The use of a constrained cementless acetabular component for instability in total hip replacement

Ahmad Emad Rady, Mohammed Kamal Asal, Ayman Abdelaziz Bassiony
Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy 2010, 20 (4): 434-9
Recurrent dislocation after total hip arthroplasty is a disabling complication that can be difficult to treat. We evaluated the early clinical and radiographic outcome associated with the use of a constrained acetabular component for instability in total hip arthroplasty. Fifteen patients underwent either primary or revision total hip arthroplasty with a cementless constrained acetabular component for different indications. The mean patient age at surgery was 57.4 years and the mean clinical and radiological follow-up period was 26.4 months. Clinical assessment was performed by the Harris hip score and at the latest follow up patients reported outcome using the Oxford hip score questionnaire. All radiographs were evaluated for evidence of loosening. Only one patient experienced redislocation with the constrained prosthesis. The average Harris hip score increased from a preoperative mean of 22 (range, 16 - 36) to a postoperative mean of 85 (range, 66-94). Preoperatively, the mean Oxford Hip Score was 48.6, which decreased to 20.5 at the final examination. All but one of the 15 hips had a well-fixed, stable cup. Femoral component stability with bone ingrowth was achieved in 10 cases. A constrained acetabular component is an effective option for the treatment of hip instability in primary and revision arthroplasty in those at high risk of dislocation. The potential for aseptic loosening requires evaluation by long term studies.

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