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Between 2007 and 2018, 535 total hip arthroplasties using the uncemented Pinnacle acetabular component (DePuy Synthes, Warsaw, IN) and polyethylene liner were implanted in our unit. Of these, 6 patients presented acutely with liner polyethylene dissociation, giving a rate of liner dissociation of 1.11%. All dissociations were atraumatic. Failure occurred at mean 37 months (range 4.5 to 130 months). Radiologically, all acetabular components were within safe zone of abduction and mean anteversion was 10 degrees (range 2-20). In one case, there was posterior impingement against the femoral neck due to femoral malalignment. All patients underwent head and liner exchange with no repeat failures. Despite excellent long-term results, the frequency of dissociated polyethylene liners is a cause of concern with the Pinnacle acetabular component. Keywords: Pinnacle, Liner dissociation, Acetabular cup

Purpose. To determine factors associated with persistent sequelae after fasciotomy for acute compartment syndrome. Methods. Records of 57 men and 3 women aged 8 to 84 (mean, 31.9) years who underwent fasciotomy of the lower (n=48) or upper (n=12) limbs for acute compartment syndrome following limb trauma were retrospectively reviewed. 58 of the fasciotomies were therapeutic and 2 were prophylactic. The mean follow-up was 3.9 (range, 1–8) years. Patients were assessed through a telephone survey for persistent sequelae (parasthaesia, dysasthaesia, and/or motor weakness), using a scale of one to 4 to indicate asymptomatic, mild, moderate, and severe, respectively. Associations of persistent sequelae with the aetiology, mechanism of injury, site of fasciotomy, time to fasciotomy (from admission to anaesthesia induction), number of operations, method of closure, time to closure, and perioperative complications were assessed. Results. 18 patients were asymptomatic and 42 reported having persistent sequelae including motor weakness (n=26), parasthaesia (n=28), and dysasthaesia (n=30). In terms of severity, these sequelae were mild (n=10), moderate (n=12), or severe (n=20). Persistent sequelae were associated with higher number of operations, post-fasciotomy complications, closures with skin grafting, and increased time to closure. Conclusion. To reduce the risk of persistent sequelae after fasciotomy, careful preoperative planning and meticulous perioperative care is needed to avoid multiple operations and post-fasciotomy complications. Patients whose wounds healed by secondary intention showed the best outcome.