Failure of a Highly Cross-Linked Polyethylene Liner After Spine Fusion

March 21, 2023

. 2023 Mar 20;7(3).

doi: 10.5435/JAAOSGlobal-D-22-00150.

eCollection 2023 Mar 1.

Affiliations

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Kimberly Roesler et al.

J Am Acad Orthop Surg Glob Res Rev.

2023.

. 2023 Mar 20;7(3).

doi: 10.5435/JAAOSGlobal-D-22-00150.

eCollection 2023 Mar 1.

Affiliation

¹ From the Creighton University School of Medicine, Omaha, NE (Dr. Roesler), and the Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE (Dr. Garvin).

Item in Clipboard

Abstract

A 73-year-old woman, 11 years after total hip arthroplasty and 2 years after a multilevel lumbar spine fusion, presented with a 2-month history of anterior hip and gluteal pain. She was diagnosed with an acetabular liner fracture that occurred through the high wall, likely related to repetitive impingement on the neck of the femoral implant, as notable burnishing was observed on the explanted femoral head. The acetabulum was successfully revised to a dual-mobility articulation. Spinal fusion after total hip arthroplasty can alter the acetabular implant position and was seen in our patient whose previously functional high-walled liner failed. Surgeons may consider alternative techniques, including a change in acetabular implant’s anteversion to mitigate the need for a high-walled liner or the use of a dual-mobility bearing.

References

1. Sing DC, Barry JJ, Aguilar TU, et al.: Prior lumbar spinal arthrodesis increases risk of prosthetic-related complication in total hip arthroplasty. J Arthroplasty 2016;31:227-232.e1.
1. Duffy GP, Wannomae KK, Rowell SL, Muratoglu OK: Fracture of a cross-linked polyethylene liner due to impingement. J Arthroplasty 2009;24:158.e15-158.e19.
1. Heckmann N, McKnight B, Stefl M, Trasolini NA, Ike H, Dorr LD: Late dislocation following total hip arthroplasty: Spinopelvic imbalance as a causative factor. J Bone Joint Surg Am 2018;100:1845-1853.
1. An VVG, Phan K, Sivakumar BS, Mobbs RJ, Bruce WJ: Prior lumbar spinal fusion is associated with an increased risk of dislocation and revision in total hip arthroplasty: A meta-analysis. J Arthroplasty 2018;33:297-300.
1. Buckland AJ, Puvanesarajah V, Vigdorchik J, et al.: Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 2017;99-B:585-591.