Cementing Liners Into Well-Fixed Acetabular Components in Revision Total Hip Arthroplasty: A Mean 7.7-Year Follow-Up.

Abstract

In revision total hip arthroplasty (THA), surgeons may encounter a well-fixed acetabular component that requires liner revision, particularly when a compatible liner is unavailable or the original locking mechanism is damaged. Cementing a new liner into the well-fixed cup may be an option. There are currently limited reports on this technique, consisting of small cohort studies or those with only early outcomes. This study aimed to evaluate the clinical outcomes at a mean follow-up of 7.7 years of liners cemented into well-fixed acetabular components. We retrospectively reviewed 62 revision THAs in which liners were cemented into well-fixed acetabular components. The average follow-up period was 7.7 years. The mean age at the time of revision THA was 54 years, with 67.7% of the patients being women. The most common indications for surgery included liner wear in 33 hips, dislocation in 14 hips, and early-stage periprosthetic joint infection in 13 hips. The survivorship free from rerevision for any reason was 88.7% (95% confidence interval = 81.0 to 97.0). The most common complication was dislocation, occurring in seven patients, with three of these requiring rerevision. This was followed by periprosthetic joint infection in three patients, and there was one patient in whom the liner dissociated from the acetabular component. Patients who underwent previous revisions were more prone to rerevision (P < 0.001), and those who underwent revision due to dislocation were at a higher risk of postoperative dislocation (P = 0.038). Cementing a liner into a well-fixed acetabular component during revision THA provides favorable clinical outcomes at mean 7.7-year follow-up. Patients undergoing revision due to dislocation face a higher risk of postoperative dislocation. In addition, patients who had a history of previous revisions tend to have a higher risk of rerevision.