Abstract
Background: A common clinical scenario encountered by an orthopaedic surgeon is a patient with a secure cementless acetabular shell and a failed polyethylene liner. One treatment option is to cement a new liner into the fixed shell. The purpose of this study was to evaluate the radiographic outcome of this technique.
Materials and Methods: From November 2001 to April 2006, 11 liner were cemented into well-fixed cementless acetabular shell of 10 patients. There were 6 males and 5 women of average age 54.3 (range 41~73) years at the time of the revision surgery. The indication for the revision procedure were aseptic loosening and wear in 9 cases, and periprosthetic fracture in 2 cases. The pre-existing screws in the shell were removed, and screw holes were filled with allogenic bone graft or cementaion. The patients were evaluated the radiographic evidence of progressive loosening and osteolysis. The average follow up period was 35.2 (range 24~76) months.
Results: There were no changes in cup and liner position or progression of osteolytic lesion around the femoral or acetabular components in the last follow-up radiographs. No compications such as a deep or superficial infection or deep vein thrombosis occurred. There were no hip dislocations.
Conclusion: A liner cemented into a secure, well-positioned cementless acetabular shell provide stability and durability at short and long term follow up. This technique also has advantages of preventing bone loss associated with removal of a well fixed component, and lower surgical morbidity and more liner options. Careful attention to the preparation of the liner, the sizing of the component, and the cementing technique are likely to reduce the failure of this construct.
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