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Weekly News, Analysis, and Commentary

Large Joints Features & News

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Padgett v. Dorr: Constrained Sockets in Revision Hips

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“Constraint should be reserved for cases where there are no other options. These liners can compromise fixation and they don’t always work,” argues Doug Padgett. “Failure with constrained liners is caused by either poor judgment or poor technique,” counters Larry Dorr. “Dual mobility is hot stuff, but it’s going up against the tried and true constrained liner.”

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Lachiewicz, Su Debate Dual Mobility in Primary Hip Replacement

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“All the benefits to dual mobility are theoretical,” argues Paul Lachiewicz. “There’s little lab data—except from the manufacturers.” “Dual mobility has a proven track record,” counters Edwin Su. “It could be indicated for primary hip because it provides greater stability and it can reduce your dislocation rate to less than 1%. I would consider it in high risk, primary cases.”

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MacDonald, Haddad Debate Femoral Head Materials

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

Cobalt-chrome or delta (ceramic) heads? According to Steve MacDonald, cobalt-chrome wins because: “There’s no evidence of decreased revision rates with a delta head and it’s more expensive.” Counters Fares Haddad: “If you look at the level one data, you will move away from cobalt-chrome heads.” Excellent debate!

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Whiteside, Rosenberg Debate Cementless, Cemented Revision

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“With cemented TKA, if you have the right skill level, instruments, design, fixation, and the correct implant, then you can guarantee your patients a well fixed TKA,” says Leo Whiteside. Aaron Rosenberg isn’t so sure about that guarantee. “The registries show a significantly higher rate of revision amongst uncemented knees. Besides, the data is trending towards cementless TKA.”