Seating of Ceramic Liners in the Uncemented Trident® Acetabular Shell: Is There Really a Problem?
Concerns have been raised regarding the risk of incomplete seating of metal-backed ceramic liners in the Trident ® acetabular system. This prompted us to audit our series of primary and revision THAs. We retrospectively reviewed 68 patients (78 arthroplasties, 55 of which were primary and 23 revisio...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2009-10, Vol.467 (10), p.2651-2655 |
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| creator | Howcroft, D. W. J. Qureshi, A. Graham, N. M. |
| description | Concerns have been raised regarding the risk of incomplete seating of metal-backed ceramic liners in the Trident
®
acetabular system. This prompted us to audit our series of primary and revision THAs. We retrospectively reviewed 68 patients (78 arthroplasties, 55 of which were primary and 23 revisions) using the Trident
®
acetabular system between 2003 and 2007. Anteroposterior and lateral radiographs were reviewed independently by two specialist registrars and one consultant surgeon to look for incomplete seating. Six liners were seated incompletely, representing 8% overall. All unseated liners were in the primary group, representing 10% risk in this group, compared with 0% risk in the revision group. The incidence of malseating in our primary arthroplasty group was similar to the published incidence (16.4%). We encountered no problems in patients having a revision. We suspect shell deformation contributes to malseating of the metal-backed ceramic liners. To reduce the rate of malseating, we now underream by 0.8 mm rather than the usual 1.8 mm, particularly if the bone is sclerotic.
Level of Evidence:
Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence. |
| doi_str_mv | 10.1007/s11999-009-0974-8 |
| format | Article |
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®
acetabular system. This prompted us to audit our series of primary and revision THAs. We retrospectively reviewed 68 patients (78 arthroplasties, 55 of which were primary and 23 revisions) using the Trident
®
acetabular system between 2003 and 2007. Anteroposterior and lateral radiographs were reviewed independently by two specialist registrars and one consultant surgeon to look for incomplete seating. Six liners were seated incompletely, representing 8% overall. All unseated liners were in the primary group, representing 10% risk in this group, compared with 0% risk in the revision group. The incidence of malseating in our primary arthroplasty group was similar to the published incidence (16.4%). We encountered no problems in patients having a revision. We suspect shell deformation contributes to malseating of the metal-backed ceramic liners. To reduce the rate of malseating, we now underream by 0.8 mm rather than the usual 1.8 mm, particularly if the bone is sclerotic.
Level of Evidence:
Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-009-0974-8</identifier><identifier>PMID: 19582522</identifier><identifier>CODEN: CORTBR</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Acetabulum - diagnostic imaging ; Acetabulum - surgery ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - instrumentation ; Biological and medical sciences ; Clinical Research ; Conservative Orthopedics ; Diseases of the osteoarticular system ; Equipment Failure Analysis ; Female ; Hip Joint - diagnostic imaging ; Hip Joint - surgery ; Hip Prosthesis ; Humans ; Male ; Materials Testing ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Prosthesis Design ; Prosthesis Failure ; Radiography ; Reoperation ; Retrospective Studies ; Sports Medicine ; Stress, Mechanical ; Surgery ; Surgical Orthopedics ; Treatment Outcome</subject><ispartof>Clinical orthopaedics and related research, 2009-10, Vol.467 (10), p.2651-2655</ispartof><rights>The Association of Bone and Joint Surgeons® 2009</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-10c7b4a971e3368285600371d68a04524d3f82319424714e780984fbd665fbdf3</citedby><cites>FETCH-LOGICAL-c497t-10c7b4a971e3368285600371d68a04524d3f82319424714e780984fbd665fbdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745475/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745475/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,41486,42555,51317,53789,53791</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22037161$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19582522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Howcroft, D. W. J.</creatorcontrib><creatorcontrib>Qureshi, A.</creatorcontrib><creatorcontrib>Graham, N. M.</creatorcontrib><title>Seating of Ceramic Liners in the Uncemented Trident® Acetabular Shell: Is There Really a Problem?</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Concerns have been raised regarding the risk of incomplete seating of metal-backed ceramic liners in the Trident
®
acetabular system. This prompted us to audit our series of primary and revision THAs. We retrospectively reviewed 68 patients (78 arthroplasties, 55 of which were primary and 23 revisions) using the Trident
®
acetabular system between 2003 and 2007. Anteroposterior and lateral radiographs were reviewed independently by two specialist registrars and one consultant surgeon to look for incomplete seating. Six liners were seated incompletely, representing 8% overall. All unseated liners were in the primary group, representing 10% risk in this group, compared with 0% risk in the revision group. The incidence of malseating in our primary arthroplasty group was similar to the published incidence (16.4%). We encountered no problems in patients having a revision. We suspect shell deformation contributes to malseating of the metal-backed ceramic liners. To reduce the rate of malseating, we now underream by 0.8 mm rather than the usual 1.8 mm, particularly if the bone is sclerotic.
