Salvage of a Recurrently Dislocating Total Hip Prosthesis with Use of a Constrained Acetabular Component

We previously reported the results at a mean of five years following the use of a tripolar constrained acetabular component to treat recurrently dislocating total hip prostheses. In this study, we report the results after longer follow-up, with emphasis on the prevalence of implant loosening, osteolysis, and later recurrent instability. Fifty-five patients treated with a total of fifty-six constrained acetabular components because of recurrent dislocations of a total hip prosthesis (average, six dislocations; range, two to twenty dislocations) were followed for an average of 10.2 years (range, 7.0 to 13.2 years) or until death. Four (7%) of the fifty-six hips had a subsequent dislocation or failure of the device. Three femoral components (5%) and two acetabular components (4%) were revised because of aseptic loosening. One hip was revised because of osteolysis. We concluded that this constrained acetabular component provides durable protection against additional dislocations without substantial deleterious effects on component fixation. We use this device to treat recurrent dislocation when other modalities are unlikely to be effective.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.