Dual Mobility Cups in Revision Total Hip Arthroplasty: Efficient Strategy to Decrease Dislocation Risk期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

Dual Mobility Cups in Revision Total Hip Arthroplasty: Efficient Strategy to Decrease Dislocation Risk

Affiliation:	1. Orthopaedic Department, Lyon North University Hospital, Lyon, France;2. Department of Orthopaedic Surgery, Western Health, Melbourne, Australia;3. Department of Surgery, The University of Melbourne, Victoria, Australia;1. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY;2. Department of Biomechanics, Hospital for Special Surgery, New York, NY;1. Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon;2. Department of Anesthesiology, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon;3. Institut de Chirurgie Orthopédique, Lyon, Rhône, France;4. Center of Evidence-based Anatomy, Sports & Orthopedic Research, Jdeideh, Beirut, Lebanon;1. Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne, France;2. EA 7424 - Inter-university Laboratory of Human Movement Science, University Lyon, University Jean Monnet, Saint-Etienne, France;3. Department of Orthopaedic Surgery, Clinique Mutualiste of Saint-Etienne, Saint-Etienne, France;4. INSERM U1059 (SAINBIOSE), University Jean Monnet, Saint-Etienne, France;1. Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia;2. Traumaplasty.Melbourne, East Melbourne, Victoria, Australia;3. Department of Orthopaedics, Royal Melbourne Hospital, Parkville, Victoria, Australia;4. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia;5. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia;6. Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia;1. Department of Orthopaedic Surgery, Maine Medical Center, Falmouth, ME;2. Department of Orthopaedic Surgery, OrthoCarolina, Charlotte, NC

Abstract:	BackgroundRevision total hip arthroplasty (rTHA) is a challenging surgery with a higher rate of complications than primary arthroplasty, particularly instability and aseptic loosening. The purpose of this study is to compare dual mobility cup (DMC) and standard mobility cup (SMC) in all rTHAs performed at our institution over a decade with a 1 year minimum follow-up.MethodsTwo hundred ninety-five rTHAs (acetabular only and bipolar revisions) between 2006 and 2016 were retrospectively reviewed. These were divided into those with a DMC (184 revisions) or SMC (111 revisions). Dislocation and complications requiring re-revision were reported.ResultsThe rTHA mean age was 69 years ± 13.9 (19-92) and the mean follow-up was 2.3 years. Dislocation risk was statistically lower (P = .01) with a DMC (3.8%; 7/184) than with an SMC (13.5%; 15/111). DMC required re-rTHA in 24/184 (13%) for any reason compared to SMC in 19/111 (17.1%) (P = .34). There was no significant difference in early aseptic loosening (P = .28) between the 2 groups. For young patients (≤55 years), results were similar with a lower dislocation rate in the DMC group (P = .24) and no increased risk of early aseptic loosening (P = .49).ConclusionThis study demonstrates that for all rTHA indications DMC compared to SMC has a significantly decreased risk of postoperative dislocation without risk of early aseptic loosening at medium term follow-up. The use of DMC in rTHA is an important consideration particularly with the predicted increased incidence of both primary and revision THA globally.

Keywords:	revision total hip arthroplasty dislocation dual mobility cup standard mobility cup re-revision
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