Polyethylene replacement by cementing a new component over the osseointegrated metal-back ☆

Abstract Objective In uncemented revision total hip replacement due to polyethylene wear, the metal cup needs to be maintained when its stability is checked during surgery, only replacing the polyethylene that is cemented if anchoring is not possible. The aim of the present study was to evaluate the medium-term clinical and radiological results of a polyethylene liner cemented into an osseointegrated acetabular shell component. Materials and methods A retrospective analysis was performed on 15 patients in whom the surgical indication was polyethylene wear, with a mean follow-up of 6.1 years (range 3.5–9.7 years). The Harris Hip Score was used to assess the clinical results before surgery and at the end of follow-up. Anteroposterior and axial X-rays of the hip were taken to rule out complications. Results The mean Harris Hip Score improved, increasing from 64.7 points before the surgery to 80.3 at the end of follow-up. The osteolytic lesions disappeared, or at least the size did not increase, in the follow-up X-rays. One patient (6.7%) suffered 2 dislocation episodes that were treated without the need for surgery. Another patient presented with aseptic loosening of the femoral stem that required a replacement. Conclusions Cementing the polyethylene liner, when anchoring is not possible, in an uncemented osseointegrated metal shell is a technique that offers good results in the medium term, and which may minimize the complications that may occur with the replacement of the shell component, without compromising its stability.