Cement-in-cement Acetabular Revision With a Constrained Tripolar Component

Full article available online at ORTHOSuperSite.com. Search: 20120123-25 Dislocation of a total hip replacement (THR) is common following total hip arthroplasty (THA). When nonoperative management fails to maintain reduction, revision surgery is considered. The use of constrained acetabular liners has been extensively described. Complete removal of the old cement mantle during revision THA can be challenging and is associated with signifi cant complications. Cement-in-cement revision is an established technique. However, the available clinical and experimental studies focus on femoral stem revision. The purpose of this study was to present a case of cement-in-cement acetabular revision with a constrained component for recurrent dislocations and to investigate the current best evidence for this technique. This article describes the case of a 74-year-old woman who underwent revision of a Charnley THR for recurrent low-energy dislocations. A tripolar constrained acetabular component was cemented over the primary cement mantle following removal of the original liner by reaming, roughening the surface, and thoroughly irrigating and drying the primary cement. Clinical and radiological results were good, with the Oxford Hip Score improving from 11 preoperatively to 24 at 6 months postoperatively. The good short-term results of this case and the current clinical and biomechanical data encourage the use of the cement-in-cement technique for acetabular revision. Careful irrigation, drying, and roughening of the primary surface are necessary. Messrs Leonidou, Pagkalos, and Luscombe are from the Department of Trauma and Orthopaedics, Worcestershire Acute Hospitals, Alexandra Hospital, Redditch, United Kingdom. Messrs Leonidou, Pagkalos, and Luscombe have no relevant fi nancial relationships to disclose. Correspondence should be addressed to: Andreas Leonidou, MRCS, MSc, Department of Trauma and Orthopaedics, Alexandra Hospital, Woodrow Dr, Redditch, B98 7UB, United Kingdom (leonidou@ doctors.org.uk). doi: 10.3928/01477447-20120123-25 Cement-in-cement Acetabular Revision With a Constrained Tripolar Component ANDREAS LEONIDOU, MRCS, MSC; JOSEPH PAGKALOS, MRCS, MSC; JONATHAN LUSCOMBE, FRCS e255 Figure: Postoperative anteroposterior (top) and lateral (bottom) radiographs showing satisfactory postion of the Trident Constrained Acetabular Component (Stryker, Mahwah, New Jersey).