Isolated liner exchange in revision total hip arthroplasty: Clinical results using the direct lateral surgical approach.

摘要

Twenty-four hips (23 patients) underwent isolated polyethylene liner exchange (modular and nonmodular liners) via the direct lateral surgical approach for a preoperative diagnosis of polyethylene wear and acetabular osteolysis. Accessible osteolytic lesions were bone grafted with cancellous allograft. Patients were followed up clinically and radiographically, with a mean follow-up time of 36 months (range, 12-100 months). A computer-assisted method measured lesional area from the radiographs of the 18 hips that presented with osteolysis. Seventeen of 18 lesions either regressed or resolved since the procedure. Two patients required repeat revisions, and no dislocations were noted. Clinically, both Harris Hip and Western Ontario and McMaster Universities Osteoarthritis Index scores improved postoperatively. In selected patients, isolated liner exchange with or without bone grafting is effective for treating polyethylene wear and associated osteolysis. Dislocation rates with revision may be reduced usinga surgical approach that preserves an adequate capsular layer for closure in liner exchange surgery.