Level of Evidence:
Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.</description><subject>Acetabulum - diagnostic imaging</subject><subject>Acetabulum - surgery</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - instrumentation</subject><subject>Biological and medical sciences</subject><subject>Clinical Research</subject><subject>Conservative Orthopedics</subject><subject>Diseases of the osteoarticular system</subject><subject>Equipment Failure Analysis</subject><subject>Female</subject><subject>Hip Joint - diagnostic imaging</subject><subject>Hip Joint - surgery</subject><subject>Hip Prosthesis</subject><subject>Humans</subject><subject>Male</subject><subject>Materials Testing</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Radiography</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Sports Medicine</subject><subject>Stress, Mechanical</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kduKFDEQhoMo7rj6AN5IEPSuNUknncQLZRk8LAwo7ix4F9Lp6pks6fSadAv7Uj6ET2aaGXZV8CIn6quqv_Ij9JSSV5QQ-TpTqrWuCClLS16pe2hFBVMVpTW7j1ZkiWhGv52gRzlflWfNBXuITqgWignGVqi9ADv5uMNjj9eQ7OAd3vgIKWMf8bQHfBkdDBAn6PA2-a7cfv3EZw4m287BJnyxhxDe4POMt3tIgL-CDeEGW_wljW2A4d1j9KC3IcOT43mKLj-8364_VZvPH8_XZ5vKcS2nihInW261pFDXjWJKNEWvpF2jLCmyeVf3itVUc8Yl5SAV0Yr3bdc0oux9fYreHupez-0AnStKkw3mOvnBphszWm_-jkS_N7vxh2GSCy5FKfDyWCCN32fIkxl8dmU6G2Gcs2lkIwTlvIDP_wGvxjnFMpxhRbsQUtMC0QPk0phzgv5WCSVmsc8c7DPFJLPYZ1TJefbnCHcZR78K8OII2Oxs6JONzudbjrHlx5qlOTtwuYTiDtKdwv93_w0zZ7GW</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Howcroft, D. 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W. J.</au><au>Qureshi, A.</au><au>Graham, N. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seating of Ceramic Liners in the Uncemented Trident® Acetabular Shell: Is There Really a Problem?</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>467</volume><issue>10</issue><spage>2651</spage><epage>2655</epage><pages>2651-2655</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><coden>CORTBR</coden><abstract>Concerns have been raised regarding the risk of incomplete seating of metal-backed ceramic liners in the Trident
®
acetabular system. This prompted us to audit our series of primary and revision THAs. We retrospectively reviewed 68 patients (78 arthroplasties, 55 of which were primary and 23 revisions) using the Trident
®
acetabular system between 2003 and 2007. Anteroposterior and lateral radiographs were reviewed independently by two specialist registrars and one consultant surgeon to look for incomplete seating. Six liners were seated incompletely, representing 8% overall. All unseated liners were in the primary group, representing 10% risk in this group, compared with 0% risk in the revision group. The incidence of malseating in our primary arthroplasty group was similar to the published incidence (16.4%). We encountered no problems in patients having a revision. We suspect shell deformation contributes to malseating of the metal-backed ceramic liners. To reduce the rate of malseating, we now underream by 0.8 mm rather than the usual 1.8 mm, particularly if the bone is sclerotic.
Level of Evidence:
Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19582522</pmid><doi>10.1007/s11999-009-0974-8</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0009-921X 1528-1132 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Acetabulum - diagnostic imaging Acetabulum - surgery Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - instrumentation Biological and medical sciences Clinical Research Conservative Orthopedics Diseases of the osteoarticular system Equipment Failure Analysis Female Hip Joint - diagnostic imaging Hip Joint - surgery Hip Prosthesis Humans Male Materials Testing Medical sciences Medicine Medicine & Public Health Middle Aged Orthopedics Prosthesis Design Prosthesis Failure Radiography Reoperation Retrospective Studies Sports Medicine Stress, Mechanical Surgery Surgical Orthopedics Treatment Outcome |
| title | Seating of Ceramic Liners in the Uncemented Trident® Acetabular Shell: Is There Really a Problem? |
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