Abstract
There are several clinical scenarios to consider cementing an acetabular liner into a secure cementless shell including cases of: 1) inadequate capturing mechanism, 2) damaged locking mechanisms, 3) unavailability of the mating polyethylene liner, 4) instability following debridement for wear, 5) instability at the time of femoral side revision, and 6) recurrent dislocation. The last two situations are common scenarios for cementing a constrained liner into a secure shell.
Technique includes: 1) scoring the shell in cases with no screw holes or polished inner shells, 2) scoring the acetabular liner in a “spider web” pattern, 3) pressurizing cement into the shell, and 4) inserting a liner that allows 2mm of cement mantle.
Results of Cementing Constrained Liner Into Secure Cementless Shell: Callaghan et al. JBJS 2004. Thirty-one hips at 2–10 year follow-up. Two of 31 failed. Technical considerations: do not cement proud and do not cement into a malpositioned shell; Haft et al. J Arthroplasty 2002. Seventeen hips with minimum 1 year follow-up. One of 17 failed. Technical considerations: do not cement proud.
Results of Cementing Non-Constrained Liners Into Secure Cementless Shell: Beaule et al. JBJS 2004. Thirty-two hips at mean 5.1 year avg f/u. Four components revised for loosening; Callaghan et al. CORR 2012. Thirty-one hips at mean 5.3 year f/u. No revisions.
