Isolated Acetabular Liner Exchange for Polyethylene Wear and Osteolysis with Well-Fixed Metal Shell.
Background
The isolated liner and head exchange procedure has been an established treatment method for polyethylene wear and osteolysis when the acetabular component remains well fixed. In this study, the mid-term results of this procedure were evaluated retrospectively.


Methods
Among the consecutive patients operated on from September 1995, two patients (three hips) were excluded because of inadequate follow-up, and the results of remaining 34 patients (34 hips) were evaluated. There were 20 men and 14 women with a mean age of 49 years. A conventional polyethylene liner was used in 26 cases and a highly cross-linked polyethylene liner was used in eight cases. In three cases, the liner was cemented in a metal shell because a compatible liner could not be used.


Results
After a follow-up of 5 to 20.2 years, re-revision surgery was necessary in 10 cases (29.4%): in eight for wear and osteolysis at 55 to 101 months after liner exchange and in two for acetabular loosening at 1 and 1.5 years after liner exchange. Re-revision surgery included all component revision (four cases), cup revision (four cases), and liner exchange (two cases). In all re-revision cases, a conventional polyethylene liner was used initially. There was no failure in the cases in which a highly cross-linked polyethylene liner was used.


Conclusions
The results of this study suggest that isolated acetabular liner exchange is a reasonable option for wear and osteolysis when the metal shell is well fixed. More promising long-term results are expected with the use of highly cross-linked polyethylene liners.
['Kim|Kyung Wook|KW|', 'Yoo|Jeong Joon|JJ|', 'Kim|Min Nyun|MN|', 'Kim|Hee Joong|HJ|']
D000077:Acetabulum D000328:Adult D000368:Aged D000369:Aged, 80 and over D019644:Arthroplasty, Replacement, Hip D001672:Biocompatible Materials D005260:Female D006622:Hip Prosthesis D006801:Humans D008297:Male D008670:Metals D008875:Middle Aged D010014:Osteolysis D020959:Polyethylene D011474:Prosthesis Design D011475:Prosthesis Failure D012086:Reoperation D012189:Retrospective Studies D055815:Young Adult
Bone screws Fracture fixation Humerus