High failure rate of the Duraloc Constrained Inlay

Labek, Gerold; Brabec, Erich; Frischhut, Stephan; Krismer, Martin

doi:10.3109/17453670903316819

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…Recent attention has focused on the difference of outcome between revision rate reported in the peerreviewed literature and those in national joint arthroplasty registers. Findings were similar to those of our study for implants used in either field: THA, total knee arthroplasty, or total ankle arthroplasty [5][6][7][46][47][48][49][50].…”

Section: Discussionsupporting

confidence: 91%

Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data

Schuh

Neumann²,

Rauf

et al. 2012

International Orthopaedics (SICOT)

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Section: Discussionsupporting

confidence: 91%

Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data

Schuh

Neumann²,

Rauf

et al. 2012

International Orthopaedics (SICOT)

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“…The choice of the Duraloc constrained liner also appears to be a limitation. This was associated with a high failure rate, 39 which was confirmed in our series in which 6 (24%) of the first 25 revisions re-dislocated. This device, however, can be used successfully if the surgeon is aware of the double click at the time of reducing the constrained liner.…”

Section: Discussionsupporting

confidence: 72%

A conservative approach to dislocation following total hip arthroplasty: a review of 8606 hips

2020

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Patients and methods: We present the data on 8606 total hip arthroplasty (THA) procedures carried out in 7818 patients through a posterior approach between 1998 and 2017. Results: 218 hips (2.5%) suffered at least 1 dislocation with dislocation rates declining from 6.2% from 1998 to 2002 to 1.5% from 2003 to 2017. Overall, 92 hips (1.06%) required revision surgery but of these, only 5 (0.06%) had a full revision of both components with the remaining 87 requiring intervention only on the acetabular side. None have had a pseudo-arthrosis; none were left dislocated and all remain stable to date. Conclusions: In patients who have a second dislocation within 3 months of their primary surgery we recommend a spica or long leg cylinder cast to reduce the need for revision surgery. We propose an algorithm to manage instability with less aggressive operative treatment in this often-elderly patient population with the potential for less physiological insult and significant cost savings.

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“…Berend et al 11 reported a long-term failure rate of 42.1% with the tripolar constrained implant, while Labek et al 12 reported a 100% failure rate using the Duraloc constrained inlay (Depuy/Johnson and Johnson, Warsaw, IN). Survival at 10.2 years was 90% with the tripolar constrained implant using component failure as the end-point, and 68% for all modes of failure.…”

Section: Constrained Linersmentioning

confidence: 99%

Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA

Guyen

2016

EFORT Open Reviews

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Dislocation remains a common cause of failure after total hip arthroplasty. The limitations of existing approaches to address instability have led to the development of powerfull options: constrained liners, dual mobility and large heads. These implant-related options have proven to be very efficient, but have raised concerns.With constrained liners, restricted range of motion (ROM) is responsible for impingement leading to high likelihood of failure, depending on the design, with various failure modes.Improvements of the bearing materials have addressed some of the concerns about increased volumetric wear of conventional polyethylene and offer an option to reduce instability: large diameter heads have the advantage of increased ROM before impingement, increased head-neck ratio, and jump distance. Highly cross-linked polyethylene helps address the risk for increased wear, and also large heads provide improved stability without the risk of mechanical failures observed with constrained liners. However, the increase of the head size remains limited as reducing the thickness of the liner may lead to fractures. In addition, the jump distance decreases as the cup abduction increases.The dual mobility concept simultaneously attempts to address head-neck ratio, constraint, and jump distance. Despite the need for longer follow-up, concerns raised about potential increased wear and intra-prosthetic dislocation with first generation implants have been addressed with modern designs.With a dramatic increase of the head-neck ratio whilst reducing the risk of mechanical failure or excessive wear, dual mobility THA outperforms large diameter heads and constrained liners at 10 years follow-up. For these reasons, dual mobility continues to gain interest worldwide and is becoming the most popular option to manage instability.Cite this article: Guyen O. Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA. EFORT Open Rev 2016;1:197-204. DOI: 10.1302/2058-5241.1.000054.

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High failure rate of the Duraloc Constrained Inlay

Cited by 8 publications

References 6 publications

Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data

Revision rate of Birmingham Hip Resurfacing arthroplasty: comparison of published literature and arthroplasty register data

A conservative approach to dislocation following total hip arthroplasty: a review of 8606 hips

Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA

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