A BIOMECHANICAL ANALYSIS OF POLYETHYLENE LINER CEMENTATION INTO A FIXED METAL ACETABULAR SHELL

Dissociation of the polyethylene liner from the acetabular shell is a rare but catastrophic complication of total hip arthroplasty (THA). There have been reports of polyethylene liner dissociation (PLD) as well as ceramic liner dissociation (CLD) in the literature. Amongst the commonly used implants, liner dissociation has been reported with the Pinnacle (DePuy), Harris–Galante (Zimmer) and Trident (Stryker) acetabular components. To the best of our knowledge, this is the first case report of PLD in an R3 (Smith & Nephew) acetabular component. This case report highlights the implant choice for treatment of the liner dissociation and the role of constrained implants in such cases.

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Cementation of a Polyethylene Liner Into a Metal Acetabular Shell

The Journal of Arthroplasty ◽

10.1016/j.arth.2008.05.027 ◽

2009 ◽

Vol 24 (5) ◽

pp. 775-782 ◽

Cited By ~ 18

Author(s):

Aaron A. Hofmann ◽

Edward J. Prince ◽

F. Thurston Drake ◽

Kenneth J. Hunt

Keyword(s):

Polyethylene Liner ◽

Acetabular Shell

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Fixation strength of an all-metal acetabular component cemented into an acetabular shell*1A biomechanical analysis

The Journal of Arthroplasty ◽

10.1016/s0883-5403(04)00545-5 ◽

2004 ◽

Vol 19 (8) ◽

pp. 45-49 ◽

Cited By ~ 2

Author(s):

E EBRAMZADEH ◽

P BEAULE ◽

J CULWELL ◽

H AMSTUTZ

Keyword(s):

Acetabular Component ◽

Biomechanical Analysis ◽

Fixation Strength ◽

Acetabular Shell

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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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