{
  "abstract": "Background\n\nManaging recurrent instability in revision total hip arthroplasty (rTHA) requires a personalized approach, as traditional constrained liners often yield suboptimal results due to locking-mechanism failure and limited impingement-free range of motion. This study aimed to evaluate the mid-term clinical outcomes of a novel constrained acetabular liner (CAL) when utilized as a patient-specific solution for a high-risk cohort undergoing complex rTHA. By tailoring the constraint to individual biomechanical deficits, this next-generation device seeks to mitigate historic failure modes.Methods\n\nWe retrospectively reviewed 32 patients who underwent 37 rTHA procedures with a next-generation CAL at a single urban academic center between March 2017 and October 2023. Average follow-up was 4.7 years (range, 0.3 to 9.7 years). The most common indication for rTHA was instability (70.3%), followed by infection (16.2%), aseptic loosening (10.8%), and polyethylene wear (2.7%). Just over one third of patients (37.5%) had undergone a prior revision. Preoperative constructs included fixed-bearing (37.8%), dual-mobility (32.4%), CAL (24.3%), static spacer (2.7%), and hemiarthroplasty (2.7%).Results\n\nIn most procedures (70.3%), the CAL was implanted into a pre-existing acetabular cup, whereas 29.7% involved both cup and liner revision. Following rTHA, no cases of implant wear, breakage, acetabular cup aseptic loosening, or periprosthetic fracture were observed. Six patients (18.8%) underwent a total of sixteen subsequent reoperations after CAL implantation-10 for instability and 6 for infection. Among instability-related reoperations, 4 involved revision to a new next-generation CAL. Survivorship free from all-cause reoperation was 83.8% at one year and 72.6% at latest follow-up.Conclusions\n\nThis study demonstrates favorable mid-term clinical outcomes and reoperation-free survivorship following complex revision THA using a novel constrained acetabular liner system. For patient cohorts suffering from severe recurrent dislocation, this next-generation CAL provides an effective, tailored tool in the surgical armamentarium by adapting to unique patient anatomy and soft-tissue compromises. Further research with larger sample sizes and extended follow-up is needed to assess long-term durability.",
  "abstract_shown": true,
  "affiliations": [
    "The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. farouk.khury@technion.ac.il.",
    "Department of Orthopedic Surgery, New York University Langone Medical Center, New York, USA. farouk.khury@technion.ac.il.",
    "Division of Orthopedic Surgery, Rambam Health Care Campus, Haifa, Israel. farouk.khury@technion.ac.il.",
    "Department of Orthopedic Surgery, New York University Langone Medical Center, New York, USA.",
    "Department of Orthopedic Surgery, New York University Langone Medical Center, New York, USA. vinay.aggarwal@nyulangone.org."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Farouk Khury"
    },
    {
      "affs": [
        3
      ],
      "name": "Blaine Luebbering"
    },
    {
      "affs": [
        3
      ],
      "name": "Garrett Ruff"
    },
    {
      "affs": [
        3
      ],
      "name": "Laith Bahlouli",
      "orcid": "0009-0008-3217-3607"
    },
    {
      "affs": [
        3
      ],
      "name": "Anzar Sarfraz",
      "orcid": "0009-0002-8297-3801"
    },
    {
      "affs": [
        3
      ],
      "name": "Ran Schwarzkopf"
    },
    {
      "affs": [
        4
      ],
      "name": "Vinay K Aggarwal"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8df9tqr5e4pkf.bib",
  "cited_by": 0,
  "doi": "10.1007/s00402-026-06527-6",
  "fulltext_url": "https://europepmc.org/articles/PMC13683562",
  "id": "8df9tqr5e4pkf",
  "issns": [
    "0936-8051",
    "1434-3916"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902017",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Orthopaedic implants and arthroplasty"
    ]
  ],
  "openalex": "W7223065522",
  "pdf_url": "https://europepmc.org/articles/PMC13683562?pdf=render",
  "pmcid": "PMC13683562",
  "pmid": "42902017",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8df9tqr5e4pkf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42902017",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902017"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Orthopaedic implants and arthroplasty",
      "subfield": "surgery"
    }
  ],
  "title": "Patient-specific management in high-risk revision total hip arthroplasty: mid-term outcomes of a next-generation constrained acetabular liner.",
  "title_text": "Patient-specific management in high-risk revision total hip arthroplasty: mid-term outcomes of a next-generation constrained acetabular liner.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:32Z",
  "url": "https://research.draconitic.com/paper/8df9tqr5e4pkf",
  "venue": "Archives of orthopaedic and trauma surgery",
  "versions": []
}