Acetabular Loosening Using an Extended Offset Polyethylene Liner

The use of extended offset femoral components and acetabular liners helps restore preoperative offset during hip arthroplasty. We report a relatively high acetabular component aseptic loosening rate with the use of offset polyethylene liners. We reviewed 1919 primary and 346 revision total hip arthroplasties (THAs). A 7-mm offset acetabular liner was used in 120 of the primary and 100 of the revision THAs. The aseptic loosening rate in the primary THA group was 0.12% in the standard offset and 4.2% in the extended offset groups at a minimum of 2 years (mean, 3.6 years; range, 2–9 years) followup. The aseptic loosening rate in the revision group was 1.7% in the standard and 7% in the extended offset groups at a mean of 4 years (range, 2–9 years) followup. Although extended offset acetabular liners help restore hip offset, torsional force applied to the implant-bone interface may have a detrimental effect on fixation. We found a relatively high failure rate in our primary and revision acetabular components used with an offset liner.

Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.