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Revision Strategy for Posterior Extrusion of the CHARITÉ Polyethylene Core

Eskander, Mark S., MD*; Onyedika, Ikechukwu I., MD; Eskander, Jonathan P., AB*; Connolly, Patrick J., MD*; Eck, Jason C., DO, MS*; Lapinsky, Anthony, MD*

doi: 10.1097/BRS.0b013e3181e9bf30
Case Reports
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Study Design. This is a case report of a posterior extrusion of the polyethylene core from a CHARITÉ arthroplasty. This is the first reported case of posterior dislocation of the polyethylene and the revision strategies used to correct this problem.

Objective. To report a novel failure mechanism and revision strategy for CHARITÉ total disc arthroplasty (TDA).

Summary of Background Data. Case report at a Level 1 tertiary care referral center in the northeastern United States.

Methods. This is a case report and review of the literature of a patient who sustained posterior dislocation of the polyethylene core from a CHARITÉ TDA several months after the index procedure.

Results. Core dislocation is a known complication of TDA. However, of the known reported dislocations all have been anterior. This case describes the first known occurrence of posterior core dislocation and the revision strategy for this problem.

Conclusion. This case report highlights the first known case of a posterior dislocation of a CHARITÉ core. It is likely that altered biomechanical forces generated over time attributed to device failure. An instrumented posterior fusion with removal of the core is what ultimately led to a stable revision construct.

This case report highlights the first known case of a posterior dislocation of a CHARITÉ core. The device failure may be attributed to altered biomechanical forces generated over time. An instrumented posterior fusion with core removal was used to stabilize the revision construct.

From the Departments of *Orthopedics and †Surgery, UMASS Memorial Medical Center, Worcester, MA.

Acknowledgment date: February 2, 2010. First revision date: April 20, 2010. Second revision date: April 28, 2010. Acceptance date: May 10, 2010.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Mark S. Eskander, MD, Department of Orthopedics, UMASS Memorial Medical Center, 55 Lake Ave North, Worcester, MA 01655; E-mail: eskanm@ummhc.org.

© 2010 Lippincott Williams & Wilkins, Inc.