Visser Jetze, van Veghel Mirthe H W, van Steenbergen Liza N, Swierstra Bart A, Bloemheuvel Esther M, Schreurs B Willem
Department of Orthopaedics, Radboud University Medical Centre, Nijmegen, the Netherlands.
Dutch Arthroplasty Register (LROI), 's Hertogenbosch, the Netherlands.
Hip Int. 2025 May;35(3):273-277. doi: 10.1177/11207000251331147. Epub 2025 Apr 1.
Constrained acetabular liners (CALs) are predominantly used as a salvage procedure in patients with a severe risk for dislocation after total hip arthroplasty (THA). However, the constrained design of CALs bears the risk of impingement with subsequent loosening or failure of the integrity of the implant. We investigated the use and survival of CALs in primary and revision THA in the Dutch Arthroplasty Register (LROI).
Use of CAL in THAs was extracted from the LROI in the period 2007-2022. 423,773 primary THAs and 52,706 revision THAs have been registered, of which 29 CALs were implanted in primary THA and 236 CALs in revision THA. Patient characteristics and survival of the CAL placed in primary and revision THA were separately analysed.
Of the CALs placed in primary THA, no revisions of the implant occurred during a median follow-up of 5.4 years (interquartile range [IQR] 4.0-12.4). The CALs in revision THA were most frequently used for cases with recurrent dislocation (183/236). Median follow-up was 4.8 (IQR 2.3-8.2) years. The re-revision rate was 10% (95% CI, 6.6-14) at 5-year follow-up and 12% (CI, 8.1-17) at 9-year follow-up. The most frequently registered reason for re-revision was dislocation ( = 19, 70%).
In the Netherlands there is a relatively low use of CALs in primary as well as revision THA. The survival rate of CALs is acceptable, with recurrent dislocation as the main reason for re-revision. The use of CALs should be reserved for specific cases with high risk for dislocation.
受限髋臼内衬（CALs）主要用于全髋关节置换术（THA）后脱位风险极高的患者的挽救手术。然而，CALs的受限设计存在撞击风险，随后可能导致植入物松动或完整性失效。我们在荷兰关节置换登记处（LROI）调查了CALs在初次和翻修THA中的使用情况和生存率。
从LROI中提取2007年至2022年期间THA中CAL的使用情况。已登记423,773例初次THA和52,706例翻修THA，其中29例CAL植入初次THA，236例CAL植入翻修THA。分别分析初次和翻修THA中植入的CAL的患者特征和生存率。
在初次THA中植入的CALs，在中位随访5.4年（四分位间距[IQR] 4.0 - 12.4）期间未发生植入物翻修。翻修THA中的CALs最常用于复发性脱位的病例（183/236）。中位随访时间为4.8年（IQR 2.3 - 8.2）。5年随访时再次翻修率为10%（95% CI，6.6 - 14），9年随访时为12%（CI，8.1 - 17）。再次翻修最常记录的原因是脱位（n = 19，70%）。
在荷兰，CALs在初次和翻修THA中的使用相对较少。CALs的生存率是可以接受的，复发性脱位是再次翻修的主要原因。CALs的使用应仅限于脱位风险高的特定病例。
