Constrained liners in revision total hip arthroplasty: an overuse syndrome: in the affirmative.

摘要

Instability after primary and revision total hip arthroplasty continues to be problematic for the surgeon. The use of constrained liners, which use a locking mechanism to capture the femoral head, has increased to help manage this problem. Constrained liners, however, present problems with acetabular component loosening, dissociation of the liner/shell interface, failure by breakage, and excessive polyethylene wear. Rather than resort to constrained liners, our approach has been to restore joint stability with large-diameter femoral heads. The advantages are increased range of motion due to more favorable headeck ratio, increased resistance to dislocation due to increased jump distance, and the avoidance of skirted femoral heads. With the addition of cross-linked polyethylene, the volumetric wear associated with large heads is much decreased and makes this a viable option today.