Constrained liners are used as part of a salvage procedure to provide stability for patients at high risk for dislocation following a total hip arthroplasty. However, no recent studies exist highlighting their effectiveness and or limitations.

This prospective review included 166 consecutive hip arthroplasties, either primary (27%) or revision (73%), with a unique design of a constrained liner Lefèvre retentive cup. There were 113 females (69%) and the average age at index surgery was 75.9 years (range 35–94). The mean follow-up was 6.2 years (range 0.3–11).

Twenty patients had a reoperation ; 10 for infection (four acute and six chronic joint infection) and 10 for cup failure (five fixation-failure, three aseptic loosening and two dislocation). Ten-year survivals for cup revision were 89% (CI, 83–94) and 92% (CI, 89–97) for all revision and revision for non-infectious reasons respectively. When solely evaluating for dislocation, the survival at 10 years was 99% (CI, 97–100). Considering primary and revision cases, ten-year survivals cup revision for aseptic reasons were 92.4% (CI, 84–100) and 92.5% (CI, 87–98) respectively.

The Lefèvre retentive cup demonstrated excellent ten-year's survivorship. With the rate of aseptic loosening around 2% and a dislocation rate around 1%, the cup is as effective as other available devices and is therefore, a cost-effective tool to reduce the risk of dislocation in at-risk patients undergoing hip arthroplasty.