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Salvage of a Recurrently Dislocating Total Hip Prosthesis with Use of a Constrained Acetabular ComponentA Concise Follow-up of a Previous Report*
Devon D. Goetz, MD1; Barron R.B. Bremner, DO2; John J. Callaghan, MD3; William N. Capello, MD4; Richard C. Johnston, MD3
1 Des Moineso Orthopaedic Surgeons, 6001 Westown Parkway, West Des Moines, IA 50266. E-mail address: dgoetz8@dmos.com
2 Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905
3 Department of Orthopaedic Surgery, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA 52242. E-mail address for J.J. Callaghan: john-callaghan@uiowa.edu. E-mail address for R.C. Johnston: richard-johnston@uiowa.edu
4 Department of Orthopaedic Surgery, Indiana University School of Medicine, 541 Clinical Drive, Room 600, Indianapolis, IN 46202
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Goetz DD, Capello WN, Callaghan JJ, Brown TD, Johnston RC. Salvage of a recurrently dislocating total hip prosthesis with use of a constrained acetabular component. A retrospective analysis of fifty-six cases. J Bone Joint Surg Am. 1998;80:502-9.
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from National Institutes of Health Bioengineering Research Partnership Grant AR-46601 and Grant AR-43314, the Veterans Administration Merit Award, and DePuy. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Stryker [W.N.C.] and DePuy [J.J.C.]). Also, a commercial entity (Depuy) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Original Publication
Investigation performed at Des Moines Orthopaedic Surgeons, West Des Moines, Iowa, University of Iowa Health Care, Iowa City, Iowa, and Indiana University School of Medicine, Indianapolis, Indiana

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Nov 01;86(11):2419-2423
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We previously reported the results at a mean of five years following the use of a tripolar constrained acetabular component to treat recurrently dislocating total hip prostheses. In this study, we report the results after longer follow-up, with emphasis on the prevalence of implant loosening, osteolysis, and later recurrent instability. Fifty-five patients treated with a total of fifty-six constrained acetabular components because of recurrent dislocations of a total hip prosthesis (average, six dislocations; range, two to twenty dislocations) were followed for an average of 10.2 years (range, 7.0 to 13.2 years) or until death. Four (7%) of the fifty-six hips had a subsequent dislocation or failure of the device. Three femoral components (5%) and two acetabular components (4%) were revised because of aseptic loosening. One hip was revised because of osteolysis. We concluded that this constrained acetabular component provides durable protection against additional dislocations without substantial deleterious effects on component fixation. We use this device to treat recurrent dislocation when other modalities are unlikely to be effective.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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