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- Title
Dissociation of polyethylene liners with the Depuy Pinnacle cup: a report of 26 cases.
- Authors
Perkins, Thomas J; Kop, Alan M; Whitewood, Colin; Pabbruwe, Moreica B
- Abstract
Background: Although the Pinnacle Acetabular Hip System (DePuy Synthes) has demonstrated excellent survivorship results since it was first introduced in 2003, there have been a growing number of cases indicating that Pinnacle liners may be subject to a higher-than-expected rate of early dissociation failure. Between 2006 and 2020, our Centre received 212 retrieved Pinnacle liners from Western Australian hospitals. Of these, 26 were removed due to liner dissociation. Methods: To better understand the frequency and cause of this complication we assessed all retrieved Pinnacle acetabular components for type, damage modes and patient demographics. The leverage force required to dissociate Pinnacle liners was also measured and compared with another commonly used acetabular system, the Trident (Stryker Orthopaedics). Results: The estimated minimum incidence of liner dissociation from our data was 0.35%. Characterisation of dissociated Pinnacle cases (n = 26) revealed 73% were female with an average age of 59 compared to all retrieved Pinnacle cases (n = 212) where 58% were female with an average age of 66. Retrieval analysis indicated plastic deformation of the liner into an ovoid shape, signs of impingement on the rim postero-superiorly and shearing of the liner's anti-rotation tabs was common. Mechanical testing indicated that the dissociation strength of Pinnacle cups decreases at approximately 6.6 N/year in situ (p = 0.01). Conclusion: The survival rate of Pinnacle acetabular cups is exceptional with only 5% revised at 10 years. However, surgeons should be aware of the clinical symptoms and high-risk demographics when assessing patients with polyethylene Pinnacle liners.
- Subjects
WESTERN Australia; RISK of prosthesis complications; ACETABULUM surgery; TOTAL hip replacement; AGE distribution; POLYETHYLENE; SURGERY; PATIENTS; DISEASE incidence; ARTIFICIAL joints; RISK assessment; COMPARATIVE studies; SEX distribution; MATERIALS testing; COMMERCIAL product evaluation; DESCRIPTIVE statistics; PROSTHESIS design &; construction; SOCIODEMOGRAPHIC factors; COMPLICATIONS of prosthesis
- Publication
Hip International, 2023, Vol 33, Issue 1, p28
- ISSN
1120-7000
- Publication type
Article
- DOI
10.1177/11207000211008459