Journal: Annals of The Royal College of Surgeons of England

Article Title: Gait instability may indicate liner failure in patients with total hip arthroplasty. A report of three cases

doi: 10.1308/rcsann.2021.0027

Figure Lengend Snippet: Patient demographics, radiographic evaluation and postoperative results.

Article Snippet: Details are summarised in . fig ft0 fig mode=article f1 fig/graphic|fig/alternatives/graphic mode="anchored" m1 Open in a separate window caption a7 Anteroposterior radiographs: (a) pelvic and (b) lateral left hip showing loosening signs of the hip resurfacing table ft1 table-wrap mode="anchored" t5 caption a7 Variable Patient 1 Patient 2 Patient 3 Body mass index (kg/m 2 ) 34 24 37 Acetabular cup 58mm primary modular uncemented (Trilogy ® , Zimmer, Warsaw, IN) 50mm primary modular uncemented (Pinnacle ® , DePuy Synthes, Warsaw, IN) 50mm primary modular uncemented (CombiCup ® , Waldemar Link, Hamburg, Germany) Liner 3.5mm lateralised HXLPE (Longevity ® , Zimmer, Warsaw, IN) and a rim thickness of 8.9mm 4mm lateralised HXLPE (Altrix ® , DePuy Synthes, IN) and a rim thickness of 7.1mm Lateralised HXLPE with 7-mm of anti-luxation shoulder height (CombiCup) Femoral stem Standard no. 1 collarless polished tapered cemented stem (CPT ® , Zimmer, Warsaw, IN) Standard no. 3 triple-tapered polished cemented stem (C-Stem ® , DePuy Synthes, Warsaw, IN) Standard no. 9 fully hydroxyapatite-coated tapered stem (LCU Hip system ® , Waldemar Link, Hamburg, Germany) Femoral head Ceramic (BIOLOX ® Delta, Ceramtec AG, Plochingen, Germany) Ceramic (BIOLOX) Cobalt-chrome (LINK ® , Waldemar Link, Hamburg, Germany) Liner/head diameter (mm) 36 32 32 Radiographical findings THA subluxation with an asymmetrical femoral head THA subluxation with an asymmetrical femoral head THA subluxation with an asymmetrical femoral head Cup abduction/anteversion (degrees) a 50/15 49/12 43/23 Intraoperative findings Anterosuperior rim liner fracture; liner fully seated; cup screws fully seated Anterosuperior rim liner rupture; liner fully seated; cup screws fully seated; metallosis signs Liner dissociation; cup screws loose; aseptic cup loosening Revision procedure Cemented dual mobility cup in the existing cup and change of femoral head Change of liner and femoral head Revised cup using the same implant, cemented liner, and change of femoral head New implants 46mm dual mobility cup; 28mm conventional polyethylene liner; 28mm cobalt-chrome femoral head 4mm lateralised HXLPE liner (Altrix); ceramic femoral head (BIOLOX) Neutral HXLPE liner (CombiCup); cobalt-chrome femoral head (LINK) Harris Hip Score 87 85 86 Open in a separate window a Lewinnek’s safe zone (40 degrees ± 10 degrees of abduction and 15 degrees ± 10 degrees of anteversion) 23 HXLPE, highly cross-linked polyethylene; THA, total hip arthroplasty Patient demographics, radiographic evaluation and postoperative results.

Techniques:

Journal: Annals of The Royal College of Surgeons of England

Article Title: Gait instability may indicate liner failure in patients with total hip arthroplasty. A report of three cases

doi: 10.1308/rcsann.2021.0027

Figure Lengend Snippet: (a) Immediate postoperative anteroposterior radiograph of the hip showing primary uncemented left total hip arthroplasty (THA). (b) First postoperative anteroposterior radiograph of the hip at 15 days of follow-up showing THA subluxation with an asymmetrical position of the femoral head and an excessively anteverted cup. (c) Postoperative anteroposterior radiograph of the hip after 14 months of revision surgery, showing no evidence of loosening.

Article Snippet: Details are summarised in . fig ft0 fig mode=article f1 fig/graphic|fig/alternatives/graphic mode="anchored" m1 Open in a separate window caption a7 Anteroposterior radiographs: (a) pelvic and (b) lateral left hip showing loosening signs of the hip resurfacing table ft1 table-wrap mode="anchored" t5 caption a7 Variable Patient 1 Patient 2 Patient 3 Body mass index (kg/m 2 ) 34 24 37 Acetabular cup 58mm primary modular uncemented (Trilogy ® , Zimmer, Warsaw, IN) 50mm primary modular uncemented (Pinnacle ® , DePuy Synthes, Warsaw, IN) 50mm primary modular uncemented (CombiCup ® , Waldemar Link, Hamburg, Germany) Liner 3.5mm lateralised HXLPE (Longevity ® , Zimmer, Warsaw, IN) and a rim thickness of 8.9mm 4mm lateralised HXLPE (Altrix ® , DePuy Synthes, IN) and a rim thickness of 7.1mm Lateralised HXLPE with 7-mm of anti-luxation shoulder height (CombiCup) Femoral stem Standard no. 1 collarless polished tapered cemented stem (CPT ® , Zimmer, Warsaw, IN) Standard no. 3 triple-tapered polished cemented stem (C-Stem ® , DePuy Synthes, Warsaw, IN) Standard no. 9 fully hydroxyapatite-coated tapered stem (LCU Hip system ® , Waldemar Link, Hamburg, Germany) Femoral head Ceramic (BIOLOX ® Delta, Ceramtec AG, Plochingen, Germany) Ceramic (BIOLOX) Cobalt-chrome (LINK ® , Waldemar Link, Hamburg, Germany) Liner/head diameter (mm) 36 32 32 Radiographical findings THA subluxation with an asymmetrical femoral head THA subluxation with an asymmetrical femoral head THA subluxation with an asymmetrical femoral head Cup abduction/anteversion (degrees) a 50/15 49/12 43/23 Intraoperative findings Anterosuperior rim liner fracture; liner fully seated; cup screws fully seated Anterosuperior rim liner rupture; liner fully seated; cup screws fully seated; metallosis signs Liner dissociation; cup screws loose; aseptic cup loosening Revision procedure Cemented dual mobility cup in the existing cup and change of femoral head Change of liner and femoral head Revised cup using the same implant, cemented liner, and change of femoral head New implants 46mm dual mobility cup; 28mm conventional polyethylene liner; 28mm cobalt-chrome femoral head 4mm lateralised HXLPE liner (Altrix); ceramic femoral head (BIOLOX) Neutral HXLPE liner (CombiCup); cobalt-chrome femoral head (LINK) Harris Hip Score 87 85 86 Open in a separate window a Lewinnek’s safe zone (40 degrees ± 10 degrees of abduction and 15 degrees ± 10 degrees of anteversion) 23 HXLPE, highly cross-linked polyethylene; THA, total hip arthroplasty Patient demographics, radiographic evaluation and postoperative results.

Techniques: