a revision hip arthroplasty. Patient’s electronic notes and the radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using Novel Lancaster Window technique. The mean age of the all the patients was 81.5 years and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular component. Rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow up. Conclusion We believe Lancaster cortical window technique can be safely used for removal of cemented stems during revision hip arthroplasty without the need for expensive equipment’s.

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Revision Hip Arthroplasty Using An Extensively Porous Coated Stem: Medium Term Results

Hip International ◽

10.5301/hip.2011.6504 ◽

2011 ◽

Vol 21 (2) ◽

pp. 129-135 ◽

Cited By ~ 6

Author(s):

Prakash Jayakumar ◽

Ahmad K. Malik ◽

Saif U. Islam ◽

Fares S. Haddad

Keyword(s):

Hip Arthroplasty ◽

Revision Hip Arthroplasty ◽

Medium Term

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Medium term outcome of Lancaster cortical window technique for extraction of femoral stem in revision hip arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02458-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Amit Singh ◽

Sunirmal Mukherjee ◽

Kuntal Patel ◽

Deepak Herlekar ◽

Srikant Gandavaram ◽

...

Keyword(s):

Hip Arthroplasty ◽

Revision Surgery ◽

Femoral Stem ◽

Revision Hip Arthroplasty ◽

Medium Term ◽

Term Outcome ◽

Window Technique ◽

Femoral Stems ◽

The Mean

Abstract Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in the speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster cortical window technique which can be used for the removal of cemented or uncemented femoral stems. Methods The study was conducted at a specialist centre in the north-west of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using the Lancaster cortical window technique for removal of the femoral implant during a revision hip arthroplasty. Patient’s electronic notes and radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using the novel Lancaster window technique. The mean age of all the patients was 81.5 years, and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular components. The rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow-up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow-up. Conclusion We believe Lancaster cortical window technique can be safely used for the removal of cemented stems during revision hip arthroplasty without the need for expensive equipment.

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A Polyethylene Liner Scratch After Revision Hip Arthroplasty Performed to Repair Ceramic Fracture

The Journal of Arthroplasty ◽

10.1016/j.arth.2011.08.018 ◽

2012 ◽

Vol 27 (5) ◽

pp. 820.e17-820.e19 ◽

Cited By ~ 3

Author(s):

Yukiharu Hasegawa ◽

Puyi Sheng ◽

Toshiya Kanoh ◽

Taisuke Seki ◽

Atsushi Matsuoka

Keyword(s):

Hip Arthroplasty ◽

Revision Hip Arthroplasty ◽

Polyethylene Liner ◽

Ceramic Fracture

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The Polished Tri-Tapered Stem for Cement-In-Cement Revision Hip Arthroplasty, a Reliable and Reproducible Technique?

Hip International ◽

10.1177/112070000801800402 ◽

2008 ◽

Vol 18 (4) ◽

pp. 272-277 ◽

Cited By ~ 8

Author(s):

J. Young ◽

V.R.P. Vallamshetla ◽

T. Lawrence

Keyword(s):

Hip Arthroplasty ◽

Womac Score ◽

Revision Hip Arthroplasty ◽

Consecutive Series ◽

Partial Recovery ◽

Prosthesis Loosening ◽

Medium Term ◽

Term Outcome ◽

Tapered Stem

The object of this study was to determine the short to medium term outcome of cementing a highly polished tapered implant into the old cement mantle once damaged cement is removed at the time of revision hip surgery. A consecutive series of 36 patients underwent c-stem cement-in-cement revision hip arthroplasty between June 2000 and April 2006. The primary outcome measure was the validated shortened Western Ontario and McMaster Universities (WOMAC) score, secondary outcomes were the Orthowave company patient satisfaction survey, radiological analysis, and general complications. The follow-up period was between 12 and 84 months (average 48.86 months). The mean post op WOMAC score at latest follow-up was 10.89 (0 to 29). Two patients died with their hip in situ. Two patients had radiological signs of prosthesis loosening on follow-up. Complications included: one sacral plexus palsy which had a partial recovery and one intra-operative periprosthetic fracture. One patient underwent cup revision for recurrent dislocation. Cement within cement revision hip arthroplasty using a highly polished tapered stem in the short to medium term provides satisfactory functional outcomes and is associated with a low complication rate and good survivorship.

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Polyethylene liner dissociation in a DePuy pinnacle cup with a manufacturer analysis of the failed component

BMJ Case Reports ◽

10.1136/bcr-2020-238333 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238333

Author(s):

David Keohane ◽

Gerard A Sheridan ◽

James Harty ◽

Padhraig O'Loughlin

Keyword(s):

Emergency Department ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Detailed Analysis ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Polyethylene Liner ◽

Radiographic Imaging ◽

Root Cause ◽

Acetabular Shell

A 74-year-old patient presented to the emergency department with acute atraumatic hip pain 9 years after her primary left total hip arthroplasty (THA). Plain radiographic imaging demonstrated lateralisation of the femoral head within the acetabular shell—indicating an issue with the polyethylene liner. The patient required revision of the acetabular component and the femoral head, as well as a new polyethylene liner. A detailed analysis of the components removed was performed by DePuy Synthes Engineering. Between 2009 and 2020, 8 publications have documented 52 cases of liner dissociation with the Pinnacle acetabular component and Marathon polyethylene liner. Various theories have been proposed in the literature as all of these components appear to fail in the same way, with shearing of the locking tabs in the polyethylene liner. In spite of a manufacturer analysis of the components, no root cause was identified as to why the polyethylene liner failed.

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